A survey in 2015 identified a high level of eye care practitioner concern about myopia with a reported moderately high level of activity, but the vast majority still prescribed single vision interventions to young myopes. This research aimed to update these findings 4 years later. Methods: A self-administrated, internet-based questionnaire was distributed in eight languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy of available strategies and adoption levels of such strategies, and reasons for not adopting specific strategies. Results: Of the 1336 respondents, concern was highest (9.0 ± 1.6; p < 0.001) in Asia and lowest (7.6 ± 2.2;

Purpose Degenerative myopia is a significant cause of vision loss; yet there is no accepted way of controlling its causative phenotypeFprogressive high axial myopia. Scleral reinforcement, introduced over 50 years ago, was discredited as a useful technique. This 5-year 'proof of concept' study examines buckling of the posterior pole for myopia control and follows the course of untreated fellow eyes. Method A total of 59 adult eyes, with myopic refractive corrections ranging from À9 to À22 D and axial lengths from 27.8 to 34.6 mm, were studied. A 1-cm-wide flexible buckle of donor sclera was positioned over the posterior pole and secured, under positive tension, to the anterior globe. The eyes were monitored for 5 years, as were unsupported fellow eyes. The axial lengths, visual acuities, and optical coherence tomography macular scans were collected and all complications were noted. Results Over 5 years, axial length control was achieved by scleral buckling, whereas axial extension progressed in the untreated group. No serious complication occurred and no eye lost visual acuity from the procedure. Temporary intra-ocular pressure elevation, small choroidal effusions, and variable periods of abduction limitation occurred after surgery. In one case of tractional myopic macular schisis, a full correction was achieved by buckling and visual acuity improved.

There has been generally little attention paid to the utilization of biomaterials as an anti-myopia treatment. The purpose of this study was to investigate whether polymeric hydrogels, either implanted or injected adjacent to the outer scleral surface, slow ocular elongation. White Leghorn (gallus gallus domesticus) chicks were used at 2 weeks of age. Chicks had either (1) strip of poly(2-hydroxyethyl methacrylate) (pHEMA) implanted monocularly against the outer sclera at the posterior pole, or (2) an in situ polymerizing gel [main ingredient: poly(vinyl-pyrrolidone) (PVP)] injected monocularly at the same location. Some of the eyes injected with the polymer were fitted with a diffuser or a −10D lens. In each experiment, ocular lengths were measured at regular intervals by high frequency Ascan ultrasonography, and chicks were sacrificed for histology at staged intervals. No in vivo signs of either orbital or ocular inflammation were observed. The pHEMA implant significantly increased scleral thickness by the third week, and the implant became encapsulated with fibrous tissue. The PVP-injected eyes left otherwise untreated, showed a significant increase in scleral thickness, due to increased chondrocyte proliferation and extracellular matrix deposition. However, there was no effect of the PVP injection on ocular elongation. In eyes wearing optical devices, there was no effect on either scleral thickness or ocular elongation. These results represent "proof of principle" that scleral growth can be manipulated without adverse inflammatory responses. However, since neither approach slowed ocular elongation, additional factors must influence scleral surface area expansion in the avian eye.

Периферическому дефокусу отводится значительная роль в формировании рефракции. Перифокальные очки позволяют дифференцированно произвести коррекцию центральной и периферической рефракции глаза по горизонтальному меридиану и исправляют или уменьшают периферическую гиперметропию. Цель исследования-изучить отдаленные результаты влияния ношения перифокальных очков на динамику рефракции у детей с прогрессирующей миопией. Материал и методы. Перифокальные очки назначали детям 7-14 лет с прогрессирующей миопией от (-)1,0 до (-)6,0 дптр по сферэквиваленту рефракции. Обследование детей проводили до назначения очков и через 6 мес, 12-18 мес, 2 года, 3 года и 4 года-5 лет. Проводили визометрию, определение характера зрения, авторефрактометрию до и после циклоплегии, биомикроскопию, офтальмоскопию, биометрию. Периферическую рефракцию исследовали в точках 15° и 30° в носовом (N15 и N30) и височном (T15 и Т30) меридианах без коррекции и в перифокальных очках. Результаты. В перифокальных очках в зоне 15° в 100% глаз формировался миопический дефокус, который составил в среднем (-)0,05±0,1 дптр в T15°, (-)0,25±0,16 дптр в N15° и (-)0,44±0,03 дптр в Т30°. В зоне N30° гиперметропический дефокус уменьшился в 4 раза и составил 0,38±0,03 дптр. Темп прогрессирования миопии снизился с 0,8 дптр (исходное значение) до 0,17 дптр на 4-5-м году наблюдения. Через 6 мес ношения перифокальных очков усиление рефракции составило (-)0,2±0,02 дптр (в контроле (-)0,38±0,04 дптр), через 12-18 мес-(-)0,38±0,04 дптр (в контроле (-)0,63±0,09 дптр), через 2 года-(-)0,78±0,06 дптр (в контроле (-)1,18±0,15 дптр), через 3 года-(-)0,99±0,12 дптр (в контроле (-)1,65±0,20 дптр). За 4 года-5 лет наблюдения усиление рефракции у пациентов основной группы составило (-)1,16±0,2 дптр, что на 60% меньше, чем у пациентов группы контроля-(-)1,95±0,2 дптр. Заключение. Постоянное ношение перифокальных очков снижает темп прогрессирования миопии у детей в 4,5 раза по сравнению с исходным и в 1,6 раза (на 60%) по сравнению с показателями у детей контрольной группы. Перифокальные очки могут быть рекомендованы в качестве оптического средства, способствующего замедлению прогрессирования миопии.

Long-term wear of orthokeratology lenses is able to slow down the axial eye growth, i.e. the progression of myopia.