Undercorrection of myopia enhances rather than inhibits myopia progression

Chung, Kahmeng; Mohidin, Norhani; O’Leary, Daniel J.

doi:10.1016/s0042-6989(02)00258-4

Cited by 229 publications

(229 citation statements)

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“…In the two studies [3,5] showing greater myopia progression when under-corrected versus corrected, we notice that the difference in progression is below the 0.25-D generally accepted step in refractions and prescriptions, a quantization error. The effect observed is less than the quantization error.…”

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confidence: 59%

“…Reports [3][4][5][6]8] discussed in the paragraphs below confirm the small and conflicting effect and exemplify the difficulty.…”

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confidence: 87%

“…Chung and Mohidin [3] showed a small (0.23 D) but significant greater rate of progression in a group of 47 children under-corrected by about 0.75 D as compared to another group of 47 children fully corrected for a period of 2 years. They paired the data in an attempt to avoid the problem of intersubject variation.…”

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confidence: 87%

“…The model also predicts that under-correcting myopia would have a small effect in reducing the progression rate.The Letter advises that there is controversy on the issue of whether under-correction of myopia will have any beneficial effect, citing four published reports [3][4][5][6] involving distance under-correction. Medina [2] cites those reports, and others, noting the conflict and suggesting experimental problems.…”

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confidence: 99%

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Detecting the effect of under-correcting myopia

Medina

2015

Graefes Arch Clin Exp Ophthalmol

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The Letter to the Editor BRefractive correction and myopia progression^[1] (Bthe Letter^) makes some good points about the article BThe progression of corrected myopia^ [2] that the article had already addressed in part.Medina's feedback model for emmetropization predicts that correction of myopes aggravates their condition, and that delaying correction will result in less progression rate and probably a reduced myopic final level. The model also predicts that under-correcting myopia would have a small effect in reducing the progression rate.The Letter advises that there is controversy on the issue of whether under-correction of myopia will have any beneficial effect, citing four published reports [3][4][5][6] involving distance under-correction. Medina [2] cites those reports, and others, noting the conflict and suggesting experimental problems. The Letter overlooks several reports that show that undercorrection for near vision with bifocals reduces myopia progression, e.g. [7] and those cited in [2].In response to the Letter, the effect of distance undercorrection would be difficult to detect experimentally due to the small effect and the difficult experiment. Reports [3][4][5][6]8] discussed in the paragraphs below confirm the small and conflicting effect and exemplify the difficulty.Chung and Mohidin [3] showed a small (0.23 D) but significant greater rate of progression in a group of 47 children under-corrected by about 0.75 D as compared to another group of 47 children fully corrected for a period of 2 years. They paired the data in an attempt to avoid the problem of intersubject variation. However, the myopia progression rate is very variable, even for paired subjects of the same age and initial refractive error. Adler and Millodot [4] show no significant myopia progression difference between two groups of 23 fully corrected myopes and 25 myopes under-corrected by 0.50 D for a period of 18 months.Vasudevan et al.[5] found a significant positive correlation between the degree of under-correction of refractive error and the rate of myopic progression. This result is contradicted by a later study [8]. The difference in myopia progression between the groups with full correction and under-corrected by 0.5 D is less than 0.25D. See its Figure 1 (as amended [9]).Ong et al.[6] in a longitudinal study concluded that, over a period of at least 3 years, refractive shifts were not significantly different among a group of full-time wearers (n = 8) of spectacle correction and a group of non-wearers (n = 5), when the data were corrected for age effects. The non-wearers, however, developed less myopia than the fulltime lens wearers, and the difference was borderline significant when there was no Bcorrection^for age effects. The age Bcorrection^may be questionable given the large variation in progression rate and the reduced number of subjects. The natural variation in myopia progression is much larger than the effect of undercorrection.A recent study of two groups of under-corrected and fully corrected children [8] fail...

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confidence: 59%

“…Reports [3][4][5][6]8] discussed in the paragraphs below confirm the small and conflicting effect and exemplify the difficulty.…”

mentioning

confidence: 87%

mentioning

confidence: 87%

mentioning

confidence: 99%

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Detecting the effect of under-correcting myopia

Medina

2015

Graefes Arch Clin Exp Ophthalmol

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“…According to our model, under-correction of myopia should reduce the progression of myopia only slightly, since the eye is still substantially corrected. Reports of the effect of under-correction, for distance and near, are varied as the following reports exemplify [12][13][14][15][16][17][18][19]. The conflicting results may be due to the small effect of under-correction and the difficulty of the experiment.…”

Section: Discussionmentioning

confidence: 99%

The progression of corrected myopia

Medina

2015

Graefes Arch Clin Exp Ophthalmol

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Purpose This study seeks to demonstrate the existence of a feedback loop controlling myopia by comparing the prediction of a feedback model to the actual progression of corrected myopia. In addition to theoretical results, confirming clinical data are presented. Methods The refraction of 13 continuously corrected myopic eyes was collected over a period of time ranging from 4 to 9 years from the time of their first correction. Refractive data was collected in an optometry office from myopic young subjects from the general population in Boston. Subjects were myopes, ages 2 to 22 at the time of first correction selected randomly from a larger population. All individuals were fully corrected with lenses; new lenses were prescribed every time that their myopia increased by 0.25 diopters or more. Subjects wore their spectacle lenses during the followed period. Results Subjects exhibit a linear time course of myopia progression when corrected with lenses. The observed rate of myopia increase is 0.2 to 1.0 diopters/year, with a mean correlation coefficient r =−0.971, p<0.005. Conclusions This report establishes that feedback control theory applies to the clinical phenomenon of progressive myopia. Continuous correction of myopia results in a linear progression that increases myopia. The Laplace transformation of temporal refractive data to the s-domain simplifies the study of myopia and emmetropia. The feedback transfer function predicts that continuous correction of myopia results in a linear progression because continuous correction opens the feedback loop. This prediction is confirmed with all subjects.

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Urban Living Environment and Myopia in Children

Li,

Qin

et al. 2023

JAMA Netw Open

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ImportanceThe global prevalence of myopia has shown a steady increase over recent decades, with urban areas seemingly experiencing a more significant impact.ObjectiveTo assess the association between urbanization and the prevalence, incidence, progression, and severity of myopia.Design, Setting, and ParticipantsThis cohort study included students in grades 1 to 6 in Tianjin, China, who underwent 3 vision examinations conducted over a 2-year period, from March 1, 2021, to March 31, 2023. Participants from grades 1 to 4 completed the 2-year follow-up.ExposuresUrban living environmentMain Outcomes and MeasuresThe association of urbanization with the incidence, progression, prevalence, and severity of myopia. To quantify urbanization, an urban score was constructed using satellite data and an iterative exploratory factor analysis.ResultsOf 177 894 students (51.7% male; mean [SD] age, 10.27 [1.75] years) included in the study, 137 087 students (52.3% male; mean [SD] age, 8.97 [1.21] years) were followed up for 2 years. A positive association was identified between myopia incidence and urbanization. Specifically, each 1-unit increment in the urban score was associated with an increased risk of myopia over a 1-year period (odds ratio [OR], 1.09; 95% CI, 1.01-1.15; P = .02) and a 2-year period (OR, 1.53; 95% CI, 1.50-1.57; P &lt; .001). Conversely, each 1-unit increase in the urban score was associated with a significant decrease in myopia progression at 1 year (OR, 0.84; 95% CI, 0.82-0.86; P &lt; .001) and 2 years (OR, 0.73; 95% CI, 0.70-0.75, P &lt; .001). In a cross-sectional data analysis, the urban score was positively associated with myopia prevalence (OR, 1.62; 95% CI, 1.08-2.42; P = .02) and negatively associated with myopia severity, as indicated by spherical equivalent refraction (OR, 1.46; 95% CI, 1.07-1.99; P = .02).Conclusions and RelevanceThis study exploring urban living environments and myopia revealed dual associations of urban living with both the incidence and the progression of myopia. The observed patterns emphasize the urgency of promptly implementing myopia control strategies in less urbanized regions, where myopia progression may be accentuated.

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Undercorrection of myopia enhances rather than inhibits myopia progression

Cited by 229 publications

References 14 publications

Detecting the effect of under-correcting myopia

Detecting the effect of under-correcting myopia

The progression of corrected myopia

Urban Living Environment and Myopia in Children

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