Myopia, Near Work, Atropine and Bifocals: Critical Reflections of the Key Literature Examining the Influence of Several Factors Upon the Progression of Myopia
Inez Eveline Elderman, DipOrth&Optom 1
Meri Vukicevic, PhD 2
1 Department of Ophthalmology & Neuroscience, Royal Melbourne Hospital, Melbourne, Australia
2 Department of Clinical Vision Sciences, La Trobe University, Melbourne, Australia
In the last century there have been many studies into the factors that influence the progression of myopia. Genetics, exposure to light, intra ocular pressure, near work, stress, presence of esophoria, level of education and living environment are described as possible factors influencing myopia. Some studies indicate that there is a possible connection between near work and myopia progression and other studies suggest that methods to delay myopia progression are negligible. The literature shows that it is impossible to measure the amount of influence each factor has on the progression of myopia as it is not possible to separate one individual factor from another. The exact mechanism that causes myopia progression is not known and there are no evidence based studies that document what the causes may be. Whilst it is known that genetics have an influence, it is also possible that reading and near work have influence on myopia. Thus, could the progression of myopia be delayed with treatment such as atropine and bifocals? The purpose of this paper is to investigate the factors that may contribute to myopia progression as outlined in the literature and to consider, by comparing two key papers, whether the use of atropine and bifocals is effective treatment. In addition, important considerations from an orthoptic perspective are also described.