A Randomized Trial of the Effect of Single-Vision vs. Bifocal Lenses on Myopia Progression in Children with Esophoria

Fulk, George W.; Cyert, Lynn; Parker, Donald E.

doi:10.1097/00006324-200008000-00006

Cited by 185 publications

(122 citation statements)

References 13 publications

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“…17 Prospective studies also supported this finding. 10,14 However, other studies 8,11,12,18,19 have been unable to demonstrate such an effect. Given that myopic children have been found to have high response accommodation convergence to accommodation ratios, 20 those with orthophoria and exophoria who wear positive lenses will have a significant exophoric shift resulting in a higher demand for positive fusional vergence.…”

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confidence: 92%

Randomized Trial of Effect of Bifocal and Prismatic Bifocal Spectacles on Myopic Progression

Cheng¹

2010

Arch Ophthalmol

116

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To determine whether bifocal and prismatic bifocal spectacles could control myopia in children with high rates of myopic progression.Methods: This was a randomized controlled clinical trial. One hundred thirty-five (73 girls and 62 boys) myopic Chinese Canadian children (myopia of Ն1.00 diopters [D]) with myopic progression of at least 0.50 D in the preceding year were randomly assigned to 1 of 3 treatments: (1) single-vision lenses (n = 41), (2) ϩ1.50-D executive bifocals (n = 48), or (3) ϩ1.50-D executive bifocals with a 3-prism diopters base-in prism in the near segment of each lens (n = 46). Main Outcome Measures: Myopic progression measured by an automated refractor under cycloplegia and increase in axial length (secondary) measured by ultrasonography at 6-month intervals for 24 months. Only the data of the right eye were used.Results: Of the 135 children (mean age, 10.29 years [SE, 0.15 years]; mean visual acuity, −3.08 D [SE, 0.10 D]), 131 (97%) completed the trial after 24 months. Myopic progression averaged −1.55 D (SE, 0.12 D) for those who wore single-vision lenses, −0.96 D (SE, 0.09 D) for those who wore bifocals, and −0.70 D (SE, 0.10 D) for those who wore prismatic bifocals. Axial length increased an average of 0.62 mm (SE, 0.04 mm), 0.41 mm (SE, 0.04 mm), and 0.41 mm (SE, 0.05 mm), respectively. The treatment effect of bifocals (0.59 D) and prismatic bifocals (0.85 D) was significant (PϽ.001) and both bifocal groups had less axial elongation (0.21 mm) than the singlevision lens group (P Ͻ.001).Conclusions: Bifocal lenses can moderately slow myopic progression in children with high rates of progression after 24 months.Applications to Clinical Practice: Bifocal spectacles may be considered for slowing myopic progression in children with an annual progression rate of at least 0.50 D.

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confidence: 92%

Randomized Trial of Effect of Bifocal and Prismatic Bifocal Spectacles on Myopic Progression

Cheng¹

2010

Arch Ophthalmol

116

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“…Indeed, myopic eyes are said to have greater lag of accommodation compared with nonmyopic eyes with resultant hyperopic defocus at near. 49 Clinical trials were conducted using bifocal spectacles [50][51][52] with an aim to reduce the accommodative demand but the results were equivocal with some studies showing benefit and others reporting no significant difference. It was suggested that poor compliance and/or improper alignment of the spectacles might have confounded results.…”

Section: Undercorrectionmentioning

confidence: 99%

Practical applications to modify and control the development of ametropia

Sankaridurg¹,

Holden²

2013

Eye

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For many individuals, the developmental trend of lessening hyperopia from birth continues past emmetropia towards myopia during childhood. The global pattern for prevalence of refractive errors indicates that the prevalence of hyperopia is low; in contrast, the burden of myopia is on the rise because of rising prevalence and magnitude of myopia. This review highlights the need to lessen the global burden of myopia by intervening with the development and/or slowing the progression of myopia. Further, outcomes from human clinical trials of pharmaceutical, optical, and environmental approaches to control myopia will be summarised. Pharmaceutical treatments are effective in controlling eye growth but are associated with deleterious side effects. Optical strategies that induce myopic defocus at the retina such as peripheral defocus reducing lenses, simultaneous defocus lenses, bifocals, and orthokeratology as well as environmental influences such as increased outdoor activity show promise and provide a substantially risk-free environment in which to control eye growth.

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“…32 The results suggested that both bifocal and PALs worked well for children with near esophoria and a large lag of accommodation, but they were not really helpful in controlling myopia progression in subjects who had near orthophoria, exophoria, or a small lag of accommodation. [33][34][35][36] To investigate accommodative performance when the subject wore near-addition lenses, Rosenfield and Carrel 37 compared binocular accommodative responses (ARs) to a 40 cm stimulus when the subject was viewing through his distance correction or his distance correction plus +0.75, +1.50, +2.00, or +2.50 D near-addition lens, respectively. They found that the appropriate plus lens which would result in no error of accommodation (no lead or lag) was determined by the subject's initial accommodative error.…”

Section: Dovepressmentioning

confidence: 99%

Effect of customized near addition lenses on transient myopia induced by near-work

Nan¹,

Seger²,

Crandall³

et al. 2010

OPTO

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Purpose: To verify whether optimal near add power can reduce near-work induced transient myopia (NITM). Methods: Eighteen subjects including nine progressive myopes (PMs) and nine stable myopes (SMs) were involved in this study. We measured the accommodative error and the near phoria at 40 cm under fully corrected conditions for each subject. These findings were then used to determine optimal near-add power for each subject based on formulae derived from a previous study. Under both with and without near-add conditions, NITM was obtained by comparing the refractions immediately before and after performing continuous computer work at 40 cm for an hour. The refraction was determined by a COAS aberrometer. Results: Using customized near-addition lenses (C-ADD) we found significantly decreased retinal defocus from 0.49 ± 0.12 (SD) D to 0.08 ± 0.11 D. The near phoria showed a significant exophoric shift from -1.84 ± 1.95 prism diopter (pd) to -5.37 ± 1.63 pd, but was still in the normal range. We also found that the differences in NITM between the two groups and between the two conditions (ie, with and without C-ADD) were both significant. Further comparisons indicated that the NITM in the SM group was significantly reduced after using C-ADD; in the PM group the reduction of NITM was not significant. Conclusions:The results suggest that C-ADD balances the load of accommodation and vergence, significantly decreasing retinal blur during the near-work, and may be able to reduce the NITM.

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A Randomized Trial of the Effect of Single-Vision vs. Bifocal Lenses on Myopia Progression in Children with Esophoria

Abstract: Use of bifocals, instead of single-vision glasses, by children with near-point esophoria seemed to slow myopia progression to a slight degree.

Cited by 185 publications

References 13 publications

Randomized Trial of Effect of Bifocal and Prismatic Bifocal Spectacles on Myopic Progression

Randomized Trial of Effect of Bifocal and Prismatic Bifocal Spectacles on Myopic Progression

Practical applications to modify and control the development of ametropia

Effect of customized near addition lenses on transient myopia induced by near-work

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