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<p><strong>Myopia</strong> (from Greek: &mu;&upsilon;&omega;&pi;ί&alpha; <em>myopia</em> &quot;near-sightedness&quot;<sup class="reference" id="_ref-0">[1]</sup>), also called <strong>near-</strong> or <strong>short-sightedness</strong>, is a refractive defect of the eye in which collimated light produces image focus in front of the retina when accommodation is relaxed.</p> <p>Those with myopia see nearby objects clearly but distant objects appear blurred. With myopia, the eyeball is too long, or the cornea is too steep, so images are focused in the vitreous inside the eye rather than on the retina at the back of the eye. The opposite defect of myopia is hyperopia or &quot;farsightedness&quot; or &quot;long-sightedness&quot; &mdash; this is where the cornea is too flat or the eye is too short.</p> <p>Mainstream ophthalmologists and optometrists most commonly correct myopia through the use of corrective lenses, such as glasses or contact lenses. It may also be corrected by refractive surgery, such as LASIK. The corrective lenses have a negative optical power (i.e. are concave) which compensates for the excessive positive diopters of the myopic eye. In some cases, pinhole glasses are used by patients with low-level myopia. These work by reducing the blur circle formed on the retina.</p> <p>&nbsp;</p> <h2><span class="mw-headline">Classification</span></h2> <p>Myopia has been classified in various manners.<sup class="reference" id="_ref-Grosvenor_0">[2]</sup><sup class="reference" id="_ref-Borish_0">[3]</sup><sup class="reference" id="_ref-Duke-Elder_0">[4]</sup></p> <p>&nbsp;</p> <h3><span class="mw-headline">Etiology</span></h3> <p>Borish and Duke-Elder classified myopia by cause:<sup class="reference" id="_ref-Borish_1">[3]</sup><sup class="reference" id="_ref-Duke-Elder_1">[4]</sup></p> <ul> <li><strong>Axial myopia</strong> is attributed to an increase in the eye's axial length.<sup class="reference" id="_ref-Cline_0">[5]</sup> </li> <li><strong>Refractive myopia</strong> is attributed to the condition of the refractive elements of the eye.<sup class="reference" id="_ref-Cline_1">[5]</sup> Borish further subclassified refractive myopia:<sup class="reference" id="_ref-Borish_2">[3]</sup> </li> </ul> <dl><dd> <ul> <li><strong>Curvature myopia</strong> is attributed to excessive, or increased, curvature of one or more of the refractive surfaces of the eye, especially the cornea.<sup class="reference" id="_ref-Cline_2">[5]</sup> In those with Cohen syndrome, myopia appears to result from high corneal and lenticular power.<sup class="reference" id="_ref-1">[6]</sup> </li> <li><strong>Index myopia</strong> is attributed to variation in the index of refraction of one or more of the ocular media.<sup class="reference" id="_ref-Cline_3">[5]</sup> </li> </ul> </dd></dl> <p>&nbsp;</p> <h3><span class="mw-headline">Clinical entity</span></h3> <p>Various forms of myopia have been described by their clinical appearance:<sup class="reference" id="_ref-Duke-Elder_2">[4]</sup><sup class="reference" id="_ref-Goss_0">[7]</sup></p> <ul> <li><strong>Simple myopia</strong> is more common than other types of myopia and is characterized by an eye that is too long for its optical power (which is determined by the cornea and crystalline lens) or optically too powerful for its axial length.<sup class="reference" id="_ref-AOA_0">[8]</sup> Both genetic and environmental factors, particularly significant amounts of near work, are thought to contribute to the development of simple myopia.<sup class="reference" id="_ref-AOA_1">[8]</sup> </li> <li><strong>Degenerative myopia</strong>, also known as <strong>malignant, pathological, or progressive myopia</strong>, is characterized by marked fundus changes, such as posterior staphyloma, and associated with a high refractive error and subnormal visual acuity after correction.<sup class="reference" id="_ref-Cline_4">[5]</sup> This form of myopia gets progressively worse over time. Degenerative myopia has been reported as one of the main causes of visual impairment.<sup class="reference" id="_ref-2">[9]</sup> Myopia with degenerative changes has been described as being very common in certain races and cultures, such as Chinese, Japanese, Arab, and Jewish people.<sup class="reference" id="_ref-Verma_0">[10]</sup> </li> <li><strong>Nocturnal myopia</strong>, also known as <em>night myopia</em> or <em>twilight myopia</em>, is a condition in which the eye has a greater difficulty seeing in low illumination areas, even though its daytime vision is normal. Essentially, the eye's far point of an individual's focus varies with the level of light. Night myopia is believed to be caused by pupils dilating to let more light in, which adds aberrations resulting in becoming more nearsighted. A stronger prescription for myopic night drivers is often needed. Younger people are more likely to be affected by night myopia than the elderly.<sup class="reference" id="_ref-3">[11]</sup> </li> <li><strong>Pseudomyopia</strong> is the blurring of distance vision brought about by spasm of the ciliary muscle.<sup class="reference" id="_ref-Cassin_0">[12]</sup> </li> <li><strong>Induced myopia</strong>, also known as <strong>acquired myopia</strong>, results from exposure to various pharmaceuticals, increases in glucose levels, nuclear sclerosis, or other anomalous conditions.<sup class="reference" id="_ref-AOA_2">[8]</sup> The encircling bands used in the repair of retinal detachments may induce myopia by increasing the axial length of the eye.<sup class="reference" id="_ref-4">[13]</sup> </li> </ul> <dl><dd> <ul> <li><strong>Index myopia</strong> is attributed to variation in the index of refraction of one or more of the ocular media.<sup class="reference" id="_ref-Cline_5">[5]</sup> Cataracts may lead to index myopia.<sup class="reference" id="_ref-5">[14]</sup> </li> <li><strong>Form deprivation myopia</strong> is a type of myopia that occurs when the eye is deprived of clear form vision.<sup class="reference" id="_ref-Shen_0">[15]</sup> Myopia is often induced this way in various animal models to study the pathogenesis and mechanism of myopia development.<sup class="reference" id="_ref-Shen_1">[15]</sup> </li> </ul> </dd></dl> <p>&nbsp;</p> <h3><span class="mw-headline">Degree</span></h3> <p>Myopia, which is measured in diopters by the strength or optical power of a corrective lens that focuses distant images on the retina, has also been classfied by degree or severity:<sup class="reference" id="_ref-Grosvenor_1">[2]</sup></p> <ul> <li><strong>Low myopia</strong> usually describes myopia of &minus;3.00 diopters or less.<sup class="reference" id="_ref-Cline_6">[5]</sup> </li> <li><strong>Medium myopia</strong> usually describes myopia between &minus;3.00 and &minus;6.00 diopters.<sup class="reference" id="_ref-Cline_7">[5]</sup> Those with moderate amounts of myopia are more likely to have pigment dispersion syndrome or pigmentary glaucoma.<sup class="reference" id="_ref-6">[16]</sup> </li> <li><strong>High myopia</strong> usually describes myopia of &minus;6.00 or more.<sup class="reference" id="_ref-Cline_8">[5]</sup> People with high myopia are more likely to have retinal detachments<sup class="reference" id="_ref-7">[17]</sup> and primary open angle glaucoma.<sup class="reference" id="_ref-8">[18]</sup> They are also more likely to experience floaters, shadow-like shapes which appear singly or in clusters in the field of vision.<sup class="noprint Template-Fact"><span title="This claim needs references to reliable sources since February 2007" style="WHITE-SPACE: nowrap">[<em>citation needed</em>]</span></sup> Roughly 30% of myopes have high myopia.<sup class="reference" id="_ref-Verma_1">[10]</sup> </li> </ul> <p>&nbsp;</p> <h3><span class="mw-headline">Age of onset</span></h3> <p>Myopia is sometimes classified by the age of onset:<sup class="reference" id="_ref-Grosvenor_2">[2]</sup></p> <ul> <li><strong>Congenital myopia</strong>, also known as <strong>infantile myopia</strong>, is present at birth and persists through infancy.<sup class="reference" id="_ref-AOA_3">[8]</sup> </li> <li><strong>Youth onset myopia</strong> occurs prior to age 20.<sup class="reference" id="_ref-AOA_4">[8]</sup> </li> </ul> <dl><dd> <ul> <li><strong>School myopia</strong> appears during childhood, particularly the school-age years.<sup class="reference" id="_ref-Morgan_1_0">[19]</sup> This form of myopia is attributed to the use of the eyes for close work during the school years.<sup class="reference" id="_ref-Cline_9">[5]</sup> </li> </ul> </dd></dl> <ul> <li><strong>Adult onset myopia</strong> </li> </ul> <dl><dd> <ul> <li><strong>Early adult onset myopia</strong> occurs between ages 20 and 40.<sup class="reference" id="_ref-AOA_5">[8]</sup> </li> <li><strong>Late adult onset myopia</strong> occurs after age 40.<sup class="reference" id="_ref-AOA_6">[8]</sup> </li> </ul> </dd></dl> <p>&nbsp;</p> <h2><span class="mw-headline">Epidemiology</span></h2> <p>The global prevalence of refractive errors has been estimated from 800 million to 2.3 billion.<sup class="reference" id="_ref-9">[20]</sup> The incidence of myopia within sampled population often varies with age, country, sex, race, ethnicity, occupation, environment, and other factors.<sup class="reference" id="_ref-Verma_2">[10]</sup><sup class="reference" id="_ref-Fredrick_0">[21]</sup> Variability in testing and data collection methods makes comparisons of prevalence and progression difficult.<sup class="reference" id="_ref-10">[22]</sup></p> <p>In some areas, such as Japan, Singapore and Taiwan, up to 44% of the adult population is myopic.<sup class="noprint Template-Fact"><span title="This claim needs references to reliable sources since February 2007" style="WHITE-SPACE: nowrap">[<em>citation needed</em>]</span></sup></p> <p>A recent study involving first-year undergraduate students in the United Kingdom found that 50% of British whites and 53.4% of British Asians were myopic.<sup class="reference" id="_ref-11">[23]</sup></p> <p>In Australia, the overall prevalence of myopia (worse than &minus;0.50 diopters) has been estimated to be 17%.<sup class="reference" id="_ref-12">[24]</sup> In one recent study, less than 1 in 10 (8.4%) Australian children between the ages of 4 and 12 were found to have myopia greater than &minus;0.50 diopters.<sup class="reference" id="_ref-13">[25]</sup> A recent review found that 16.4% of Australians aged 40 or over have at least &minus;1.00 diopters of myopia and 2.5% have at least &minus;5.00 diopters.<sup class="reference" id="_ref-14">[26]</sup></p> <p>In Brazil, a 2005 study estimated that 6.4% of Brazilians between the ages of 12 and 59 had &minus;1.00 diopter or myopia or more, compared with 2.7% of the indigenous people in northwestern Brazil.<sup class="reference" id="_ref-15">[27]</sup> Another found nearly 1 in 8 (13.3%) of the students in one city were myopic.<sup class="reference" id="_ref-16">[28]</sup></p> <p>In Greece, the prevalence of myopia among 15 to 18 year old students was found to be 36.8%.<sup class="reference" id="_ref-Mavracanas_0">[29]</sup></p> <p>In India, the prevalence of myopia in the general population has been reported to be only 6.9%.<sup class="reference" id="_ref-17">[30]</sup><sup class="reference" id="_ref-Mavracanas_1">[29]</sup></p> <p>A recent review found that 26.6% of Western Europeans aged 40 or over have at least &minus;1.00 diopters of myopia and 4.6% have at least &minus;5.00 diopters.<sup class="reference" id="_ref-18">[31]</sup></p> <p>In the United States, the prevalence of myopia has been estimated at 20%.<sup class="reference" id="_ref-Verma_3">[10]</sup> Nearly 1 in 10 (9.2%) American children between the ages of 5 and 17 have myopia.<sup class="reference" id="_ref-19">[32]</sup> Approximately 25% of Americans between the ages of 12 and 54 have the condition.<sup class="reference" id="_ref-Sperduto_0">[33]</sup> A recent review found that 25.4% of Americans aged 40 or over have at least &minus;1.00 diopters of myopia and 4.5% have at least &minus;5.00 diopters.<sup class="reference" id="_ref-20">[34]</sup></p> <p>A study of Jordanian adults aged 17 to 40 found that over half (53.7%) were myopic.<sup class="reference" id="_ref-21">[35]</sup></p> <p>&nbsp;</p> <h3><span class="mw-headline">Ethnicity and race</span></h3> <p>The prevalence of myopia in has been reported as high as 70-90% in some Asian countries. 30-40% in Europe and the United States, and 10-20% in Africa.<sup class="reference" id="_ref-Fredrick_1">[21]</sup></p> <p>Myopia is less common in black, Nubians, and Sudanese people.<sup class="reference" id="_ref-Verma_4">[10]</sup> In Americans between the ages of 12 and 54, myopia has been found to affect whites less than blacks.<sup class="reference" id="_ref-Sperduto_1">[33]</sup>. Asians had the highest prevalence (18.5%), followed by Hispanics (13.2%). Whites had the lowest prevalence of myopia (4.4%), which was not significantly different from African Americans (6.6%). For hyperopia, whites had the highest prevalence (19.3%), followed by Hispanics (12.7%). Asians had the lowest prevalence of hyperopia (6.3%) and were not significantly different from African Americans (6.4%). For astigmatism, Asians and Hispanics had the highest prevalences (33.6% and 36.9%, respectively) and did not differ from each other (P = .17). African Americans had the lowest prevalence of astigmatism (20.0%), followed by whites (26.4%)<sup class="reference" id="_ref-22">[36]</sup>.</p> <p><br /> </p> <p>&nbsp;</p> <h3><span class="mw-headline">Education, intelligence, and IQ</span></h3> <p>A number of studies have shown that the prevalence of myopia increases with level of education <sup class="reference" id="_ref-Sperduto_2">[33]</sup><sup class="reference" id="_ref-Mavracanas_2">[29]</sup> and many studies have shown a relationship between myopia and IQ. However, care must be taken in interpreting these results as correlation does not imply causation.</p> <p>According to Arthur Jensen, myopes average 7-8 IQ points higher than non-myopes. The relationship also holds within families, and siblings with a higher degree of refraction error average higher IQs than siblings with less refraction error. Jensen believes that this indicates myopia and IQ are pleiotropically related as they are caused or influenced by the same genes. The mechanism that has caused a relationship between myopia and IQ is not yet known with certainty <sup class="noprint Template-Fact"><span title="This claim needs references to reliable sources since May 2007" style="WHITE-SPACE: nowrap">[<em>citation needed</em>]</span></sup>.</p> <p>&nbsp;</p> <h2><span class="mw-headline">Etiology and pathogenesis</span></h2> <p>Because in the most common, &quot;simple&quot; myopia, the eye length is too long, any etiologic explanation must account for such axial elongation. To date, no single theory has been able to satisfactorily explain this elongation.</p> <p>In the early 1900s, William Bates controversially asserted that myopia, as with all refractive errors, resulted from a particular type of &quot;eyestrain&quot; that was itself a result of &quot;mental strain&quot;.<sup class="reference" id="_ref-23">[37]</sup> He stated that the shape of the eyeball responded instantaneously to the action of the extraocular muscles upon it<sup class="reference" id="_ref-24">[38]</sup> and that myopia was produced due to contraction of the inferior oblique and superior oblique muscles which lengthened the eye.<sup class="reference" id="_ref-25">[39]</sup> According to Bates, myopia was associated with a &quot;strain&quot; to see distance objects rather than near work.<sup class="reference" id="_ref-26">[40]</sup> Bates theories were rejected by mainstream ophthalmologists of his time and remain so today. <sup class="reference" id="_ref-Bradley_0">[41]</sup><sup class="reference" id="_ref-Rawstron_0">[42]</sup></p> <p>In the mid-1900s, mainstream ophthalmologists and optometrists believed myopia to be primarily hereditary; the influence of near work in its development seemed &quot;incidental&quot; and the increased prevalence of the condition with increasing age was viewed as a &quot;statistical curiosity&quot;.<sup class="reference" id="_ref-Borish_3">[3]</sup><sup class="reference" id="_ref-Duke-Elder_3">[4]</sup><sup class="reference" id="_ref-Mutti_0">[43]</sup></p> <p>Among mainstream researchers and eye care professionals, myopia is now thought to be a combination of genetic and environmental factors.<sup class="reference" id="_ref-AOA_7">[8]</sup><sup class="reference" id="_ref-Morgan_1_1">[19]</sup></p> <p>There are currently two basic mechanisms believed to cause myopia: form deprivation (also known as pattern deprivation<sup class="reference" id="_ref-27">[44]</sup>) and optical defocus.<sup class="reference" id="_ref-Saw_1_0">[45]</sup> Form deprivation occurs when the image quality on the retina is reduced; optical defocus occurs when light focus in front of or behind the retina. Numerous experiments with animals have shown that myopia can be artificially generated by inducing either of these conditions. In animal models wearing negative spectacle lenses, axial myopia has been shown to occur as the eye elongates to compensate for optical defocus.<sup class="reference" id="_ref-Saw_1_1">[45]</sup> The exact mechanism of this image-controlled elongation of the eye is still unknown.<sup class="noprint Template-Fact"><span title="This claim needs references to reliable sources since February 2007" style="WHITE-SPACE: nowrap">[<em>citation needed</em>]</span></sup> It has been suggested that accommodative lag leads to blur (i.e. optical defocus) which in turn stimulates axial elongation and myopia.<sup class="reference" id="_ref-28">[46]</sup></p> <p>&nbsp;</p> <h3><span class="mw-headline">Theories</span></h3> <ul> <li><strong>Combination of genetic and environmental factors</strong> &mdash; In China, myopia is more common in those with higher education background<sup class="reference" id="_ref-Xu_0">[47]</sup> and some studies suggest that near work may exacerbate a genetic predisposition to develop myopia.<sup class="reference" id="_ref-Wolffsohn_0">[48]</sup> Other studies have shown that near work (reading, computer games) may not be associated with myopic progression, however<sup class="reference" id="_ref-29">[49]</sup>. A &quot;genetic susceptibility&quot; to environmental factors has been postulated as one explanation for the varying degrees of myopia among individuals or populations,<sup class="reference" id="_ref-Hammond_0">[50]</sup> but there exists some difference of opinion as to whether it exists.<sup class="reference" id="_ref-Morgan_1_2">[19]</sup><sup class="reference" id="_ref-Morgan_2_0">[51]</sup> High heritability simply means that most of the variation in a particular population at a particular time is due to genetic differences. If the environment changes &mdash; as, for example, it has by the introduction of televisions and computers &mdash; the incidence of myopia can change as a result, even though heritability remains high. From a slightly different point of view it could be concluded that &mdash; determined by heritage &mdash; some people are at a higher risk to develop myopia when exposed to modern environmental conditions with a lot of extensive near work like reading. In other words, it is often not the myopia itself which is inherited, but the reaction to specific environmental conditions &mdash; and this reaction can be the onset and the progression of myopia. </li> </ul> <ul> <li><strong>Genetic factors</strong> &mdash; The wide variability of the prevalence of myopia in different ethnic groups has been reported as additional evidence supporting the role of genetics in the development of myopia.<sup class="reference" id="_ref-30">[52]</sup> Measures of the heritability of myopia have yielded figures as high as 89%, and recent research has identified genes that may be responsible: defective versions of the PAX6 gene seem to be associated with myopia in twin studies [1]. Under this theory, the eye is slightly elongated front to back as a result of faults during development, causing images to be focused in front of the retina rather than directly on it. It is usually discovered during the pre-teen years between eight and twelve years of age. It most often worsens gradually as the eye grows during adolescence and then levels off as a person reaches adulthood. Genetic factors can work in various biochemical ways to cause myopia, a weak or degraded connective tissue is a very essential one. Genetic factors include an inherited, increased susceptibility for environmental influences like excessive near work, and the fact that some people do not develop myopia in spite of very adverse conditions is a clear indication that heredity is involved somehow in any case. </li> </ul> <ul> <li><strong>Environmental factors</strong> &mdash; It has been suggested that a genetic susceptibility to myopia does not exist.<sup class="reference" id="_ref-Morgan_1_3">[19]</sup> A high heritability of myopia (as for any other condition) does not mean that environmental factors and lifestyle have no effect on the development of the condition. Some recommend a variety of eye exercises to strengthen the ciliary muscle. Other theories suggest that the eyes become strained by the constant extra work involved in &quot;nearwork&quot; and get stuck in the near position, and eye exercises can help loosen the muscles up thereby freeing it for far vision. These primarily mechanical models appear to be in contrast to research results, which show that the myopic elongation of the eye can be caused by the image quality, with biochemical processes as the actuator. Common to both views is, however, that extensive near work and corresponding accommodation can be essential for the onset and the progression of myopia. </li> </ul> <dl><dd>One Austrian study confirmed that the axial length of the eye does mildly increase while reading, but attributed this elongation due to contraction of the ciliary muscle during accommodation (the process by which the eye increases optical power to maintain a clear image focus), not &ldquo;squeezing&rdquo; of the extraocular muscles.<sup class="reference" id="_ref-31">[53]</sup> </dd></dl><dl><dd>Near work and nightlight exposure in childhood have been hypothesized as environmental risk factors for myopia.<sup class="reference" id="_ref-Saw_2_0">[54]</sup> Although one initial study indicated a strong association between myopia and nightlight exposure,<sup class="reference" id="_ref-32">[55]</sup> recent research has found none.<sup class="reference" id="_ref-Saw_2_1">[54]</sup><sup class="reference" id="_ref-33">[56]</sup><sup class="reference" id="_ref-34">[57]</sup><sup class="reference" id="_ref-35">[58]</sup> <ul> <li>Near work. Near work has been implicated as a contributing factor to myopia in some studies, but refuted in others<sup class="reference" id="_ref-36">[59]</sup>. One recent study suggested that students exposed to extensive &quot;near work&quot; may be at a higher risk of developing myopia, whereas extended breaks from near work during summer or winter vacations may retard myopic progression [2]. Near work in certain cultures (e.g. Vanuatu) does not result in greater myopia[3][4][5][6]. It has been hypothesized that this outcome may be a results of genetics or environmental factors such as diet or over-illumination, changes in which seem to occur in Asian, Vanuatu and Inuit cultures acclamating to intensive early studies[7]. </li> <li>Diet and nutrition - One 2002 article suggested that myopia may be caused by over-consumption of bread in childhood, or in general by diets too rich in carbohydrates, which can lead to chronic hyperinsulinemia. Various other components of the diet, however, were made responsible for contributing to myopia as well, as summarized in a documentation. </li> <li>Stress has been postulated as a factor in the development of myopia.<sup class="reference" id="_ref-37">[60]</sup> </li> </ul> </dd></dl> <p>&nbsp;</p> <h3><span class="mw-headline">Relevant research</span></h3> <ul> <li>A Turkish study found that accommodative convergence, rather than accommodation, may be a factor in the onset and progression of myopia in adults.<sup class="reference" id="_ref-38">[61]</sup> </li> <li>A recent Polish study revealed that &quot;with-the-rule astigmatism&quot; may lead to the creation of myopia.<sup class="reference" id="_ref-39">[62]</sup> </li> </ul> <p>&nbsp;</p> <h2><span class="mw-headline">Presbyopia and the 'payoff' for the nearsighted</span></h2> <p>Many people with myopia are able to read comfortably without eyeglasses. Myopes considering refractive surgery are advised that this may be a disadvantage after the age of 40 when the eyes become presbyopic and lose their ability to accommodate or change focus.</p> <p>&nbsp;</p> <h2><span class="mw-headline">Diagnosis</span></h2> <p>A diagnosis of myopia is typically confirmed during an eye examination by an ophthalmologist or an optometrist. Frequently an autorefractor or retinoscope is used to give an initial objective assessment of the refractive status of each eye, then a phoropter is used to subjectively refine the patient's eyeglass prescription.</p> <p>&nbsp;</p> <h2><span class="mw-headline">Treatment, management, and prevention</span></h2> <div class="thumb tright"> <div class="thumbinner" style="WIDTH: 182px"><img class="thumbimage" height="101" alt="Glasses are commonly used to address short-sightedness." width="180" border="0" src="http://upload.wikimedia.org/wikipedia/commons/thumb/a/af/Briller2.JPG/180px-Briller2.JPG" /> <div class="thumbcaption"> <div class="magnify" style="FLOAT: right"><img height="11" alt="" width="15" src="http://en.wikipedia.org/skins-1.5/common/images/magnify-clip.png" /></div> Glasses are commonly used to address short-sightedness.</div> </div> </div> <p>Eyeglasses, contact lenses, and refractive surgery are the primary options to treat the visual symptoms of those with myopia. Orthokeratology is the practice of using special rigid contact lenses to flatten the cornea to reduce myopia.</p> <p>&nbsp;</p> <h3><span class="mw-headline">Eye-exercises and biofeedback</span></h3> <p>Practitioners and advocates of alternative therapies often recommend eye exercises and relaxation techniques such as the Bates method. However, the efficacy of these practices is disputed by scientists and eye care practitioners. <sup class="reference" id="_ref-Bradley_1">[41]</sup> A 2005 review of scientific papers on the subject concluded that there was &quot;no clear scientific evidence&quot; that eye exercises were effective in treating myopia. <sup class="reference" id="_ref-Rawstron_1">[42]</sup></p> <p>In the eighties and nineties, there was a flurry of interest in biofeedback as a possible treatment for myopia. A 1997 review of this biofeedback research concluded that &quot;controlled studies to validate such methods ... have been rare and contradictory.&quot; <sup class="reference" id="_ref-Rupolo_0">[63]</sup> It was found in one study that <strong class="selflink">myopes</strong> could improve their visual acuity with biofeedback training, but that this improvement was &quot;instrument-specific&quot; and did not generalise to other measures or situations. <sup class="reference" id="_ref-Randle_0">[64]</sup> In another study an &quot;improvement&quot; in visual acuity was found but the authors concluded that this could be a result of subjects learning the task <sup class="reference" id="_ref-Gallaway_0">[65]</sup> Finally, in an evaluation of a training system designed to improve acuity, &quot;no significant difference was found between the control and experimental subjects&quot; <sup class="reference" id="_ref-Koslowe_0">[66]</sup></p> <p>&nbsp;</p> <h3><span class="mw-headline">Prevention</span></h3> <p>There is no universally accepted method of preventing myopia.<sup class="reference" id="_ref-AOA_8">[8]</sup> Some clinicians and researchers recommend plus power (convex) lenses in the form of single vision reading lenses or bifocals. <sup class="reference" id="_ref-AOA_9">[8]</sup> <sup class="reference" id="_ref-Rehm_0">[67]</sup> A recent Malaysian study reported in <em>New Scientist</em><sup class="reference" id="_ref-NS_0">[68]</sup> suggested that undercorrection of myopia caused more rapid progression of myopia,<sup class="reference" id="_ref-40">[69]</sup> However, the reliability of this data has been called into question.<sup class="reference" id="_ref-Wildoset_0">[70]</sup> Many myopia treatment studies suffer from any of a number of design drawbacks: small numbers, lack of adequate control group, failure to mask examiners from knowledge of treatments used, etc.</p> <p>Pirenzepine eyedrops had a limited effect on retarding myopic progression in a recent, placebo-control, double-blinded prospective controlled study <sup class="reference" id="_ref-Siatkowski_0">[71]</sup>.</p> <p>&nbsp;</p> <h3><span class="mw-headline">Myopia control</span></h3> <p>Various methods have been employed in an attempt to decrease the progression of myopia.<sup class="reference" id="_ref-Saw_1_2">[45]</sup> Altering the use of eyeglasses between full-time, part-time, and not at all does not appear to alter myopia progression.<sup class="reference" id="_ref-41">[72]</sup><sup class="reference" id="_ref-42">[73]</sup> Bifocal and progressive lenses have not shown significant differences in altering the progression of myopia.<sup class="reference" id="_ref-Saw_1_3">[45]</sup></p> <p>&nbsp;</p> <h2><span class="mw-headline">Myopia as metaphor</span></h2> <p>The terms <em>myopia</em> and <em>myopic</em> have also been used metaphorically to refer to cognitive thinking and decision making that is narrow sighted or lacking in concern for wider or long-term consequences.</p> <p>&nbsp;</p> <h2><span class="mw-headline">See also</span></h2> <ul> <li>Astigmatism (eye) </li> <li>Optician </li> <li>Relaxed selection </li> </ul> <p>&nbsp;</p> <h2><span class="mw-headline">References</span></h2> <div class="references-small" style="-moz-column-count: 3; -webkit-column-count: 3; column-count: 3"> <ol class="references"> <li id="_note-0"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-0">^</a></strong> <a class="external free" title="http://www.etymonline.com/index.php?term=myopia" rel="nofollow" href="http://www.etymonline.com/index.php?term=myopia">http://www.etymonline.com/index.php?term=myopia</a> </li> <li id="_note-Grosvenor">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Grosvenor_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Grosvenor_1">^{<em><strong>b</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Grosvenor_2">^{<em><strong>c</strong></em>}</a> Grosvenor T. &quot;A review and a suggested classification system for myopia on the basis of age-related prevalence and age of onset.&quot; <em>Am J Optom Physiol Opt.</em> 1987 Jul;64(7):545-54. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=3307441" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=3307441">PMID 3307441</a> </li> <li id="_note-Borish">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Borish_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Borish_1">^{<em><strong>b</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Borish_2">^{<em><strong>c</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Borish_3">^{<em><strong>d</strong></em>}</a> Borish, Irvin M. (1949). <em>Clinical Refraction</em>. Chicago: The Professional Press. </li> <li id="_note-Duke-Elder">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Duke-Elder_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Duke-Elder_1">^{<em><strong>b</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Duke-Elder_2">^{<em><strong>c</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Duke-Elder_3">^{<em><strong>d</strong></em>}</a> Duke-Elder, Sir Stewart (1969). <em>The Practice of Refraction</em> (8th ed.). St. Louis: The C.V. Mosby Company. <a class="internal" href="http://en.wikipedia.org/w/index.php?title=Special:Booksources&amp;isbn=0700014101">ISBN 0-7000-1410-1</a>. </li> <li id="_note-Cline">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_1">^{<em><strong>b</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_2">^{<em><strong>c</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_3">^{<em><strong>d</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_4">^{<em><strong>e</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_5">^{<em><strong>f</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_6">^{<em><strong>g</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_7">^{<em><strong>h</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_8">^{<em><strong>i</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cline_9">^{<em><strong>j</strong></em>}</a> <cite class="book" id="Reference-Cline-1997" style="FONT-STYLE: normal">Cline, D; Hofstetter HW; Griffin JR (1997). <em>Dictionary of Visual Science</em>, 4th ed, Boston: Butterworth-Heinemann. <a class="internal" href="http://en.wikipedia.org/w/index.php?title=Special:Booksources&amp;isbn=0750698950">ISBN 0-7506-9895-0</a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Dictionary+of+Visual+Science&amp;rft.aulast=Cline&amp;rft.aufirst=D&amp;rft.edition=4th+ed&amp;rft.pub=Butterworth-Heinemann&amp;rft.place=Boston&amp;rft.isbn=0-7506-9895-0">&nbsp;</span> </li> <li id="_note-1"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-1">^</a></strong> <cite style="FONT-STYLE: normal">Summanen, P; Kivitie-Kallio, S; Norio, R; Raitta, C; Kivel&auml;, T (2002). &quot;Mechanisms of myopia in Cohen syndrome mapped to chromosome 8q22&quot;. <em>Invest. Ophthalmol. Vis. Sci.</em> <strong>43</strong> (5): 1686&ndash;1693. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=11980891" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=11980891">PMID 11980891</a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Mechanisms+of+myopia+in+Cohen+syndrome+mapped+to+chromosome+8q22&amp;rft.jtitle=Invest.+Ophthalmol.+Vis.+Sci.&amp;rft.date=2002&amp;rft.volume=43&amp;rft.issue=5&amp;rft.aulast=Summanen&amp;rft.aufirst=P&amp;rft.pages=1686%E2%80%931693&amp;rft_id=info:pmid/11980891">&nbsp;</span> </li> <li id="_note-Goss"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Goss_0">^</a></strong> <cite class="book" id="Reference-Goss-1988" style="FONT-STYLE: normal">Goss, DA; Eskridge JB (1988). &quot;Myopia&quot;, in Amos, JB (ed): <a class="new" title="Template:Cite book/editor" href="http://en.wikipedia.org/w/index.php?title=Template:Cite_book/editor&amp;action=edit"></a><em>Diagnosis and management in vision care</em>. Boston: Butterworths, 445. <a class="internal" href="http://en.wikipedia.org/w/index.php?title=Special:Booksources&amp;isbn=0409950823">ISBN 0409950823</a>. <a title="OCLC" href="http://en.wikipedia.org/wiki/OCLC">OCLC</a> <a class="external text" title="http://worldcat.org/oclc/14967262" rel="nofollow" href="http://worldcat.org/oclc/14967262">14967262</a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Diagnosis+and+management+in+vision+care&amp;rft.atitle=Myopia&amp;rft.aulast=Goss&amp;rft.aufirst=DA&amp;rft.pub=Butterworths&amp;rft.place=Boston&amp;rft.pages=445&amp;rft.isbn=0409950823&amp;rft_id=info:oclcnum/14967262">&nbsp;</span> </li> <li id="_note-AOA">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_1">^{<em><strong>b</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_2">^{<em><strong>c</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_3">^{<em><strong>d</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_4">^{<em><strong>e</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_5">^{<em><strong>f</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_6">^{<em><strong>g</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_7">^{<em><strong>h</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_8">^{<em><strong>i</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-AOA_9">^{<em><strong>j</strong></em>}</a> American Optometric Association. <em><a class="external text" title="http://www.aoa.org/documents/CPG-15.pdf" rel="nofollow" href="http://www.aoa.org/documents/CPG-15.pdf">Optometric Clinical Practice Guideline: Care of the patient with myopia.</a></em> 1997. </li> <li id="_note-2"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-2">^</a></strong> Li CY, Lin KK, Lin YC, Lee JS. <a class="external text" title="http://www.cgmh.org.tw/cgmj/2503/250302.pdf" rel="nofollow" href="http://www.cgmh.org.tw/cgmj/2503/250302.pdf">&quot;Low vision and methods of rehabilitation: a comparison between the past and present.&quot;</a> <em>Chang Gung Med J.</em> 2002 Mar;25(3):153-61. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=12022735" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=12022735">PMID 12022735</a>. </li> <li id="_note-Verma">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Verma_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Verma_1">^{<em><strong>b</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Verma_2">^{<em><strong>c</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Verma_3">^{<em><strong>d</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Verma_4">^{<em><strong>e</strong></em>}</a> Verma A, Singh D. <a class="external text" title="http://www.emedicine.com/oph/topic668.htm" rel="nofollow" href="http://www.emedicine.com/oph/topic668.htm">&quot;Myopia, Phakic IOL.&quot;</a> eMedicine.com. August 19, 2005. </li> <li id="_note-3"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-3">^</a></strong> The Eyecare Trust. <em><a class="external text" title="http://www.eye-care.org.uk/item_view.php?item_id=52&amp;content_id=3" rel="nofollow" href="http://www.eye-care.org.uk/item_view.php?item_id=52&amp;content_id=3">Night Driving - The Facts.</a></em> January 26, 2005. </li> <li id="_note-Cassin"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Cassin_0">^</a></strong> Cassin, B. and Solomon, S. <em>Dictionary of Eye Terminology</em>. Gainsville, Florida: Triad Publishing Company, 1990. </li> <li id="_note-4"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-4">^</a></strong> <cite style="FONT-STYLE: normal">Vukojević, N; Sikić J, Curković T, Juratovac Z, Katusic D, Saric B, Jukic T (2005). &quot;Axial eye length after retinal detachment surgery&quot;. <em>Collegium antropologicum</em> <strong>29</strong> (Suppl 1): 25&ndash;27. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=16193671" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=16193671">PMID 16193671</a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Axial+eye+length+after+retinal+detachment+surgery&amp;rft.jtitle=Collegium+antropologicum&amp;rft.date=2005&amp;rft.volume=29&amp;rft.issue=Suppl+1&amp;rft.aulast=Vukojevi%C4%87&amp;rft.aufirst=N&amp;rft.pages=25%E2%80%9327&amp;rft_id=info:pmid/16193671">&nbsp;</span> </li> <li id="_note-5"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-5">^</a></strong> <cite style="FONT-STYLE: normal">Metge, P; Donnadieu M (1993). &quot;[Myopia and cataract]&quot; (in French). <em>La Revue du praticien</em> <strong>43</strong> (14): 1784&ndash;1786. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=8310218" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=8310218">PMID 8310218</a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=%5BMyopia+and+cataract%5D&amp;rft.jtitle=La+Revue+du+praticien&amp;rft.date=1993&amp;rft.volume=43&amp;rft.issue=14&amp;rft.aulast=Metge&amp;rft.aufirst=P&amp;rft.pages=1784%E2%80%931786&amp;rft_id=info:pmid/8310218">&nbsp;</span> </li> <li id="_note-Shen">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Shen_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Shen_1">^{<em><strong>b</strong></em>}</a> <cite style="FONT-STYLE: normal">Shen, W; Vijayan M, Sivak JG (2005). &quot;<a class="external text" title="http://www.iovs.org/cgi/content/full/46/5/1797" rel="nofollow" href="http://www.iovs.org/cgi/content/full/46/5/1797">Inducing form-deprivation myopia in fish</a>&quot;. <em>Invest. Ophthalmol. Vis. 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<em>Arch Ophthalmol.</em> 1983 Mar;101(3):405-7. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=6830491" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=6830491">PMID 6830491</a>. </li> <li id="_note-20"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-20">^</a></strong> Kempen JH, Mitchell P, Lee KE, Tielsch JM, Broman AT, Taylor HR, Ikram MK, Congdon NG, O'Colmain BJ; Eye Diseases Prevalence Research Group. &quot;The prevalence of refractive errors among adults in the United States, Western Europe, and Australia.&quot; <em>Arch Ophthalmol.</em> 2004 Apr;122(4):495-505. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=15078666" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=15078666">PMID 15078666</a>. </li> <li id="_note-21"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-21">^</a></strong> Mallen EA, Gammoh Y, Al-Bdour M, Sayegh FN. &quot;Refractive error and ocular biometry in Jordanian adults.&quot; <em>Ophthalmic Physiol Opt.</em> 2005 Jul;25(4):302-9. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=15953114" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=15953114">PMID 15953114</a>. </li> <li id="_note-22"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-22">^</a></strong> <cite style="FONT-STYLE: normal">Kleinstein, RN; Jones LA, Hullett S, Kwon S, Lee RJ, Friedman NE, Manny RE, Mutti DO, Yu JA, Zadnik K (2003). &quot;Refractive error and ethnicity in children&quot;. <em>Arch. Ophthalmol.</em> <strong>121</strong> (8): 1141&ndash;1147. <a title="Digital object identifier" href="http://en.wikipedia.org/wiki/Digital_object_identifier">doi</a>:<a class="external text" title="http://dx.doi.org/10.1001/archopht.121.8.1141" rel="nofollow" href="http://dx.doi.org/10.1001/archopht.121.8.1141">10.1001/archopht.121.8.1141</a>. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=12912692" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=12912692">PMID 12912692</a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Refractive+error+and+ethnicity+in+children&amp;rft.jtitle=Arch.+Ophthalmol.&amp;rft.date=2003&amp;rft.volume=121&amp;rft.issue=8&amp;rft.aulast=Kleinstein&amp;rft.aufirst=RN&amp;rft.pages=1141%E2%80%931147&amp;rft_id=info:pmid/12912692&amp;rft_id=info:doi/10.1001%2Farchopht.121.8.1141">&nbsp;</span> </li> <li id="_note-23"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-23">^</a></strong> <a class="external text" title="http://www.iblindness.org/books/bates/ch10.html" rel="nofollow" href="http://www.iblindness.org/books/bates/ch10.html">&quot;Chapter X: Strain.&quot;</a> </li> <li id="_note-24"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-24">^</a></strong> <a class="external text" title="http://www.iblindness.org/books/bates/ch7.html" rel="nofollow" href="http://www.iblindness.org/books/bates/ch7.html">&quot;Chapter VII: The Variability of the Refraction of the Eye.&quot;</a> </li> <li id="_note-25"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-25">^</a></strong> <a class="external text" title="http://www.iblindness.org/books/bates/ch4.html" rel="nofollow" href="http://www.iblindness.org/books/bates/ch4.html">Chapter IV&nbsp;: The Truth about Accommodation as Demonstrated by Experiments on the Eye Muscles of Fish, Cats, Dogs, Rabbits and Other Animals.&quot;</a> </li> <li id="_note-26"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-26">^</a></strong> <a class="external text" title="http://www.iblindness.org/books/bates/ch1.html" rel="nofollow" href="http://www.iblindness.org/books/bates/ch1.html">&quot;Chapter I: Introductory.&quot;</a> </li> <li id="_note-Bradley">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Bradley_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Bradley_1">^{<em><strong>b</strong></em>}</a> Robyn E. Bradley. &quot;<a class="external text" title="http://visioneducators.com/articles/advocates_see_only_benefits_from_eye_exercises.pdf" rel="nofollow" href="http://visioneducators.com/articles/advocates_see_only_benefits_from_eye_exercises.pdf">ADVOCATES SEE ONLY BENEFITS FROM EYE EXERCISES</a>&quot;, The Boston Globe (MA), September 23, 2003.<span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&amp;rft.type=newspaperArticle&amp;rft.subject=News&amp;rft.au=Robyn+E.+Bradley&amp;rft.title=ADVOCATES+SEE+ONLY+BENEFITS+FROM+EYE+EXERCISES&amp;rft.identifier=http%3A%2F%2Fvisioneducators.com%2Farticles%2Fadvocates_see_only_benefits_from_eye_exercises.pdf&amp;rft.publisher=The+Boston+Globe+%28MA%29&amp;rft.date=September+23%2C+2003">&nbsp;</span> </li> <li id="_note-Rawstron">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Rawstron_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Rawstron_1">^{<em><strong>b</strong></em>}</a> <cite style="FONT-STYLE: normal">Rawstron JA, Burley CD, Elder MJ (2005). &quot;<a class="external text" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&amp;cmd=Retrieve&amp;dopt=AbstractPlus&amp;list_uids=15825744&amp;query_hl=13&amp;itool=pubmed_DocSum" rel="nofollow" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&amp;cmd=Retrieve&amp;dopt=AbstractPlus&amp;list_uids=15825744&amp;query_hl=13&amp;itool=pubmed_DocSum">A systematic review of the applicability and efficacy of eye exercises.</a>&quot;. <em>J Pediatr Ophthalmol Strabismus</em> <strong>42</strong> (2): 82-8.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=A+systematic+review+of+the+applicability+and+efficacy+of+eye+exercises.&amp;rft.jtitle=J+Pediatr+Ophthalmol+Strabismus&amp;rft.date=2005&amp;rft.volume=42&amp;rft.issue=2&amp;rft.au=Rawstron+JA%2C+Burley+CD%2C+Elder+MJ&amp;rft.pages=82-8&amp;rft_id=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Fdb%3Dpubmed%26cmd%3DRetrieve%26dopt%3DAbstractPlus%26list_uids%3D15825744%26query_hl%3D13%26itool%3Dpubmed_DocSum">&nbsp;</span> </li> <li id="_note-Mutti"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Mutti_0">^</a></strong> Mutti D. <a class="external text" title="http://www.revoptom.com/index.asp?ArticleType=SiteSpec&amp;page=osc/apr01/lesson_0401.htm" rel="nofollow" href="http://www.revoptom.com/index.asp?ArticleType=SiteSpec&amp;page=osc/apr01/lesson_0401.htm">&quot;Can We Conquer Myopia?&quot;</a> <em>Review of Optomery.</em> Optometric Study Center: April, 2001. </li> <li id="_note-27"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-27">^</a></strong> <a class="external free" title="http://arapaho.nsuok.edu/~salmonto/VSIII_2006/Lecture27.pdf" rel="nofollow" href="http://arapaho.nsuok.edu/~salmonto/VSIII_2006/Lecture27.pdf">http://arapaho.nsuok.edu/~salmonto/VSIII_2006/Lecture27.pdf</a> </li> <li id="_note-Saw_1">^ <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Saw_1_0">^{<em><strong>a</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Saw_1_1">^{<em><strong>b</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Saw_1_2">^{<em><strong>c</strong></em>}</a> <a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Saw_1_3">^{<em><strong>d</strong></em>}</a> Saw SM, Gazzard G, Au Eong KG, Tan DT. <a class="external text" title="http://bjo.bmjjournals.com/cgi/content/short/86/11/1306" rel="nofollow" href="http://bjo.bmjjournals.com/cgi/content/short/86/11/1306">&quot;Myopia: attempts to arrest progression.&quot;</a> <em>Br J Ophthalmol.</em> 2002 Nov;86(11):1306-11. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=12386095" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=12386095">PMID 12386095</a>. </li> <li id="_note-28"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-28">^</a></strong> Schor C. &quot;The influence of interactions between accommodation and convergence on the lag of accommodation.&quot; 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[The effect of the type of astigmatism on the incidence of myopia]. <em>Klin Oczna.</em> 2005;107(1-3):73-4. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=16052807" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=16052807">PMID 16052807</a>. </li> <li id="_note-Rupolo"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Rupolo_0">^</a></strong> <cite style="FONT-STYLE: normal">G Rupolo, M Angi, E Sabbadin, S Caucci, E Pilotto, E Racano and C de Bertolini (1997). &quot;Treating myopia with acoustic biofeedback: a prospective study on the evolution of visual acuity and psychological distress&quot;. <em>Psychosomatic Medicine</em> <strong>59</strong> (3): 313-317.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Treating+myopia+with+acoustic+biofeedback%3A+a+prospective+study+on+the+evolution+of+visual+acuity+and+psychological+distress&amp;rft.jtitle=Psychosomatic+Medicine&amp;rft.date=1997&amp;rft.volume=59&amp;rft.issue=3&amp;rft.au=G+Rupolo%2C+M+Angi%2C+E+Sabbadin%2C+S+Caucci%2C+E+Pilotto%2C+E+Racano+and+C+de+Bertolini&amp;rft.pages=313-317">&nbsp;</span> </li> <li id="_note-Randle"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Randle_0">^</a></strong> <cite style="FONT-STYLE: normal">Randle RJ (1988). &quot;Responses of myopes to volitional control training of accommodation.&quot;. <em>Ophthalmic Physiol Opt</em> <strong>8</strong>: 333-340.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Responses+of+myopes+to+volitional+control+training+of+accommodation.&amp;rft.jtitle=Ophthalmic+Physiol+Opt&amp;rft.date=1988&amp;rft.volume=8&amp;rft.au=Randle+RJ&amp;rft.pages=333-340">&nbsp;</span> </li> <li id="_note-Gallaway"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Gallaway_0">^</a></strong> <cite style="FONT-STYLE: normal">Gallaway M, Pearls SM, Winkelstein AM, et al. (1987). &quot;Biofeedback training of visual acuity and myopia: A pilot study.&quot;. <em>Am J Optom Physiol Opt</em> <strong>64</strong>: 62-71.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Biofeedback+training+of+visual+acuity+and+myopia%3A+A+pilot+study.&amp;rft.jtitle=Am+J+Optom+Physiol+Opt&amp;rft.date=1987&amp;rft.volume=64&amp;rft.au=Gallaway+M%2C+Pearls+SM%2C+Winkelstein+AM%2C+et+al.&amp;rft.pages=62-71">&nbsp;</span> </li> <li id="_note-Koslowe"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Koslowe_0">^</a></strong> <cite style="FONT-STYLE: normal">Koslowe KC, Spierer A, Rosner M, et al. (1991). &quot;Evaluation of accommotrac biofeedback training for myopia control.&quot;. <em>Optom Vis Sci</em> <strong>68</strong>: 252-4.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Evaluation+of+accommotrac+biofeedback+training+for+myopia+control.&amp;rft.jtitle=Optom+Vis+Sci&amp;rft.date=1991&amp;rft.volume=68&amp;rft.au=Koslowe+KC%2C+Spierer+A%2C+Rosner+M%2C+et+al.&amp;rft.pages=252-4">&nbsp;</span> </li> <li id="_note-Rehm"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Rehm_0">^</a></strong> Rehm, Donald &quot;The Myopia Myth-The Truth About Nearsightedness And How To Prevent It&quot; Chapter 6 Published by The International Myopia Prevention Assn., 1054 Gravel Hill Road, Ligonier, PA 15658. 1981 <a class="internal" href="http://en.wikipedia.org/w/index.php?title=Special:Booksources&amp;isbn=096084760X">ISBN 0-9608476-0-X</a> </li> <li id="_note-NS"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-NS_0">^</a></strong> Andy Coghlan and Michael Le Page. &quot;<a class="external text" title="http://www.newscientist.com/article.ns?id=dn3082" rel="nofollow" href="http://www.newscientist.com/article.ns?id=dn3082">Eye correction is seriously short sighted</a>&quot;, New Scientist, 20 November 2002.<span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&amp;rft.type=newspaperArticle&amp;rft.subject=News&amp;rft.au=Andy+Coghlan+and+Michael+Le+Page&amp;rft.title=Eye+correction+is+seriously+short+sighted&amp;rft.identifier=http%3A%2F%2Fwww.newscientist.com%2Farticle.ns%3Fid%3Ddn3082&amp;rft.publisher=New+Scientist&amp;rft.date=20+November+2002">&nbsp;</span> </li> <li id="_note-40"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-40">^</a></strong> Chung K, Mohidin N, O'Leary DJ. &quot;Undercorrection of myopia enhances rather than inhibits myopia progression.&quot; <em>Vision Res.</em> 2002 Oct;42(22):2555-9. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=12445849" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=12445849">PMID 12445849</a>. </li> <li id="_note-Wildoset"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Wildoset_0">^</a></strong> The Wildoset Lab.. <a class="external text" title="http://vision.berkeley.edu/wildsoet/myopiaNews/controllingMyopia.html" rel="nofollow" href="http://vision.berkeley.edu/wildsoet/myopiaNews/controllingMyopia.html">Controlling Myopia Progression - A Confusing Story</a>. Retrieved on <a class="new" title="September 1, 2006" href="http://en.wikipedia.org/w/index.php?title=September_1%2C_2006&amp;action=edit">September 1, 2006</a>. </li> <li id="_note-Siatkowski"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-Siatkowski_0">^</a></strong> <cite style="FONT-STYLE: normal">Siatkowski R, Cotter S, Miller J, Scher C, Crockett R, Novack G (2004). &quot;Safety and efficacy of 2% pirenzepine ophthalmic gel in children with myopia: a 1-year, multicenter, double-masked, placebo-controlled parallel study.&quot;. <em>Arch Ophthalmol</em> <strong>122</strong> (11): 1667-74. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=15534128" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=15534128">PMID 15534128</a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Safety+and+efficacy+of+2%25+pirenzepine+ophthalmic+gel+in+children+with+myopia%3A+a+1-year%2C+multicenter%2C+double-masked%2C+placebo-controlled+parallel+study.&amp;rft.jtitle=Arch+Ophthalmol&amp;rft.date=2004&amp;rft.volume=122&amp;rft.issue=11&amp;rft.au=Siatkowski+R%2C+Cotter+S%2C+Miller+J%2C+Scher+C%2C+Crockett+R%2C+Novack+G&amp;rft.pages=1667-74">&nbsp;</span> </li> <li id="_note-41"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-41">^</a></strong> Ong E, Grice K, Held R, Thorn F, Gwiazda J. &quot;Effects of spectacle intervention on the progression of myopia in children.&quot; <em>Optom Vis Sci.</em> 1999 Jun;76(6):363-9. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=10416930" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=10416930">PMID 10416930</a>. </li> <li id="_note-42"><strong><a title="" href="http://en.wikipedia.org/wiki/Myopia#_ref-42">^</a></strong> Parssinen O, Hemminki E, Klemetti A. Effect of spectacle use and accommodation on myopic progression: final results of a three-year randomised clinical trial among schoolchildren. Br J Ophthalmol. 1989 Jul;73(7):547-51. <a class="external" title="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=2667638" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=2667638">PMID 2667638</a>. </li> </ol> </div> <p><a id="External_links" name="External_links"></a></p> <h2><span class="mw-headline">External links</span></h2> <ul> <li><a class="external text" title="http://www.pupileyes.com/index.php?content=myopia&amp;lang=english" rel="nofollow" href="http://www.pupileyes.com/index.php?content=myopia&amp;lang=english">pupilEyes - Learn how Myopia happens</a> </li> <li><a class="external text" title="http://www.myopia-manual.de/" rel="nofollow" href="http://www.myopia-manual.de/"><em>Myopia Manual &mdash; an impartial documentation of all the reasons, therapies and recommendations</em></a> &mdash; summary of scientific publications, status February 2007 </li> <li><a class="external text" title="http://www.VisionSimulations.com/" rel="nofollow" href="http://www.visionsimulations.com/">VisionSimulations.com |What the world looks like to people with various diseases and conditions of the eye</a> </li> <li><a class="external text" title="http://vision.berkeley.edu/wildsoet/index.html" rel="nofollow" href="http://vision.berkeley.edu/wildsoet/index.html">The Wildsoet Lab</a> - Myopia research at the University of California, Berkeley </li> <li><a class="external text" title="http://www.ssc.education.ed.ac.uk/resources/vi&amp;multi/eyeconds/Myop.html" rel="nofollow" href="http://www.ssc.education.ed.ac.uk/resources/vi&amp;multi/eyeconds/Myop.html">Scottish Sensory Centre - Medical Info on Myopia</a> </li> </ul>

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