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Speaker: Correcting peripheral refraction, time outdoors provides meaningful myopia control
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NEW YORK – Correcting peripheral refractive error in children with myopia seems to, according to the evidence, have a therapeutic effect on the child’s eyes, a lecturer said during a continuing education session here at Vision Expo East.
In the pursuit of meaningful myopia control, defined as at least a 50% reduction in the progression of myopia, modern vision science has to date developed only two methods that achieve this goal: multifocal soft contact lenses and orthokeratology, which both target peripheral refractive errors, Pat Caroline, FAAO, said during a lecture.
“We have to remember that whatever we do to correct the child’s peripheral refractive error, we are going to increase spherical aberration,” Caroline said. “It is the spherical aberration that seems to have that myopia-controlling component.
“And the beauty of this is that these children are extremely adaptable and they adjust incredibly well to this increase in spherical aberration,” he added.
The outdoors also seem to provide a therapeutic effect, according to Caroline. The wide open spaces cause less accommodative stress, and even the sunlight contributes via the vitamin D and dopamine levels in the retina.
Vision science is close to the target of 50% reduction in myopia progression with these optical interventions, he said, but it is exciting to think about what could be done by combining them with the latest pharmacological interventions to augment that result. For example, consider what could be accomplished by combining orthokeratology with a 0.01% atropine drop, which has been shown to have a relatively equivalent outcome as the 0.1% concentration, but without the negative side effects.
“That’s a very intriguing proposition to think about down the road,” Caroline said.