Practical applications to modify and control the development of ametropia

Sankaridurg, Padmaja; Holden, Brien A.

doi:10.1038/eye.2013.255

Cited by 67 publications

(57 citation statements)

References 62 publications

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“…This is particularly important when a pharmacological and environmental modification can potentially prevent or slow down the progression of myopia. [9101112131415]…”

Section: Discussionmentioning

confidence: 99%

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The opportunistic screening of refractive errors in school-going children by pediatrician using enhanced Brückner test

Jain

Kothari²,

Gode

2016

Indian J Ophthalmol

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Aim:The aim of this study was to compare the results of enhanced Brückner test (EBT) performed by a pediatrician and an experienced pediatric ophthalmologist.Subjects and Methods:In this prospective double-masked cohort study, a pediatrician and a pediatric ophthalmologist performed the EBT in a classroom of a school in semi-dark lighting condition using a direct ophthalmoscope. The results of the test were compared using 2 × 2 Bayesian table and kappa statistics. The findings of the pediatric ophthalmologists were considered gold standard.Results:Two hundred and thirty-six eyes of 118 subjects, mean age 6.8 ± 0.5 years (range, 5.4–7.8 years), were examined. The time taken to complete this test was <10 s per subject. The ophthalmologist identified 59 eyes as ametropic (12 hyperopic and 47 myopic eyes) and 177 as emmetropic compared to 61 eyes as ametropic and 175 emmetropic by pediatrician. The prevalence of the test positive was 25.9%. The sensitivity of the pediatrician was 90.2%, specificity was 97.7%, predictive value of the positive test was 93.2%, and predictive value of the negative test was 96.6%. The clinical agreement (kappa) between the pediatric ophthalmologist and the pediatrician was 0.9.Conclusion:The results of the EBT performed by pediatrician were comparable to that of an experienced pediatric ophthalmologist. Opportunistic screening of refractive errors using EBT by a pediatrician can be an important approach in the detection of ametropia in children.

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“…This is particularly important when a pharmacological and environmental modification can potentially prevent or slow down the progression of myopia. [9101112131415]…”

Section: Discussionmentioning

confidence: 99%

“…[9101112] Atropine eye drop is also well established in its role to arrest or slow down the progression of myopia. [131415] Other refractive errors such as hypermetropia, astigmatism, as well as anisometropia are amblyogenic and can cause significant visual impairment.…”

mentioning

confidence: 99%

The opportunistic screening of refractive errors in school-going children by pediatrician using enhanced Brückner test

Jain

Kothari²,

Gode

2016

Indian J Ophthalmol

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“…The greatest effect has been found for the performance of many continuous hours of near work and for a working distance <30 cm . An important explanation for the latter is that peripheral hyperopia increases at a nearer gaze . Lower image quality due to a nearer gaze may also be a driver for ocular growth.…”

Section: Environmental Factorsmentioning

confidence: 99%

Myopia management in the Netherlands

Klaver

Polling

2020

Ophthalmic Physiologic Optic

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Purpose A trend that myopia is becoming gradually more common is shown in studies worldwide. Highest frequencies have been found in East Asian urban populations (96.5%) but also a study in Europe shows that nearly half of the 25‐29 year olds has myopia. With the increase in prevalence, high myopia, i.e. a spherical equivalent of ‐6 or more and an axial length of 26 mm or more is also on the rise. High myopia particularly carries a significant risk of ocular pathology related to the long axial length. This highlights the need for myopia management in children with progressive myopia, in particular progression to high myopia. Recent findings During the last decade, many intervention studies for myopia progression have emerged. Although lifestyle adjustments are effective, pharmacological and optical interventions have shown the highest efficacy on reduction of eye growth. High concentration atropine (0.5%‐1.0%) shows the most reduction in axial length progression, but has drawbacks of light sensitivity and loss of accommodation. Nevertheless, when these side effects are mitigated by multifocal photochromatic glasses, the long‐term adherence to high dose atropine is high. Lower concentrations of atropine are less effective, but have less side effects. Studies on optical interventions have reported reduction of progression for Ortho‐K and multifocal contact lenses, but are in need for replication in larger studies with longer duration. Summary The field of myopia management is rapidly evolving, and a position on the best approach for daily clinics is desirable. Over the last 10 years, our team of clinical researchers has developed a strategy which involves decision‐making based on age, axial length, position on the axial length growth chart, progression rate, risk of high myopia, risk profile based on lifestyle and familial risk, side effects, and individual preference. This personalised approach ensures the most optimal long‐term myopia control, and helps fight against visual impairment and blindness in the next generations of elderly.

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“…4 Later reports in the 80s by Kerns, 5 Drobec, 6 Andreo,7 and Goldschmidt 8 reported the potential of CL to reduce myopia progression. Although pharmacological and spectacle-based optical treatments were the object of extensive review works, [9][10][11][12] no updated information is available in the CL field, despite the numerous advances in the last half of that decade. 13 In the 90s, Singaporean researchers Heng and Khoo published a review article with a suggestive title, "Can contact lenses control the progression of myopia?"…”

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confidence: 97%

Strategies to Regulate Myopia Progression With Contact Lenses

González-Meijóme

Peixoto-de-Matos

Faria‐Ribeiro

et al. 2016

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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CLs were reported to be well accepted, consistent, and safe methods to address myopia regulation in children. Corneal refractive therapy (orthokeratology) is so far the method with the largest demonstrated efficacy in myopia regulation across different ethnic groups. However, factors such as patient convenience, the degree of initial myopia, and non-CL treatments may also be considered. The combination of different strategies (i.e., central defocus, peripheral defocus, spectral filters, pharmaceutical delivery, and active lens-borne illumination) in a single device will present further testable hypotheses exploring how different mechanisms can reinforce or compete with each other to improve or reduce myopia regulation with CLs.

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Practical applications to modify and control the development of ametropia

Cited by 67 publications

References 62 publications

The opportunistic screening of refractive errors in school-going children by pediatrician using enhanced Brückner test

The opportunistic screening of refractive errors in school-going children by pediatrician using enhanced Brückner test

Myopia management in the Netherlands

Strategies to Regulate Myopia Progression With Contact Lenses

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