The Risks and Benefits of Myopia Control

Bullimore, Mark A.; Ritchey, Eric R; Shah, Sunil; Leveziel, Nicolas; Bourne, Rupert R A; Flitcroft, Daniel Ian

doi:10.1016/j.ophtha.2021.04.032

Cited by 131 publications

(140 citation statements)

References 160 publications

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“…The 21 st century has seen our perception of myopia transition from a benign refractive condition to a disease that represents an important public health issue. The American Academy of Ophthalmology's Board of Trustees, for example, believes that “myopia is a high‐priority cause of visual impairment, warranting a timely evaluation and synthesis of the scientific literature and formulation of an action plan to address the issue from different perspectives.” 1 Increasing levels of myopia are strongly associated with an increased risk of a number of eye diseases including myopic maculopathy, open angle glaucoma, posterior subcapsular cataract and retinal detachment 2–4 . Likewise, each additional dioptre of myopia is associated with a 30% increased risk of visual impairment 4 …”

Section: Introductionmentioning

confidence: 99%

The impact of spectacle lenses for myopia control on visual functions

Gao¹,

Lim²,

Yang³

et al. 2021

Ophthalmic Physiologic Optic

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Purpose Spectacle lenses containing multiple small peripheral elements have been developed for myopia control in children. It is important that their effect on vision be quantified by (i) fixation through the peripheral portion, thereby using foveal vision and (ii) by fixation through the central portion and presentation of peripheral targets. Methods The above approaches were used in five studies to evaluate two novel spectacle lens designs: spectacle lenses with Highly Aspherical Lenslets (HAL) and Slightly Aspherical Lenslets (SAL). A single vision lens served as a control. Visually normal adults participated in each study. The first two studies had subjects fixate through the periphery of the lenses. High and low (10%) contrast visual acuity was measured with the Freiburg Vision Test and reading speed for high and low contrast words measured with a sentence generator. The other three studies assessed peripheral vision while subjects fixated through the central portion of the lens. Peripheral contrast sensitivity was measured using two cycles per degree drifting Gabor stimuli. Peripheral motion perception was further evaluated using random dot stimuli. Finally, attention was measured using an established test of useful field of view with three levels of complexity. Results The periphery of the HAL lens significantly reduced low contrast visual acuity, but not high contrast visual acuity, while the effect of the SAL lens was not significant for either. Neither test lens affected reading speed for high contrast words, but the HAL lens significantly affected performance for low contrast words. Neither test lens affected peripheral motion perception or useful field of view. Conclusions Low contrast visual acuity and reading was slightly reduced while high contrast visual acuity was unaffected when fixating through the periphery of the novel lens designs. None of the peripheral measures of vision was affected by the novel lens designs.

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Section: Introductionmentioning

confidence: 99%

The impact of spectacle lenses for myopia control on visual functions

Gao¹,

Lim²,

Yang³

et al. 2021

Ophthalmic Physiologic Optic

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“…With children being the primary demographic for orthokeratology, it is reassuring to see that, similar to large-scale studies, corneal staining is the most commonly reported complication of orthokeratology. Adverse events with orthokeratology have been reported in the literature to occur in low frequency 17,27–31 . The large majority of adverse events reported are minor and resolve without complications.…”

Section: Discussionmentioning

confidence: 99%

“…This result correlates well with the published literature. Bullimore et al 27 found that approximately only 3% of cases of microbial keratitis in orthokeratology wearers result in loss of best-corrected visual acuity.…”

Section: Discussionmentioning

confidence: 99%

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Fitting of Orthokeratology in the United States: A Survey of the Current State of Orthokeratology

Lipson¹,

Curcio²

2022

Optom Vis Sci

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SIGNIFICANCE:The Fitting of Orthokeratology in the United States (FOKUS) survey provides information about the US orthokeratology market. This independent survey is the first to attain detailed assessment of the orthokeratology market.PURPOSE: This study aimed to develop and administer a survey to eye care providers in the United States who are managing orthokeratology patients and those who are not, to determine a profile of prescribers, patients, and overall market.METHODS: The FOKUS survey was administered and distributed online. Outcome measures of the FOKUS survey involved general categories of (1) practice and practitioner profiles, (2) clinical prescribing patterns, (3) patient profile, (4) products and marketing, (5) fees, and (6) market size and growth. RESULTS:The number of eye care providers who are actively fitting and managing orthokeratology patients in the United States is approximately 3000. A total of 545 responded to the survey; 283 reported that they were actively fitting orthokeratology. Furthermore, 68% of respondents prescribed orthokeratology with the intent of managing myopia, 53% monitor axial length, and 61% start orthokeratology patients at 13 years or younger. The mean number of years a patient wears orthokeratology is 7.8 years. A commonly reported complication with orthokeratology is corneal staining. Microbial keratitis is rarely or never seen by 86% of respondents. Of those currently fitting, 56% anticipate growth of orthokeratology fitting over the next 12 months. Of those not currently fitting orthokeratology, 46% plan to start within 2 years.CONCLUSIONS: Orthokeratology represents a small but growing segment of the US contact lens market. The number of practitioners actively prescribing and fitting orthokeratology in the United States is approximately 3000 with high potential for growth within the next 2 years. Results of the FOKUS survey are relevant to practitioners currently fitting or considering orthokeratology, manufacturers, educators, and researchers as baseline for future orthokeratology market assessment.

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“…Of the ever-growing global myopic population, 312 million people are under the age of 19 years [1]. Excessive axial elongation is associated with myopia, and this leads to structural changes in the posterior segment of the eye (including posterior staphyloma, myopic maculopathy, and high myopia-associated optic neuropathy) that may culminate in loss of best-corrected visual acuity in adulthood [2]. In addition, aging and the high utilization of touchscreen technology might increase the risk of eye diseases [3].…”

Section: Introductionmentioning

confidence: 99%

A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study

Sun

Liao

et al. 2021

IJERPH

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Orthokeratology (OK) lens wear is an effective modality to inhibit axial elongation in myopic children. Willingness for commitment from both parents and children contributes to the success of OK treatment. We aimed to develop and assess the usability of a mobile application on OK lens wear by quantitatively and qualitatively evaluating parents with myopic children and eye care professionals (ECPs). Moreover, the preliminary outcome was also evaluated in this study. The app was developed and tested using a co-design approach involving key stakeholders. Two prototype tests were conducted during the feasibility and utility assessment. The app features include self-reported compliance documentation, analytics, and personalized and generalized messages for compliance behaviors of OK lenses. After the trial period, the full usage of app functions ranged from 40% to 60% among the enrolled parents. After app implementation, the compliance with follow-up visits substantially improved. Qualitative data show that the high-satisfaction app functions reported by parents were the app’s reminder and axial length recording, although it was recommended that the number of compliance questions should be reduced to minimize the survey completion time. Additionally, who should complete the recording of the axial length data as well as the management and reminder for the follow-up visit remained controversial. This is the first app developed to improve parents of myopic children’s compliance with OK lens wear and to assist ECPs and parents in collaboratively monitoring and managing the use and care of OK lenses among myopic children. This study highlights the importance of interdisciplinary collaboration in the design, development, and validation of such an app.

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The Risks and Benefits of Myopia Control

Cited by 131 publications

References 160 publications

The impact of spectacle lenses for myopia control on visual functions

The impact of spectacle lenses for myopia control on visual functions

Fitting of Orthokeratology in the United States: A Survey of the Current State of Orthokeratology

A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study

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