Evidence about intervention to prevent myopia progression

Discussion in 'Optometry Archives' started by Dr Judy, Aug 11, 2009.

  1. Dr Judy

    Dr Judy Guest

    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

    Dr Judy, Aug 11, 2009
  2. Dr Judy

    Otis Guest

    Dear Judy,

    Subject: Missing the point.

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

    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

    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

    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,
    Otis, Aug 11, 2009
  3. Dr Judy

    Neil Brooks Guest

    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."
    Neil Brooks, Aug 11, 2009
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