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Medical Forum / General / Vision / June 2009

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Health Professionals ask WHY the eye goes negative (in refractive     STATE).

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Otis - 26 Jun 2009 14:22 GMT
Excerpt for Review, by Ophthalmologist D. I. Flitcroft.

British Journal of Ophthalmology 1998;82:210-211; doi:10.1136/bjo.
82.3.210
Copyright © 1998 by the BMJ Publishing Group Ltd.
Br J Ophthalmol 1998;82:210-211 ( March )
Commentary

Ophthalmologists should consider the causes of myopia and not simply
treat its consequences

The first 150 words of the full text of this article appear below.

Myopia has been undergoing a major re-evaluation in recent years both
by ophthalmologists and basic scientists, though for different
reasons.

For ophthalmologists the rise of refractive surgery in the past decade
has seen myopia changing from a condition requiring optical correction
to one that can be managed surgically with the aid of the excimer
laser and other techniques.

For basic scientists interested in the control of eye growth, the past
decade has been equally revolutionary with a huge increase in the
understanding of mechanisms by which eye growth is regulated by the
quality of the retinal image.

This research offers insights into why myopia develops in humans and
offers clinicians a novel perspective from which to approach the
management of myopia.

Rather than attempting to alter corneal curvature to "treat" myopia,
it may be possible to prevent or "cure" myopia by directly
manipulating the growth mechanisms of the eye.

============

I would add, by PREVENTIVE methods suggested in Dr. Flitcroft's
excellent paper on the subject.

Perhaps the better idea would be to explain to the person (by way of
Soon's graph), that entry into a negative STATE CAN BE PREVENTED, and
that is would be wise to begin to understand Dr. Flitcroft's second-
opinion on the subject.

Enjoy,
Mike Tyner - 26 Jun 2009 14:30 GMT
> Perhaps the better idea would be to explain to the person
> (by way of Soon's graph), that entry into a negative STATE
> CAN BE PREVENTED, and that is would be wise to begin
> to understand Dr. Flitcroft's second-opinion on the subject.

Wise would be reading Dr. Flitcroft's paper before telling us what it says.

-MT
Dr Judy - 26 Jun 2009 20:50 GMT
> Excerpt for Review, by Ophthalmologist D. I. Flitcroft.
>
[quoted text clipped - 3 lines]
> Br J Ophthalmol 1998;82:210-211 ( March )
> Commentary

Here are some quotes from Flitcroft's paper:

"Certainly in animal studies minus lenses do result in ocular growth
towards myopia. Whether this implies that myopic children should be
undercorrected remains controversial. Ultimately, resolving whether
these
findings are applicable in humans can only be achieved by appropriate
clinical studies."

"Another possible avenue that might allow manipulation or prevention
of myopia has arisen from developments in
our understanding of the pharmacological mechanisms by which retinal
image quality influences eye growth."

"Pharmacological manipulation of these growth mechanisms clearly
offers a very direct means of altering the
natural history of myopia. [offering drugs to influence] the signals
that promote myopia without the confounding
effects on the retinal image that result from the cycloplegia
generated by atropine."

"In terms of both the optical and pharmacological manipulation of
myopia, there are questions that can only be addressed by clinical
studies."

In the decade following the publication of this paper, clinical
studies have been done.  Alas, the optical intervention  (COMET study)
was not clinically effective.  The drug trials are ongoing but early
results there are also not promising.

Judy
 
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