Search Results (12)

To compare oculomotor profiles among children wearing orthokeratology, defocus spectacle, and diffusion optics technology lenses in a routine pediatric myopia management setting. This real-world observational study included children who had worn one of the three lens types for approximately one year and had available eye tracking data. Lens type was selected during routine clinical care rather than assigned by the investigators. Oculomotor parameters were compared among lens groups using Kruskal–Wallis tests with false discovery rate correction. One-year spherical equivalent change was examined only in the defocus spectacle and diffusion optics technology groups. Adjusted and exploratory analyses included age, sex, baseline spherical equivalent, baseline axial length, axial elongation, and parental education categories. A total of 134 children were analyzed, including 46 in the orthokeratology group, 49 in the defocus spectacle group, and 39 in the diffusion optics technology group. Significant group differences were observed for microsaccade frequency (FDR adjusted p = 0.00099), peak velocity (FDR adjusted p = 0.00099), latency (FDR adjusted p = 0.00395), fixation disparity (FDR adjusted p = 0.00395), and conjugacy (FDR adjusted p = 0.0274). Saccade frequency and saccade amplitude did not differ significantly. One-year spherical equivalent change did not differ significantly between the defocus spectacle group and the diffusion optics technology group (−0.27 ± 0.43 D vs. −0.34 ± 0.36 D, p = 0.312). No statistically significant correlation was observed between spherical equivalent change and microsaccade frequency in the two spectacle lens groups (Spearman r = −0.231, p = 0.069). Parental education categories showed no consistent association with oculomotor parameters after correction for multiple comparisons. Children wearing different myopia control lenses showed selective differences in oculomotor profiles. Refractive change in the two spectacle lens groups was similar, and the observed oculomotor differences should not be interpreted as direct indicators of myopia control efficacy. Eye tracking may provide complementary information about visual behavior and lens adaptation, but prospective studies with age-balanced designs and longitudinal refractive and axial length outcomes are needed. Full article

Background/Objectives: Given the growing prevalence of myopia worldwide, prevention and proactive management of at-risk children becomes increasingly important. This study sought to evaluate trends in myopia development in pediatric pre-myopic patients and determine how optometrists in Canada manage pre-myopia. Methods: In this retrospective chart review, records for children aged 6–10 years who had an eye exam between 2017 and 2021 were reviewed. Pre-myopic children were included if the presenting refraction at the first visit was between +0.75D and −0.25D (inclusive). Up to five unique patients were selected for each age (6, 7, 8, 9, and 10) and initial visit year (2017 to 2021) at each clinical site. Demographic information, refractive status and recommended interventions were recorded. Results: A total of 1740 pre-myopic patients were included across 15 practices in Ontario, of which 184 patients developed myopia (10.6%) during the years studied. Cohort year groups did not differ in baseline age (mean ± SD 8.39 ± 1.43 years) or baseline refractive error (+0.13 ± 0.27 DS). At initial encounters, most clinicians monitored without intervention (mean across cohort years 91.9%), with some recommending lifestyle changes (3.5%) and SV spectacles/CL (3.0%). This pattern remained stable over the years studied. Pre-myopic children developed myopia at a similar age over the study period (mean ± SE: 9.66 ± 0.16 years) and experienced a faster rate of loss of hyperopic reserve (loss of −0.26 ± 0.07 D/year in the 2017 cohort vs. −0.73 ± 0.18 D/year in the 2020 cohort and −0.71 ± 0.10 D/year in the 2021 cohort) regardless of patient age. Conclusions: Pre-myopic children in the 2020 and 2021 cohort years experienced an accelerated loss of hyperopic reserve compared to those in the 2017 cohort. Despite this, very few pre-myopic children were recommended lifestyle changes, which were known to be effective for delaying myopia onset. Since delaying myopia onset may be more impactful than subsequent myopia treatment, additional research should focus on effective interventions for the pre-myopic population. Full article

Childhood myopia progression remains a major global public health concern, and spectacle lenses designed to induce peripheral myopic defocus have emerged as a non-pharmacological strategy for myopia control; however, real-world evidence from European populations remains limited. This retrospective observational study evaluated the 12-month real-world effectiveness of cylindrical annular refractive element spectacle lenses in a Turkish pediatric cohort. Children aged 5–15 years who wore myopia-control spectacle lenses from the CARE platform or single-vision lenses were included. Cycloplegic spherical equivalent refraction (SER) and axial length (AL) were measured at baseline and at 12 months. The primary outcomes were 12-month changes in SER and AL. Multivariable generalized estimation equations were applied to account for inter-eye correlation and to adjust for age and gender. A total of 168 eyes were analyzed (85 with single-vision lenses; 83 with myopia-control lenses). After 12 months, the myopia-control group demonstrated significantly slower progression than the single-vision group, with mean SER changes of −0.40 ± 0.92 D versus −0.77 ± 0.74 D and axial elongation of 0.17 ± 0.25 mm versus 0.31 ± 0.30 mm, respectively. Treatment group remained a significant predictor of both refractive progression (p = 0.008) and axial elongation (p = 0.003). Age was independently associated with axial length change (p < 0.001), whereas gender was not. These findings provide real-world European evidence supporting the role of defocus-modulating spectacle lenses in pediatric myopia management. Full article

Objectives: This study aims to evaluate the intrasession repeatability of the HBM-1 (Huvitz) optical biometer and to assess its agreement with the IOLMaster 700 (Zeiss) for the main biometric parameters used in intraocular lens (IOL) power calculation and in myopia management. Methods: A cross-sectional observational study was conducted in 82 eyes of 82 patients with the following age distribution: pediatric 26.8%, young adults 35.4%, and older adults 37.8% (total range 6–79 years). Optical biometry was performed three consecutive times with both biometers in the same session by a single trained examiner. HBM-1 repeatability was assessed using the within-subject standard deviation (Sw), the repeatability coefficient, and the intraclass correlation coefficient (ICC). Agreement between biometers was analyzed using Bland–Altman plots (limits of agreement, LoA). Results: The HBM-1 showed excellent intrasession repeatability, with very low Sw values—on the order of hundredths of a millimeter for axial length (AL), anterior chamber depth (ACD), and lens thickness (LT), and hundredths of a diopter for keratometry—with ICC ≥ 0.97 for most parameters. The mean bias (HBM-1 vs. IOLMaster 700) was small: AL 0.012 ± 0.052 mm (p = 0.045; LoA: −0.09 to 0.11 mm), ACD 0.059 ± 0.068 mm (p < 0.001; −0.07 to 0.19 mm), LT 0.052 ± 0.090 mm (p < 0.001; −0.12 to 0.23 mm), and central corneal thickness 0.82 ± 7.12 μm (p = 0.301; −13.1 to 14.8 μm). For corneal diameter and corneal curvature, mean differences were small (≤0.07 D) and not statistically significant in most cases. Age was not associated with discrepancies in AL but showed weak correlations with some anterior segment differences, without clear clinical relevance. Conclusions: The HBM-1 demonstrated excellent intrasession repeatability and a good level of clinical agreement with the IOLMaster 700 in a broad population that included children, young adults, and older adults. Full article

Background/Objectives: Nutritional supplementation has been proposed as a potential adjunct strategy in myopia prevention and control through antioxidative, anti-inflammatory, and extracellular matrix-regulating mechanisms. This systematic review aimed to evaluate randomized controlled trial (RCT) evidence on the effects of carotenoids, anthocyanins, polyunsaturated fatty acids, and combined nutraceutical formulations on refractive outcomes, axial length, macular pigment optical density (MPOD), visual function, and symptoms of visual fatigue. Methods: The review was registered in PROSPERO (CRD420251149727) and conducted in accordance with PRISMA 2020 and AMSTAR-2 guidelines. PubMed, Web of Science, and Scopus were searched up to 5 August 2025. Eligible studies were RCTs involving individuals with myopia or at risk of myopia, comparing nutritional supplementation with placebo or active controls. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. Results: Nine RCTs were included. Carotenoids such as crocetin, lutein, zeaxanthin, and astaxanthin produced modest benefits, including improved MPOD, reduced visual fatigue, and—in one pediatric trial—slightly less axial elongation. Anthocyanin-rich extracts improved mesopic contrast sensitivity and subjective asthenopia. A combined carotenoid–polyphenol formulation enhanced accommodative facility. However, no consistent clinically meaningful reduction in myopia progression was observed. Trials were generally small, heterogeneous, and short in duration. Conclusions: Nutritional supplementation may improve visual function and retinal antioxidant status but lacks strong evidence for slowing myopia progression. Larger, long-term RCTs are needed before recommending supplementation for routine myopia management. Full article

Background/Objectives: Myopia is a growing global health concern, especially among school-aged children in East Asia. Topical atropine is a key treatment for pediatric myopia control, but individual responses vary, with some children showing rapid progression despite higher doses. This retrospective observational study aims to develop an interpretable machine learning model to predict individualized treatment responses and support personalized clinical decisions, based on data collected over a 3-year period without a control group. Methods: A total of 1545 pediatric eyes treated with topical atropine for myopia control at a single tertiary medical center are analyzed. Classification and regression tree (CART) is constructed to predict changes in spherical equivalent (SE) and identify influencing risk factors. These factors are mainly received treatments for myopia including atropine dosage records, treatment duration, and ophthalmic examinations. Furthermore, decision rules that closely resemble the clinical diagnosis process are provided to assist clinicians with more interpretable insights into personalized treatment decisions. The performance of CART is evaluated by comparing with the benchmark model of least absolute shrinkage and selection operator regression (Lasso) to confirm the practicality of CART usage. Results: Both the CART and Lasso models demonstrated comparable predictive performance. The CART model identified baseline SE as the primary determinant of myopia progression. Children with a baseline SE more negative than −3.125 D exhibited greater myopic progression, particularly those with prolonged treatment duration and higher cumulative atropine dosage. Conclusions: Baseline SE has been identified as the key factor affecting SE difference. The generated decision rules from CART demonstrate the use of explainable machine learning in precision myopia management. Full article

Objectives: To determine how optometrists in Canada manage their pediatric myopia patients and to assess whether this has changed over time. Methods: In a retrospective chart review, records for children aged 6–10 years who had an eye exam between 2017 to 2021 were reviewed. Children were grouped by presenting refraction (myopes ≤ −0.50 D or pre-myopes ≤ +0.75 D). Up to five unique patients were selected for each age (6, 7, 8, 9, and 10) and initial visit year (2017 to 2021) for each group (myopes and pre-myopes), for a maximum of 250 files per practice. Demographic information, refraction, and recommended interventions were recorded. Logistic regression was used to model the likelihood of being prescribed a myopia control intervention based on patient and optometrist characteristics. Results: A total of 2905 patients (n = 1467 (50%) female) from 15 practices across Ontario, Canada, were included, accounting for 8546 visits. Optometrists predominantly prescribed single-vision spectacle correction as a first-line intervention for myopic children, although this declined from 98.2% in 2017 to 56.7% in 2023. The use of myopia control modalities increased from 1.8% to 43.3% over this same period. Optometrists began recommending myopia control at lower myopic refractive errors over time (−2.63 DS in 2017 vs and −1.49 DS in 2020). Myopia control spectacles were the most commonly prescribed intervention, despite the observation that optometrists are not hesitant to fit contact lenses in younger children. Optometrists who had been in practice longer were more likely to prescribe older forms of myopia control (e.g., bifocals/progressives) than more recent graduates. Conclusions: While single-vision spectacle correction remains a primary approach for initial myopia management in Ontario, Canada, optometrists increasingly recommend myopia control and are initiating interventions earlier. Full article

Background: Myopia progression in children is a growing public health concern, with increasing evidence suggesting that lifestyle factors may influence its development. This study aimed to evaluate the potential benefits of regular badminton activity in slowing myopia progression in children. Methods: We analyzed data from 40 children aged 7–14 years with myopia ranging from −1.50 D to −6.25 D who participated in supervised badminton training (three 45 min sessions per week) for 10 months. A control group of 62 myopic children who did not engage in regular physical activity was included. Ophthalmological assessments were performed at baseline and after 10 months. Results: The axial length increased by 0.37 mm in the badminton group compared to 0.56 mm in the control group. The mean change in the spherical equivalent was −0.52 D in the badminton group and −0.84 D in controls. Myopia progression was slower in the group participating in regular physical activity. Conclusions: Regular badminton activity may help reduce the rate of axial elongation and myopia progression in children. These findings support the inclusion of physical activity as a complementary strategy in managing pediatric myopia. However, further research is needed to determine whether this effect is specific to badminton or reflects the general benefit of physical activity. Full article

Objective: To assess the educational impact of a worldwide webinar approach to myopia progression management in children <8 years and 8–12 years old. Design: Cross-sectional study. Methods: A self-administered survey was conducted for attendees of a 3 h worldwide webinar held in two parts on consecutive days on the management of myopia progression in children. The survey was administered before, immediately after completion of the webinar, and 8 weeks later; responses were recorded on a Likert scale. Questions were posed to assess (a) the confidence of attendees in managing myopia in children <12 years old, (b) attendees’ understanding of latest treatment options, (c) any improvement in attendees’ knowledge after the webinar, and (d) any changes made to practice 8 weeks after the webinar. Pre- and post-responses were analyzed using an unpaired two-tailed t-test. Results: The webinar had 701 and 606 global attendees on the first and second days, respectively. Based on a comparison of contact information, 372 attendees participated on days 1 and 2, meaning 288 and 233 participants attended only day 1 and day 2, respectively. There was a significant increase in the percentage of attendees who were “very confident” in managing myopia after the webinar (p < 0.05). Ninety-nine attendees completed the survey at 8 weeks. Of these, 76% believed that the webinar had “very significantly” or “significantly” improved their ability to manage pediatric myopia and 91% had implemented or intended to implement a change in their practice. The respondents who did not implement a change identified cost and patient compliance as the common barriers. Conclusion: There is a tsunami of research and management options in the field of myopia management at present. We demonstrate that an effective way of disseminating information and education about myopia management is a pre-designed comprehensive webinar held over two consecutive days. There is evidence that such a webinar may also influence a change in clinical practice. Full article

Refractive errors, particularly myopia, are among the most prevalent visual impairments globally, with rising incidence in children and adolescents. This review explores the epidemiology and risk factors associated with the development of refractive errors, focusing on the environmental and lifestyle factors contributing to the current surge in myopia. We provide an overview of key genetic factors and molecular pathways driving the pathogenesis of myopia and other refractive errors, emphasizing the complex interplay between genetic predisposition and environmental triggers. Understanding the underlying mechanisms is crucial for identifying new strategies for intervention. We discuss current approaches to slow myopia progression in pediatric populations, including pharmacological treatment regimens (low-dose atropine), optical interventions, and lifestyle modifications. In addition to established therapies, we highlight emerging innovations, including new pharmacological agents and advanced optical devices, and insights into potential future treatments. Cutting-edge research into gene therapy, molecular inhibitors, and neuroprotective strategies may yield novel therapeutic targets that address the root causes of refractive errors. This comprehensive review underscores the importance of early intervention and highlights promising avenues for future research, aiming to provide pediatricians with guidance to ultimately improve clinical outcomes in managing and preventing myopia progression in children and young adults. Full article

In this paper, we summarize the current knowledge on refractive surgery performed in the myopic pediatric population. We describe the main concerns about refractive surgery in myopic children and the indications for refractive surgery in this age group. We present a range of surgical procedures that are being used for the management of unilateral/bilateral myopia in children: corneal refractive surgery (PRK, LASEK, LASIK, FS-LASIK and SMILE) and intraocular refractive surgery (phakic intraocular lens implantation, refractive lens exchange or clear lens extraction), with both their advantages and drawbacks. We also describe the various complications and measures to prevent them. Full article

Determining the axial length (AL) of the eye is of significant interest in the management of myopia. However, the devices that allow this value to be obtained are either expensive, for example, optical biometers, or inconvenient for use in pediatric population, such is the case with ultrasound biometers. Therefore, this study aimed to develop a mathematical model for estimating the AL value based on easily obtainable variables, with the novel addition of body height to the analysis. A total of 170 eyes of 85 myopic volunteers (mean age of 10.8 ± 1.45 years, ranging from 7 to 14 years) were included in the analysis. Participants underwent anamnesis, keratometry by NVISION-K 5001, subjective refraction by an optometrist, AL measurement by the Topcon MYAH biometer, and body height measurement. Spearman’s correlation test was employed to analyze the relationships between AL and keratometry, spherical equivalent, body height (Sperman’s correlation, all r ≥ 0.267, all p < 0.001), and age (Spearman’s correlation, p = 0.081). Subsequently, multiple regression analysis was conducted on the variables that demonstrated a previous correlation. The mathematical model obtained permits the estimation of AL based on average keratometry, spherical equivalent, and body height. This model is significant (p < 0.001) and explains 82.4% of AL variability. Full article