Editing Refractive error (section)

==Management==
The management of refractive error is done post-diagnosis of the condition by either optometrists, ophthalmologists, refractionists, or ophthalmic medical practitioners.<ref name="Cochrane c1711">{{Cite journal|last1=Cochrane|first1=Gillian M.|last2=Toit|first2=Rènée du|last3=Mesurier|first3=Richard T. Le|date=2010-04-12|title=Management of refractive errors|url=https://www.bmj.com/content/340/bmj.c1711|journal=BMJ|language=en|volume=340|pages=c1711|doi=10.1136/bmj.c1711|issn=0959-8138|pmid=20385718|s2cid=8240093|url-access=subscription}}</ref>

How refractive errors are treated or managed depends upon the amount and severity of the condition. Those who possess mild amounts of refractive error may elect to leave the condition uncorrected, particularly if the person is asymptomatic. For those who are symptomatic, [[glasses]], [[contact lenses]], [[refractive surgery]], or a combination are typically used.<ref name=":1" /><ref name=":2" /><ref name="Morgan 1739–1748" />

=== Glasses ===
These are the most effective ways of correcting the refractive error. However, the availability and affordability of eyeglasses can present a difficulty for people in many low income settings of the world. Glasses also pose a challenge to children to whom they are prescribed to, due to children's tendency to not wear them as consistently as recommended.<ref>{{Cite journal|last1=Wedner|first1=S.|last2=Masanja|first2=H.|last3=Bowman|first3=R.|last4=Todd|first4=J.|last5=Bowman|first5=R.|last6=Gilbert|first6=C.|date=2008-01-01|title=Two strategies for correcting refractive errors in school students in Tanzania: randomised comparison, with implications for screening programmes|url=https://bjo.bmj.com/content/92/1/19|journal=British Journal of Ophthalmology|language=en|volume=92|issue=1|pages=19–24|doi=10.1136/bjo.2007.119198|issn=0007-1161|pmid=18156372|s2cid=2157969|url-access=subscription}}</ref>

As mentioned earlier refractive errors are because of the improper focusing of the light in the retina. Eyeglasses work as an added lens of the eye serving to bend the light to bring it to focus on the retina. Depending on the eyeglasses, they serve many functions.<ref>{{Cite web |title=Pediatric Ophthalmology, Optometry and Orthoptics |url=https://asianeyeinstitute.com/custom_services/pediatric-ophthalmology-orthoptics-strabismus/ |access-date=2022-08-03 |website=Asian Eye Institute}}</ref>

; Reading glasses: These are general over-the-counter glasses which can be worn for easier reading, especially for defective vision due to aging called presbyopia.
; Single vision prescription lenses: They can correct only one form of defective vision, either far-sightedness or near-sightedness.
; Multifocal lenses: The multifocal lenses can correct defective vision in multiple focus, for example: near-vision as well as far-vision. This are particularly beneficial for presbyobia.<ref>{{Cite web|title=Eyeglasses for Refractive Errors {{!}} National Eye Institute|url=https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/refractive-errors/eyeglasses-refractive-errors|access-date=2021-06-29|website=www.nei.nih.gov}}</ref>

=== Contact lenses ===
Alternatively, many people choose to wear contact lenses. One style is hard contact lenses, which can distort the shape of the cornea to a desired shape. Another style, soft contact lenses, are made of silicone or hydrogel. Depending on the duration they are designed for, they may be worn daily or may be worn for an extended period of time, such as for weeks.<ref name="Cochrane c1711"/>

There are a number of complication associated with contact lenses. Typically the ones that are used daily.{{cn|date=September 2024}}
{| class="wikitable"
|+
! Complications of contact lens wear
! Description
|-
| Conjunctivitis (giant papillary form)
| Caused in response to the allergen present in the material from which the contact lens is made from. There is often discomfort in the eye after wearing and vision may be affected. Choosing the right lens material and changing it regularly might prevent conjunctivitis.
|-
| Corneal abrasion
| Caused by a foreign body, dust, sand, or grit trapped under the lens.
|-
| Corneal edema
| Caused by decreased oxygen delivery to the tissue compressed by the lens. Usually resolved after the removal of the lenses. Discomfort upon lens removal may be seen.
|-
| Neovascularization
| New blood vessels may form in the iris region and the limbus. This may impair vision.
|-
| Infections
| Various viral, bacterial, and fungal infection may be seen in the eye post-contact-lens wear, if proper lens hygiene is not maintained. Acanthamoeba are the most common infections in the people using contact lenses.
|}

If redness, itching, and difficulty in vision develops, the use of the lenses should be stopped immediately and the consultation of ophthalmologists may be sought.

=== Surgery ===
Laser in situ keratomileusis (LASIK) and photo-refractive keratectomy (PRK) are popular procedures; while use of laser epithelial keratomileusis (LASEK) is increasing. Other surgical treatments for severe myopia include insertion of implants after [[clear lens extraction]] (refractive lens exchange). Full thickness corneal graft may be a final option for patients with advanced kerataconus although currently there is interest in new techniques that involve collagen crosslinking. As with any surgical procedure complications may arise post-operatively Post-operative monitoring is normally undertaken by the specialist ophthalmic surgical clinic and optometry services. Patients are usually informed pre-operatively about what to expect and where to go if they suspect complications. Any patient reporting pain and redness after surgery should be referred urgently to their ophthalmic surgeon.<ref>{{Cite web |date=2023-05-03 |title=10 Cataract Surgery Side Effects, and How to Cope |url=https://www.aao.org/eye-health/tips-prevention/side-effects-cataract-surgery-complications-cope |access-date=2023-11-06 |website=[[American Academy of Ophthalmology]] |last=Mukamal |first=Reena}}</ref><ref>{{Cite web |date=2023-07-26 |title=LASIK — Laser Eye Surgery |url=https://www.aao.org/eye-health/treatments/lasik |access-date=2023-11-06 |website=American Academy of Ophthalmology |language=en}}</ref>

=== Medical treatment ===
Atropine has believed to slow the progression of near-sightedness and is administered in combination with multifocal lenses. These, however, need further research.<ref>{{Cite journal|last1=Shih|first1=Yung-Feng|last2=Hsiao|first2=C. Kate|last3=Chen|first3=Chien-Jen|last4=Chang|first4=Ching-Wei|last5=Hung|first5=Por T.|last6=Lin|first6=Luke L.-K.|date=June 2001|title=An intervention trial on efficacy of atropine and multi-focal glasses in controlling myopic progression|journal=Acta Ophthalmologica Scandinavica|volume=79|issue=3|pages=233–236|doi=10.1034/j.1600-0420.2001.790304.x|pmid=11401629|issn=1395-3907|doi-access=free}}</ref><ref>{{Cite journal|last1=Lee|first1=Jong-Jer|last2=Fang|first2=Po-Chiung|last3=Yang|first3=I-Hui|last4=Chen|first4=Chih-Hsin|last5=Lin|first5=Pei-Wen|last6=Lin|first6=Sue-Ann|last7=Kuo|first7=Hsi-Kung|last8=Wu|first8=Pei-Chang|date=February 2006|title=Prevention of Myopia Progression with 0.05% Atropine Solution|url=http://dx.doi.org/10.1089/jop.2006.22.41|journal=Journal of Ocular Pharmacology and Therapeutics|volume=22|issue=1|pages=41–46|doi=10.1089/jop.2006.22.41|pmid=16503774|issn=1080-7683|url-access=subscription}}</ref>

=== Prevention ===
Strategies being studied to slow worsening include adjusting working conditions, increasing the time children spend outdoors,<ref name="Wojciechowski 301–320" /> and special types of contact lenses.<ref name="Li2017">{{cite journal|last1=Li|first1=X|last2=Friedman|first2=IB|last3=Medow|first3=NB|last4=Zhang|first4=C|title=Update on Orthokeratology in Managing Progressive Myopia in Children: Efficacy, Mechanisms, and Concerns.|journal=Journal of Pediatric Ophthalmology and Strabismus|date=1 May 2017|volume=54|issue=3|pages=142–148|doi=10.3928/01913913-20170106-01|pmid=28092397}}</ref> In children special contact lenses appear to slow worsening of nearsightedness.<ref name="Li2017" /><ref>{{cite journal|last1=Walline|first1=JJ|s2cid=24069302|title=Myopia Control: A Review.|journal=Eye & Contact Lens|date=January 2016|volume=42|issue=1|pages=3–8|doi=10.1097/ICL.0000000000000207|pmid=26513719}}</ref>

A number of questionnaires exist to determine [[quality of life]] impact of refractive errors and their correction.<ref>{{cite journal |last1=Kandel |first1=H |last2=Khadka |first2=J |last3=Goggin |first3=M |last4=Pesudovs |first4=K |date=2017 |title=Patient-reported outcomes for assessment of quality of life in refractive error: a systematic review|journal=Optometry and Vision Science |volume=94 |issue=12 |pages=1102–1119 |doi=10.1097/OPX.0000000000001143 |pmid=29095758 |s2cid=21512136 |name-list-style=vanc}}</ref><ref>{{cite journal |last1=Kandel |first1=H |last2=Khadka |first2=J |last3=Lundström |first3=M |last4=Goggin |first4=M |last5=Pesudovs |first5=K |date=2017 |title=Questionnaires for measuring refractive surgery outcomes |journal=Journal of Refractive Surgery |volume=33 |issue=6 |pages=416–424 |doi=10.3928/1081597X-20170310-01|pmid=28586503 |name-list-style=vanc}}</ref>