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Myopia
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==Prevention and control== Various methods have been employed in an attempt to decrease the progression of myopia, although studies show mixed results.<ref name="Saw 1">{{cite journal | vauthors = Saw SM, Gazzard G, Au Eong KG, Tan DT | title = Myopia: attempts to arrest progression | journal = The British Journal of Ophthalmology | volume = 86 | issue = 11 | pages = 1306–1311 | date = November 2002 | pmid = 12386095 | pmc = 1771373 | doi = 10.1136/bjo.86.11.1306 }}</ref> Many myopia treatment studies have a number of design drawbacks: [[Sample size determination|small numbers]], lack of adequate [[Scientific control|control]] group, and failure to [[Blind experiment|mask examiners]] from knowledge of treatments used. The best approach is to combine multiple prevention and control methods.<ref>{{Cite journal |last1=Zhang |first1=Guanghong |last2=Jiang |first2=Jun |last3=Qu |first3=Chao |date=2023-04-27 |title=Myopia prevention and control in children: a systematic review and network meta-analysis |journal=Eye |volume=37 |issue=16 |pages=3461–3469 |doi=10.1038/s41433-023-02534-8 |issn=1476-5454 |pmid=37106147|pmc=10630522 |s2cid=258376819 }}</ref> A test of repeated low-level red-light therapy (LLRL) on myopic Chinese children showed it to be a promising alternative treatment for myopia control in children.<ref>Jiang M.D., Yu, et al., ''[https://www.aaojournal.org/article/S0161-6420(21)00916-7/fulltext Effect of Repeated Low-Level Red-Light Therapy for Myopia Control in Children]'', ''Ophthalmology'', American Academy of Ophthalmology, Volume 129, Issue 5P509-519, May 2022</ref> === Spending time outdoors === Some studies have indicated that having children spend time outdoors reduces the incidence of myopia.<ref name=":1">{{Cite journal |last1=Lawrenson |first1=John G. |last2=Shah |first2=Rakhee |last3=Huntjens |first3=Byki |last4=Downie |first4=Laura E. |last5=Virgili |first5=Gianni |last6=Dhakal |first6=Rohit |last7=Verkicharla |first7=Pavan K. |last8=Li |first8=Dongfeng |last9=Mavi |first9=Sonia |last10=Kernohan |first10=Ashleigh |last11=Li |first11=Tianjing |last12=Walline |first12=Jeffrey J. |date=2023-02-16 |title=Interventions for myopia control in children: a living systematic review and network meta-analysis |journal=The Cochrane Database of Systematic Reviews |volume=2023 |issue=2 |pages=CD014758 |doi=10.1002/14651858.CD014758.pub2 |issn=1469-493X |pmc=9933422 |pmid=36809645}}</ref> A 2017 study investigated the leading causal theory of association between greenspace exposure and spectacles use as a proxy for myopia, finding a 28% reduction in the likelihood of spectacles use per interquartile range increase in time spent in greenspace.<ref>{{Cite journal |last1=Sprague |first1=Nadav L. |last2=Bancalari |first2=Pilar |last3=Karim |first3=Wasie |last4=Siddiq |first4=Shabnaz |date=September 2022 |title=Growing up green: a systematic review of the influence of greenspace on youth development and health outcomes |journal=Journal of Exposure Science & Environmental Epidemiology |volume=32 |issue=5 |pages=660–681 |doi=10.1038/s41370-022-00445-6 |issn=1559-064X |pmc=9482936 |pmid=35614136|bibcode=2022JESEE..32..660S }}</ref> In Taiwan, government policies that require schools to send all children outdoors for a minimum amount of time have driven down the prevalence of myopia in children.<ref name=":1" /><ref name=":2">{{Cite magazine |last=Katwala |first=Amit |title=The World Is Going Blind. Taiwan Offers a Warning, and a Cure |language=en-US |magazine=Wired |url=https://www.wired.com/story/taiwan-epicenter-of-world-myopia-epidemic/ |access-date=2023-09-01 |issn=1059-1028}}</ref><!-- This popular magazine is offered in lieu of the old |laysource= parameter, to explain the research concepts and history in simpler language. --> === Glasses and contacts === The use of reading glasses when doing close work may improve vision by reducing or eliminating the need to accommodate. Altering the use of eyeglasses between full-time, part-time, and not at all does not appear to alter myopia progression.<ref name="pmid10416930">{{cite journal | vauthors = Ong E, Grice K, Held R, Thorn F, Gwiazda J | title = Effects of spectacle intervention on the progression of myopia in children | journal = Optometry and Vision Science | volume = 76 | issue = 6 | pages = 363–9 | date = June 1999 | pmid = 10416930 | doi = 10.1097/00006324-199906000-00015 }}</ref><ref name="pmid2667638">{{cite journal | vauthors = Pärssinen O, Hemminki E, Klemetti A | title = Effect of spectacle use and accommodation on myopic progression: final results of a three-year randomised clinical trial among schoolchildren | journal = The British Journal of Ophthalmology | volume = 73 | issue = 7 | pages = 547–51 | date = July 1989 | pmid = 2667638 | pmc = 1041798 | doi = 10.1136/bjo.73.7.547 }}</ref> The American Optometric Association's Clinical Practice Guidelines found evidence of effectiveness of bifocal lenses and recommends it as the method for "myopia control".<ref name="AOA" /> In some studies, bifocal and [[progressive lens]]es have not shown differences in altering the progression of myopia compared to placebo.<ref name="Saw 1" /><ref>{{Cite journal |last1=Wolffsohn |first1=James S. |last2=Flitcroft |first2=Daniel Ian |last3=Gifford |first3=Kate L. |last4=Jong |first4=Monica |last5=Jones |first5=Lyndon |last6=Klaver |first6=Caroline C. W. |last7=Logan |first7=Nicola S. |last8=Naidoo |first8=Kovin |last9=Resnikoff |first9=Serge |last10=Sankaridurg |first10=Padmaja |last11=Smith |first11=Earl L. |last12=Troilo |first12=David |last13=Wildsoet |first13=Christine F. |date=2019 |title=IMI – Myopia Control Reports Overview and Introduction |journal=Investigative Ophthalmology & Visual Science |volume=60 |issue=3 |pages=M1–M19 |doi=10.1167/iovs.18-25980 |issn=0146-0404 |pmc=6735780 |pmid=30817825}}</ref> In the United States, the Food and Drug Administration (FDA) has approved myopia control contact lenses such as CooperVision’s MiSight and Johnson & Johnson Vision’s Acuvue Abiliti. Yet the agency has yet to approve any myopia control spectacle lenses. ===Medication=== [[muscarinic antagonist|Anti-muscarinic]] topical medications in children under 18 years of age may slow the worsening of myopia.<ref name="Walline">{{cite journal | vauthors = Walline JJ, Lindsley KB, Vedula SS, Cotter SA, Mutti DO, Ng SM, Twelker JD | title = Interventions to slow progression of myopia in children | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD0O6460 | date = 2020 | volume = 1 | pmid = 31930781 | pmc = 6984636 | doi = 10.1002/14651858.CD004916.pub4 }}</ref><ref>{{cite journal | vauthors = Smith MJ, Walline JJ | title = Controlling myopia progression in children and adolescents | journal = Adolescent Health, Medicine and Therapeutics | volume = 6 | pages = 133–40 | date = 2015 | pmid = 26316834 | pmc = 4542412 | doi = 10.2147/AHMT.S55834 | doi-access = free }}</ref> These treatments include [[pirenzepine|pirenzepine gel]], [[cyclopentolate|cyclopentolate eye drops]], and [[atropine]] [[eye drops]]. While these treatments were shown to be effective in slowing the progression of myopia and reducing eyeball elongation associated with the condition, side effects included light sensitivity and near blur.<ref name="Walline" /><ref>{{Cite journal |last1=Li |first1=Fen Fen |last2=Yam |first2=Jason C. |date=2019-10-04 |title=Low-Concentration Atropine Eye Drops for Myopia Progression |journal=Asia-Pacific Journal of Ophthalmology |volume=8 |issue=5 |pages=360–365 |doi=10.1097/APO.0000000000000256 |issn=2162-0989 |pmc=6784858 |pmid=31478936}}</ref> === Other methods === [[Scleral reinforcement surgery]] is aimed to cover the thinning posterior pole with a supportive material to withstand [[intraocular pressure]] and prevent further progression of the posterior staphyloma. The strain is reduced, although damage from the pathological process cannot be reversed. By stopping the progression of the disease, vision may be maintained or improved.<ref name="ward">{{cite journal | vauthors = Ward B, Tarutta EP, Mayer MJ | title = The efficacy and safety of posterior pole buckles in the control of progressive high myopia | journal = Eye | volume = 23 | issue = 12 | pages = 2169–74 | date = December 2009 | pmid = 19229272 | doi = 10.1038/eye.2008.433 | doi-access = free }}</ref> The use of orthoK can also slow down axial lens elongation.<ref>{{Cite journal |last1=Wolffsohn |first1=James S. |last2=Flitcroft |first2=Daniel Ian |last3=Gifford |first3=Kate L. |last4=Jong |first4=Monica |last5=Jones |first5=Lyndon |last6=Klaver |first6=Caroline C. W. |last7=Logan |first7=Nicola S. |last8=Naidoo |first8=Kovin |last9=Resnikoff |first9=Serge |last10=Sankaridurg |first10=Padmaja |last11=Smith |first11=Earl L |last12=Troilo |first12=David |last13=Wildsoet |first13=Christine F. |date=2019 |title=IMI – Myopia Control Reports Overview and Introduction |journal=Investigative Ophthalmology & Visual Science |volume=60 |issue=3 |pages=19 |doi=10.1167/iovs.18-25980 |issn=0146-0404 |pmc=6735780 |pmid=30817825 }}</ref>
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