Evidence about intervention to prevent myopia progression

For Fred

Here is a literature review for you:

Interventions to retard myopia progression in children: an evidence-
based update.Saw SM, Shih-Yen EC, Koh A, Tan D.
Department of Community, Occupational and Family Medicine, National
University of Singapore, 16 Medical Drive, Singapore 117597, Republic
of Singapore.

TOPIC: To evaluate the efficacy of interventions such as eyedrops,
bifocal lenses, or contact lenses in retarding the progression of
myopia in myopic children. CLINICAL RELEVANCE: Myopia is a common
ocular disorder, and high myopia (myopia at least -6.0 diopters) is
associated with potentially blinding conditions. At present, there are
no general guidelines on interventions that may decrease myopia
progression in children, but some interventions such as contact lenses
are offered on an ad hoc basis. METHODS OR LITERATURE REVIEWED:
English and non-English language articles published from 1968 to 2000
were retrieved using a keyword search of MEDLINE, Embase, Cochrane
Library, and Science Citation Index databases. Randomized controlled
trials with comparisons of the effectiveness of interventions to
decrease myopia progression in myopic children were reviewed. RESULTS:
Ten clinical trials of different interventions to retard myopia
progression were reviewed, including three trials that evaluated
atropine and one trial that evaluated soft contact lenses. Atropine
eye drops of 0.5% concentration were effective in clinical trials, but
no significant effect was found for tropicamide or timolol eyedrops.
Five of the six trials on bifocal spectacle lenses with various
additions failed to show significant retardation, and results of the
remaining trial were barely significant (P = 0.047). A trial of soft
contact lenses failed to show significant effects. CONCLUSIONS: The
latest evidence from randomized clinical trials does not provide
sufficient information to support interventions to prevent the
progression of myopia. Long-term large-scale double-masked randomized
clinical trials, including cycloplegic refraction, are needed before
any recommendations about interventions in clinical practice to
prevent high myopia in myopic children are considered.

PMID: 11874738

Judy

 

Dear Judy,

Subject: Missing the point.

The issue is not "slowing down the rate at which is it is "getting
worse".

The issue is that the person "empower" himself to recognize that you
are "part of the problem", and can not be "part of the PREVENTIVE
solution."

This is the concept that Fred "woke up" to -- that true PREVENTION,
and Snellen clearing had to be under HIS control, and that is the real
goal of educational science.

In deed as you stated many times, you prescribe for, "best visual
acuity".

In practice this means that a child with 20/40 (passes the DMV
requirement) gets up to a -2 diopter "prescription". That is not
"prevention" -- that is the first step into stair-case myopia.

Second-opinion prevention best,

 

You ARE the expert.

Didn't work for you.

Didn't work for Fred.

Didn't work for your niece.

Or, in your case, "stair-case idiocy."