Optical Interventions for Myopia Control

Myopia is a common eye problem that is becoming more prevalent worldwide, particularly in East Asia. The cost of long-term care for myopia-related eye diseases significantly impacts the respective economies and places a great burden on the public health services. There is no doubt that myopia is a major East Asian public health concern and a significant concern globally, and effective control of myopia would help to alleviate the costs that are related to this problem. Currently, there are many types of optical interventions involving the use of spectacle lenses or contact lenses to slow down myopia progression in children. However, none of these myopia control methods have been proven to stop the development or progression of myopia completely and each method has their own limitations. Orthokeratology, soft bifocal contact lenses, prismatic bifocals, and myopic defocus incorporated spectacle lenses have all been shown to have clinically meaningful reductions in myopia progression ranging from 45% to 60%. Although pharmaceutical agents such as atropine have relatively better myopia control effects than optical methods, the associated side effects and uncertainty in the safety of long-term atropine use may hinder its widespread clinical application. Optical interventions are non-invasive and have become more popular compared to pharmaceutical treatments. This chapter provides an overview of the optical interventions for slowing myopia progression and their effectiveness in myopia control. Other myopia control methods will also be discussed briefly

Effects of Lubricating Agents with Different Osmolalities on Tear Osmolarity and Other Tear Function Tests in Patients with Dry Eye

Purpose: To evaluate the effects of different artificial tear eye drops on Ocular Surface Disease Index (OSDI), tear osmolarity, Schirmer's I test, and tear break-up time (TBUT) in patients with dry eye disease. Materials and methods: This 12-week, single-institution, single-masked, randomized, pilot study was conducted in Turkey between March and July 2012 in patients with dry eye. Patients were randomly assigned to receive Systane (R) for their right eye and Eyestil (R) for their left eye or to receive Tears Naturale II (R) for their right eye and Refresh Tears (R) for their left eyes. Outcomes were assessed at baseline and weeks 2, 4 and 12 after treatment initiation. Results: Twenty-two patients received Systane (right eye) and Eyestil (left eye) and 21 patients received Tears Naturale (right eye) and Refresh (left eye). At each visit and for each outcome, each treatment group demonstrated a significant improvement from baseline (p<0.001); however, none of these outcomes were significantly different among treatment groups at any visit. At week 12, the mean OSDI improvement was similar between the Systane/Eyestil group (-26.4 +/- 10.6) and the Tears Naturale/Refresh group (-27.6 +/- 14.8). The mean tear osmolarity decrease (mOsm/L) at week 12 was -33.8 +/- 8.3 for Eyestil, -30.3 +/- 9.2 for Refresh, 28.4 +/- 8.2 for Systane and 25.7 +/- 13.1 for Tears Naturale. The mean Schirmer's test increase at week 12 (mm/5 min) was 6.7 +/- 3.4 for Eyestil, 6.4 +/- 2.9 for Systane, 4.7 +/- 2.4 for Tears Naturale and 4.7 +/- 2.8 for Refresh. The mean TBUT increase at week 12 (s) was 7.0 +/- 3.4 for Systane, 6.1 +/- 3.3 for Eyestil, 5.8 +/- 2.3 for Tears Naturale, and 5.6 +/- 2.8 for Refresh. Conclusion: All four artificial tear formulations were effective in relieving dry eye signs and symptoms. Although the greatest improvement in two of the objective tests was achieved by Eyestil, the drug with the lowest osmolality, differences among the four artificial tear eye drops were not statistically significant.Canakkale Onsekiz Mart University, Scientific Research Project Center [2010/121]This research is funded by Canakkale Onsekiz Mart University, Scientific Research Project Center. Project number: 2010/121