Visual environment

What role do accommodation and binocular vision issues play in eyestrain symptoms?

While 80% of pre-presbyopic adults with Digital Eye Strain symptoms preferred reading with low-addition lenses, the improvement in reading speed was generally small and did not appear to correlate with specific accommodation or binocular vision dysfunctions. In the 8% who showed a significant improvement in reading rate of at least 15%, a majority showed reduced accommodation amplitude.

How could man-made environments influence childhood development of myopia?

This study demonstrated that man-made indoor environments may provide a myopigenic effect from reduced illumination and spatial frequencies. More research is needed to confirm if the mechanism for form deprivation from reduced spatial frequencies in humans is similar to that found for animals, and what improvements can be made to indoor environments to offset the risk for myopia.

The effect of online learning on myopia progression

By using a wearable device to objectively monitor visual behaviour, this study found progression in young myopic children was correlated with less time outdoors, more time working at near for online learning and less time spent wearing their glasses.

Time spent outdoors improves success with MiSight 1 day

This paper identified time spent outdoors as the key factor in predicting better myopia control outcomes in children wearing with MiSight 1 day contact lenses. Other factors which weren’t predictive included age, refraction, binocular vision findings, pupil size and time spent at near.

Evaluating the impact of pandemic lifestyle changes for Dutch teens

Teenagers in the Netherlands were able to spend time outdoors during the COVID pandemic but still significantly increased near work on digital devices.. This is expected to give an increase in myopia prevalence and progression in European teens but to a lesser extent than in Asia where there was restricted outdoor time with stricter lockdown.

Atropine 0.01% combined with orthokeratology over two years

Atropine 0.01% combined with orthokeratology slows axial elongation to less than 0.1mm/year over two years in Chinese children aged 6-11 years. This is the equal-longest study on this topic and first to measure potential mechanisms of pupil size and choroidal thickness. The largest effect of the combination occurred in the first 6 months.

How do lighting levels and contrast affect vision with multifocal contact lenses?

In young adult myopes, Biofinity centre-distance +2.50 Add and NaturalVue multifocal contact lenses both showed reduced visual acuity in lower lighting and low contrast conditions, and especially with a glare source, compared to single vision. Reading rate under normal lighting was also reduced by 4-8%. The multifocal designs performed similarly, although Biofinity required more over-refraction for best distance acuity.

Examining the posture of myopic children during various near tasks

This study investigated the working distance and head posture of Chinese myopic children while reading, writing and playing video games. The average working distance across all tasks was 24.5cm, with the shortest working distance and largest head declination observed while children played video games. There was no influence of level of myopia or accommodative lag on working distance or head position. 

IMI Report on Risk Factors for Myopia

This report details non-modifiable and modifiable risk factors for myopia. Of the latter, Increasing the time children spend outside is an evidence-based intervention for myopia management. Near work is also a risk factor, although the causal relationship is less clear and future research with objective measures will provided more guidance on targeted clinical interventions.