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I have a friend who no longer needs glasses. He previously had myopia in both eyes but over the years it has improved until he no longer needs glasses clinically. He's had glasses for over 30 years since he was around 20.
Based on the above, I'd like to know if myopia can be improved naturally. Specifically whether not using glasses helps the underlying architecture of the visual system compensate in someway, or perhaps if nutrition can reduce myopia or finally if aging is known to decrease myopia. I'm interested in any biological mechanism at play.
I have a good understanding of Opthalmology and additionally would like any answers to be evidence based.
Apparently reduction of myopia with age is fairly common. It is thought that the improved vision comes from relaxation of the ciliary muscle as the person ages. Since the lens changes shape the aberrant myopic focusing of light can be corrected to the correct location. While age was found to be the strongest factor influencing myopia progression, other factors like ethnicity and sex also play a role. http://archopht.jamanetwork.com/article.aspx?articleid=417134#
For additional info see:
I'll give you an answer based on my personal experience. I know that presbyopia usually increases with aging, so presbyopia and myopia can compensate each other with time. That's maybe what happened to your friend. But I don't know if myopia is related to nutrition or the use of glasses…
Your Biology Adapts To Minus
So here’s something you already know: Whenever you put on higher minus correction, your un corrected (or lower diopter) vision quickly becomes more blurry. Your biology goes, ah yea ok. More negative refractive state. Swell. And your visual cortex thinks, nice additional sharpness. I could get used to this.
What about the opposite direction, less minus?
This of course looks worse. Less clear, more blur, more suckiness. And that’s the stage you set, if you go from more diopters, to less diopters.
So here’s the guru trick: DON’T.
An eye guru of yore would just drop the mic here.
Most wisdom relates best when you have to make some effort to discover its meaning. You have to look at various Buddhist writings and ponder them. Put them in perspective, mull over them, find the meaning yourself.
But alas we don’t live in those fun old-timey times. So for real this time, here’s what you do:
For Better Vision, Let the Sunshine In
Being nearsighted is far more common than it once was. The prevalence of myopia, the condition’s medical name, in Americans has soared by 66 percent since the early 1970s, according to a 2009 study by the National Eye Institute in China and other East Asian countries, as many as 90 percent of recent high school graduates are thought to be nearsighted.
Myopia results when eyeballs are longer than normal, changing the angle at which light enters the eye and therefore the ability to focus on distant objects. The disorder involves a complex interplay of genetics and environment and usually begins before adolescence, when the eye is growing, but it can worsen in early adulthood.
Some experts connect the elevated rates of myopia to the many hours young people stare at computers and other screens. But a recent study published in JAMA Ophthalmology suggests that a greater factor may be a side effect of all that screen-watching — it’s keeping children inside. This new study joins a growing body of research indicating that a lack of direct sunlight may reshape the human eye and impair vision.
Researchers at King’s College London, the London School of Hygiene and Tropical Medicine and other institutions gave vision exams to more than 3,100 older European men and women and interviewed them at length about their education, careers and how often they remembered being outside during various stages of their lives. This biographical information was then cross-referenced with historical data about sunlight, originally compiled for research on skin cancer and other conditions.
Strong correlations were found between current eyesight and volunteers’ lifetime exposure to sunlight, above all UVB radiation (which is responsible for burning). Those who had gotten the most sun, particularly between the ages of 14 and 19, were about 25 percent less likely to have developed myopia by middle age. Exposure to sunlight up to the age of 30 also conferred a protective benefit. This relationship held true even when the researchers controlled for education as a marker primarily of time spent reading and gazing at screens.
Because this study was not an experiment, it could not determine whether too little sunlight actually causes nearsightedness, or otherwise explain the connection. “But people with myopia have long eyeballs,” says Katie Williams, a clinical research fellow at King’s College London and the study’s lead author, “so there must be something in sunlight that affects how the eye grows, especially in childhood.”
Sunlight is associated with harmful impacts too, of course. Exposure increases the risks of developing cataracts and skin cancer. But Williams says that with appropriate cautions, including sunscreen use and the avoidance of midday sunlight, young people should be able to reduce those risks while potentially bolstering their vision. “There is definitely something in modern-day childhood that is triggering a massive rise in the number of people with myopia,” she says. “And a lack of time outdoors certainly appears to be contributing.”
Improving myopia - Biology
Visual perception is the ability to interpret the surrounding environment by processing information that is contained in visible light. The resulting perception is also known as eyesight, sight, or vision. Eyes are the organs of vision. They detect light and convert it into electro-chemical impulses in neurons. Eyes can be prone to many diseases and disorders. This project is focused on eye disorders:how it is caused, why it is caused, how to prevent/treat it are inscribed here. In addition, a survey was taken among 50 students, each having an eye disorder. The data and other features areattached to the report as well.
The human eye is a spheroid structure that rests in a bony cavity (socket, or orbit) on the frontal surface of the skull.
The thick wall of the eyeball contains three covering layers: the sclera, the choroid, and the retina.
The sclera is the outermost layer of eye tissue part of it is visible as the "white" of the eye. In the center of the visible sclera and projecting slightly, in the manner of a crystal raised above the surface of a watch, is the cornea, a transparent membrane that acts as the window of the eye.
A delicate membrane, the conjunctiva, covers the visible portion of the sclera.
Underneath the sclera is the second layer of tissue, the choroid, composed of a dense pigment and blood vessels that nourish the tissues.
Near the center of the visible portion of the eye, the choroid layer forms the ciliary body, which contains the muscles used to change the shape of the lens (that is, to focus).
The ciliary body in turn merges with the iris, a diaphragm that regulates the size of the pupil.
The iris is the area of the eye where the pigmentation of the choroid layer, usually brown or blue, is visible because it is not covered by the sclera.
The pupil is the round opening in the center of the iris it is dilated and contracted by muscular action of the iris, thus regulating the amount of light that enters the eye.
Behind the iris is the lens, a transparent, elastic, but solid ellipsoid body that focuses the light on the retina, the third and innermost layer of tissue.
The retina is a network of nerve cells, notably the rods and cones, and nerve fibers that fan out over the choroid from the optic nerve as it enters the rear of the eyeball from the brain. Unlike the two outer layers of the eye, the retina does not extend to the front of the eyeball.
Between the cornea and iris and between the iris and lens are small spaces filled with aqueous humor, a thin, watery fluid.
The large spheroid space in back of the lens (the center of the eyeball) is filled with vitreous humor, a jellylike substance.
Some Common Eye Disorders
&bull Myopia (Nearsightedness)
Nearsighted individuals typically have problems seeing well at a distance and are forced to wear glasses or contact lenses. The nearsighted eye is usually longer than a normal eye, and its cornea may also be steeper. Therefore, when light passes through the cornea and lens, it is focused in front of the retina. This will make distant images appear blurred.
&bull Hypermetropia (Farsightedness)
Farsighted individuals typically develop problems reading up close. The farsighted eye is usually slightly shorter than a normal eye and may have a flatter cornea. Thus, the light of distant objects focuses behind the retina unless the natural lens can compensate fully. Near objects require even greater focusing power to be seen clearly and therefore, blur more easily.
Conjunctivitis is a condition in which the tissue that lines the eyelids and covers the cornea becomes inflamed. It is sometimes called "pink eye" or "red eye." It can cause redness, itching, burning, tearing, discharge, or a feeling of something in the eye. Conjunctivitis occurs in people of all ages and can be caused by infection, exposure to chemicals and irritants, or allergies.
Amblyopia is the medical term used when the vision of one eye is reduced because it fails to work properly with the brain. The eye itself looks normal, but for various reasons the brain favors the other eye. This condition is also sometimes called lazy eye. Amblyopia can occur when one eye is more nearsighted, more farsighted, or has more astigmatism
Asthenopiaor eye strainmanifests itself through nonspecific symptoms such as fatigue, pain in or around the eyes, blurred vision, headache and occasional double vision. Symptoms often occur after reading, computer work, or other close activities that involve tedious visual tasks.
Photokeretitis or ultraviolet keratitis is a painful eye condition caused by exposure of insufficiently protected eyes to the ultraviolet (UV) rays from either natural (e.g. intense sunlight at high altitudes) or artificial sources. Photokeratitis is akin to a sunburn of the cornea and conjunctiva, and is not usually noticed until several hours after exposure. Symptoms include increased tears and a feeling of pain, likened to having sand in the eyes.
The survey was taken on Feb, 2015 at Itanagar, Arunachal Pradesh particularly at VKV Itanagar, Chimpu.
Total students were 50 each having an eye disorder. The age range is 6 to 18.
Questions that were asked:
1) Name and age of the person
2) Information on their eye disorder
3) Age when the disorder was diagnosed
No specific tool was used. A friend to assist proved to be helpful.
The pie chart shows relative percentage of people having certain disorders.
&bull Myopia stands as the most common refractive disorder in children and teens with a big 70%.
&bull 7 out of 10 people having a disorder are diagnosed with Myopia
&bull 1 out of 10 people have Hypermetropia.
&bull 1 out of 10 people have Amblyopia
&bull 1 out of 25 people have Asthenopia.
&bull 1 out of 25 people have the problem of eye pain.
If a person is nearsighted, the first number ("sphere") on the eyeglasses prescription or contact lens prescription will be preceded by a minus sign (&ndash). The higher the number, the more nearsighted one is.
Nearsightedness can be corrected with glasses, contact lenses or refractive surgery.
Refractive surgery can reduce or even eliminate the need for glasses or contacts. The most common procedures are performed with an excimerlaser.
1. In PRK the laser removes a layer of corneal tissue, which flattens the cornea and allows light rays to focus more accurately on the retina.
2. In LASIK &mdash the most common refractive procedure &mdash a thin flap is created on the surface of the cornea, a laser removes some corneal tissue, and then the flap is returned to its original position.
If a glasses or contact lens prescription begins with plus numbers, like +2.50, then the person is farsighted.
Farsightedness can be corrected with glasses or contact lenses to change the way light rays bend into the eyes.
Refractive surgery, such as LASIK or CK, is another option for correcting hyperopia. Surgery may reduce or eliminate your need to wear glasses or contact lenses.
The most common treatment for amblyopia is to force the brain to start using the "bad" eye. This is done by putting a patch over the "good" eye. It can take weeks or months for an eye patch to improve vision.
In cases of mild amblyopia, the doctor might recommend using an eye drop called atropine in the "good" eye instead of a patch. Atropine dilates the pupil and blurs the vision in the "good&rdquo eye, forcing the "bad" eye to do most of the work.
Most children with amblyopia will also need glasses to help focus.
Amblyopia becomes much more difficult to treat after about 7-9 years of age
Preventative measures, such as taking breaks from activities that cause eye strain are suggested.
The most effective way to ease the pain or discomfort that the affliction causes is to remove all light sources from a room, and allow the eyes to relax in darkness.
Cool compresses also help to some degree, though care should be taken to not use anything cool enough (such as ice) to damage the eyes themselves.
Photokeratitis can be prevented by using sunglasses or eye protection that transmits 5&ndash10% of visible light and absorbs almost all UV rays.
1. Bacterial Conjunctivitis
There is no treatment for most cases of viral conjunctivitis. Instead, thevirus needs time to run its course &mdash up to two or three weeks.
Outdoor time is good for your eyes
The share of young children who need glasses because they are nearsighted &mdash or myopic &mdash has been rising.
Christos Tsoumplekas / Flickr (CC BY-NC 2.0)
December 20, 2016 at 7:00 am
Today, kids are more likely to have a hard time seeing distant objects clearly than they would have even a few decades ago. That has been a consistent finding in studies from around the world. New Canadian research sheds more light on why this nearsightedness is increasing. Its conclusion: Kids today spend too little time playing outdoors.
The idea is not new. In parts of the world where people spend most of their time indoors, rates of nearsightedness — or myopia — have been skyrocketing. By adulthood, one in three people in the United States has myopia. In parts of Asia, the rates are far higher. In some nations there, more than 95 percent of children and teens may wear glasses to correct for myopia.
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Myopia, or nearsightedness, occurs when images aren’t focused directly on the back of the eye – the retina. EyeSmart/ American Academy of Ophthalmology
Previous research suggested this might stem from children spending too much time focusing on close-up objects. Those might include books, smartphones and video screens. Other research has linked rising rates of myopia to a drop in the time kids spend outdoors.
The new Canadian study goes further. It shows that for one additional hour of outdoor time per week, the risk a child will develop myopia drops by about 14 percent.
Mike Yang led the study at Canada’s Centre for Contact Lens Research in Waterloo, Ontario. As an optometrist, he examines eyes for defects and prescribes treatment, including glasses and contact lenses. Yang worked with researchers at the Canadian National Institute for the Blind in Toronto, Ontario. Their findings have just been issued in a new 29-page report.
The team examined the eyes of 166 students in Waterloo during the 2014 to 2015 school year. All were in first to eighth grade. Among these kids, the share with myopia rose dramatically by middle school. On average, just 6 percent of first graders were myopic. By age 13, nearly 29 percent were.
The researchers then surveyed the parents about their kids’ activities and how much time they spend on each. Those questions included ones on the time each child typically spends outside. And this outdoor time proved a big predictor of whether kids had become nearsighted.
Children who spend plenty of time outdoors in the bright light face a lower risk of needing glasses for myopia. triggerhapi / Flickr (CC BY 2.0)
Why might that be? “It probably has something to do with the lighting being much brighter than indoors,” concludes Yang. Also, when outside, your eyes have more opportunity to focus on things in the distance, he notes. For now, he says, “No one is sure why these things make a difference.”
Jeremy Guggenheim agrees. He is an optometrist who has studied myopia in Great Britain and Hong Kong. “While the exact cause remains unknown, the bright light levels outdoors are thought by scientists to be key,” he says.
Guggenheim says the link between outdoor time and myopia rates could have an added explanation: Children who wear glasses may avoid outdoor sports for fear of damaging or losing their glasses. So children who wear glasses for myopia might just spend less time outside.
The Canadian study also found that almost one in every three children with myopia had not been diagnosed. So they were never prescribed glasses to correct for the condition.
“If they’ve never experienced perfect vision before, they may think everybody sees the same way,” explains Yang. It’s therefore up to parents, he says, to see that their child’s vision is checked regularly.
Without glasses, he notes, myopic children probably can’t see the blackboard. This can slow learning and hurt how well they perform in school. Even more worrying, Yang says, is that children are becoming nearsighted at younger and younger ages.
“Historically, myopia started at age 12 or 13,” he notes. “Now it is showing up more often in kids six or seven years old.” Yang could not compare the number of young children with myopia in his study to those from earlier generations in Canada. His is the first to measure these rates among children there.
But research in other countries, such as the United States and China, show that myopia is becoming common in ever younger kids. That worries Yang. When young children become myopic, he says, they risk an even greater decline in their eyesight over time when compared to their parents’ and grandparents’ generations.
Britain Another name for England. It is not the same thing as Great Britain, which refers not only to England but also to Scotland and Wales. It&rsquos also not the same thing as the United Kingdom, which includes England, Scotland, Wales and Northern Ireland.
generation A group of individuals born about the same time or that are regarded as a single group. Your parents belong to one generation of your family, for example, and your grandparents to another. Similarly, you and everyone within a few years of your age across the planet are referred to as belonging to a particular generation of humans. The term also is sometimes extended to year classes or types of inanimate objects, such as electronics or automobiles.
Great Britain The territory of England, Scotland and Wales. This is not the same thing as Britain, which refers only to England. It&rsquos also not the same thing as the United Kingdom, which includes Northern Ireland in addition to all of Great Britain.
lens (in biology) A transparent part of the eye behind the colored iris that focuses incoming light onto the light-absorbing membrane at the back of the eyeball.
link A connection between two people or things.
middle school A designation for grades six through eight in the U.S. educational system. It comes immediately prior to high school. Some school systems break their age groups slightly different, including sixth grade as part of elementary school and then referring to grades seven and eight as &ldquojunior&rdquo high school.
myopia The medical term for nearsightedness. An inability to focus on anything much more than an arm&rsquos length away.
nearsighted An inability to focus anything that isn&rsquot nearby. It&rsquos due to an elongation of the eyeball. Many factors can contribute to this inappropriate elongation, and so the cause of nearsightedness is still under debate.
optometrist In the United States, this is someone trained and licensed to examine eyes for defects and to prescribe treatment or corrective lenses. Although eye doctors, optometrists are not trained as physicians. Physicians who specialize in the eye are called ophthalmologists.
retina A layer at the back of the eyeball containing cells that are sensitive to light and that trigger nerve impulses that travel along the optic nerve to the brain, where a visual image is formed.
risk The chance or mathematical likelihood that some bad thing might happen. For instance, exposure to radiation poses a risk of cancer. Or the hazard &mdash or peril &mdash itself. Among cancer risks that the people faced were radiation and drinking water tainted with arsenic.
smartphone A cell (or mobile) phone that can perform a host of functions, including search for information on the internet.
REPORT: M. Yang et al. Myopia prevalence in Canadian school children — a pilot study. Centre for Contact Lens Research, School of Optometry & Vision Science, University of Waterloo, Canada. October 25, 2016.
Learn more about myopia here from the National Eye Institute.
About Sharon Oosthoek
Sharon Oosthoek is a freelance science journalist. She likes to write about animals and their habitats. Sharon also really likes chocolate. Her sons have learned to hide their Halloween candy.
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Circadian rhythms, refractive development, and myopia
Purpose: Despite extensive research, mechanisms regulating postnatal eye growth and those responsible for ametropias are poorly understood. With the marked recent increases in myopia prevalence, robust and biologically-based clinical therapies to normalize refractive development in childhood are needed. Here, we review classic and contemporary literature about how circadian biology might provide clues to develop a framework to improve the understanding of myopia etiology, and possibly lead to rational approaches to ameliorate refractive errors developing in children.
Recent findings: Increasing evidence implicates diurnal and circadian rhythms in eye growth and refractive error development. In both humans and animals, ocular length and other anatomical and physiological features of the eye undergo diurnal oscillations. Systemically, such rhythms are primarily generated by the 'master clock' in the surpachiasmatic nucleus, which receives input from the intrinsically photosensitive retinal ganglion cells (ipRGCs) through the activation of the photopigment melanopsin. The retina also has an endogenous circadian clock. In laboratory animals developing experimental myopia, oscillations of ocular parameters are perturbed. Retinal signaling is now believed to influence refractive development dopamine, an important neurotransmitter found in the retina, not only entrains intrinsic retinal rhythms to the light:dark cycle, but it also modulates refractive development. Circadian clocks comprise a transcription/translation feedback control mechanism utilizing so-called clock genes that have now been associated with experimental ametropias. Contemporary clinical research is also reviving ideas first proposed in the nineteenth century that light exposures might impact refraction in children. As a result, properties of ambient lighting are being investigated in refractive development. In other areas of medical science, circadian dysregulation is now thought to impact many non-ocular disorders, likely because the patterns of modern artificial lighting exert adverse physiological effects on circadian pacemakers. How, or if, such modern light exposures and circadian dysregulation contribute to refractive development is not known.
Summary: The premise of this review is that circadian biology could be a productive area worthy of increased investigation, which might lead to the improved understanding of refractive development and improved therapeutic interventions.
Keywords: circadian rhythms clock genes dopamine melanopsin myopia refractive development.
© 2018 The Authors Ophthalmic & Physiological Optics © 2018 The College of Optometrists.
Contact lenses to slow progression of myopia
The prevalence of myopia has been steadily rising, with 28 per cent of the global population said to be affected in 2010 and to rise to affect nearly 50 per cent by 2050. Increasing levels of myopia increase the risk of vision impairment and in particular, high myopia is associated with the risk of serious and permanent visual disability due to associated sight-threatening complications. To stem the burden associated with higher levels of myopia, there are efforts to slow the progression of myopia, and several optical and pharmaceutical strategies have been found useful in slowing myopia to varying degrees. More recently, numerous multifocal soft contact lenses and extended depth of focus soft contact lenses (collectively referred to as myopia control contact lenses) were found effective in slowing myopia. As opposed to overnight orthokeratology, myopia control contact lenses are worn during the day and the hypotheses proposed to explain the efficacy of these lenses are generally based on the premise that the stimulus for eye growth is a defocused retinal image with hyperopic blur either centrally or peripherally. Although the individual power profiles of the lenses vary, the contact lens generally incorporates 'positive power' to reduce the hyperopic blur and/or impose myopic defocus or in the case of the extended depth of focus lens, has a power profile designed to optimise retinal image quality for points on or in front of the retina. The use of soft contact lenses as a platform for myopia control offers an exciting and effective avenue to manage myopia but there is a need for further research on issues such as the mechanism underlying control of myopia, improving efficacy with lenses, and understanding rebound on discontinuation. More significantly, although contact lenses are generally safe and improve quality of life in older children, one of the major challenges for improved uptake and acceptance of contact lenses centres on the perceived risk of complications with lens wear. This issue needs to be addressed.
Keywords: children contact lenses myopia progression.
How To Improve Eyesight With Food?
Food plays an important role in eye health. And most people today get insufficient amounts of micro nutrients. Because the world focuses on macro nutrients. That's the start of the problem.
Macro nutrients are carbohydrates, proteins, and fats. But there is more to a healthy diet than that. And it's not calorie counting.
These macro nutrients do provide building blocks and energy for our cells. But we also need micro nutrients (minerals and vitamins) to build healthy cells. And to protect the cells.
In today's world our bodies are under constant attack. Toxicity is everywhere. Our cells are under constant attack. Micro nutrients are the body's tools to defend itself.
Plus, you have to take care of your digestive system. You have to know how to detoxify your body on a daily basis. You have to make sure that your diet is anti-inflammatory. Meaning that it reduces inflammation in your body.
So food and diet in the 21st century play an important role. You can't improve eyesight without anymore. It's not as simple as eat carrots and all will be good. You have to know the in's and out's to support your eyesight.
Take Away #6
The topic takes up two modules in the Pure Vision Method™. It's the most comprehensive nutrient and detox information. It's that important.
Three Ways to Slow Down Myopia
Myopia, which is also known as short-sightedness or nearsightedness, is a growing problem. In fact, a recent study predicts that myopia will affect vision for nearly half of the global population by 2050. 1
Myopia usually begins in childhood when the eyeball grows too long, causing blurry distance vision. The condition is caused by family history, lifestyle or both. It also tends to get worse as kids get older because their eyes continue to grow. 2 This can have a significant impact on a child’s everyday life and can sometimes lead to future eye health problems. Fortunately, new research is lighting the path to improved strategies to manage myopia in children. Here’s how.
- Put the devices away. Data from 145 studies covering 2.1 million participants revealed that increases in myopia are driven principally by lifestyle. 1 Today’s youth spend a lot of time performing near work activities, often on electronic devices. Of course it’s unrealistic to ask kids not to use these tools at all, but try to limit them so that there’s more balance in your child’s day.
- Send kids outside. Kids spend a lot of time indoors at home and in classrooms, so whenever possible, try to plan more outdoor activities. Researchers suggest that myopia progression may be caused by light levels, 1 which may be directly related to how little time kids spend outdoors nowadays. In fact, according to the Vision Council, nearly one in four kids spend more than three hours per day using digital devices, 3 when they might be better off heading outside for some good old-fashioned play. Increased outdoor activity has been shown to retard the onset of myopia by 11-34%. 4 One possible reason for this is because components of sunlight activate vitamin D, which may play a potential role in eye growth. 4 Also, kids are usually engaged in more distance-vision activities when they’re outside, which places fewer strenuous near-vision demands on young eyes.
- Ask your doctor about ways to manage myopia. Regular glasses and contact lenses can help kids see more clearly, but they do not slow down the progression of myopia, which means kids may need increasingly stronger prescriptions as they continue to grow. However, certain types of contact lenses—including soft lenses—can slow down the speed at which myopia develops. 5 According to the American Optometric Association multifocal contact lenses for children with myopia can slow the progression of nearsightedness, providing a more effective and efficient treatment option. 6
Controlling myopia in children is important because as their eyes grow and their myopia increases, the dependency on glasses increases. This can reduce the ability of children to participate actively in sports and other activities. Increasing myopia can also lead to eye health problems in the future.
We can’t change kids’ genes, but we can take steps to ensure that we’re doing all we can to keep them healthy.
1. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. In Press (DOI: http://dx.doi.org/10.1016/j.ophtha.2016.01.006)
2. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 201231(6):622-660.
3. The Vision Council. 2015 Digital Eyestrain Report.
4. Wolffsohn JS, Calossi A, Cho P, et al GlobalTrends in Myopia Management Attitudes and Strategies in Clinical Practice. Cont Lens Anterior Eye. 201639'106-16.
5. Sankaridurg P. Fitting Multifocal Contact Lenses for Myopia Control. Review of Cornea and Contact Lenses. February 2017.