Articles about Eye Health and Disease 2002
 

Interventions to Decrease the Worsening of Nearsightedness in Children: Are They Effective?

(From Sean-Mei Saw, Ophthalmology 2002;109:415-427).

 The rate of nearsightedness (myopia) is rising rapidly in several Asian countries, with the rate being at least 60% of young adults.  In the United States and Europe, the rate of nearsightedness is 20% to 50%.  The rate of progression is highest in young children, stabilizing around age 16.  There are many theories that attempt to explain the development and worsening of nearsightedness, and several interventions have been attempted to stop the worsening of nearsightedness based on these theories.  These include:

• The use of contact lenses in children to flatten the curvature of the cornea to retard growth in the length of the eye.

• Use of Atropine eye drops to slow growth of the eye.

• Use of eye pressure lowering eye drops (otherwise used to treat glaucoma) to reduce growth in the length of the eye.

• Use of bifocal glasses in children to prevent growth of the length of the eye by reducing the need to focus.

Conflicting results have been published in the literature about whether or not these techniques are effect at reducing the worsening of nearsightedness in children.  The study cited above evaluated published studies from 1968 to 2000 to compare evidence of effectiveness in decreasing the progression of nearsightedness in children.

Ten clinical trials of different interventions were evaluated.  While the use of Atropine eye drops was found effective in 3 clinical trials, the use of eye drops to lower eye pressure, the use of bifocal spectacles, and the use of contact lenses were all found ineffective.

The investigators concluded that there is insufficient evidence to support the use of interventions to prevent the progression of nearsightedness.

 

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