Prevention of Refractive Errors
Over the years, many treatments have been proposed to prevent or slow the progression of myopia. Because accommodation is a postulated mechanism for the progression of myopia, optical correction through the use of bifocal or multifocal spectacles or the removal of distance spectacles when performing close work has been recommended to reduce the progression of myopia. Administration of atropine eyedrops also has long been proposed because it inhibits accommodation, which may exert forces on the eye that result in axial elongation. Studies have suggested a protective effect of low-dose atropine (eg, 0.01% eye drops), even in the absence of evident cycloplegia. Use of a drug that lowers intraocular pressure has been suggested as an alternative pharmacologic intervention; this approach works presumably by reducing internal pressure on the eyewall. It has also been postulated that use of rigid contact lenses could slow the progression of myopia in children. Visual training purported to reduce myopia includes convergence exercises and those that incorporate changes in near–far focus.
The need to correct refractive errors depends on the patient’s symptoms and visual needs. Patients with low refractive errors may not require correction, and small changes in refractive corrections in asymptomatic patients are not generally recommended. Correction options include spectacles, contact lenses, or surgery. Various occupational and recreational requirements, as well as personal preferences, affect the specific choices for any individual patient.
Excerpted from BCSC 2020-2021 series : Section 3 - Clinical Optics. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.