J Korean Med Assoc.  2007 Mar;50(3):259-264. 10.5124/jkma.2007.50.3.259.

Prevention and Treatment of School Myopia

• Oh SY

• KMID: 2184808
• DOI: http://doi.org/10.5124/jkma.2007.50.3.259

Abstract

Myopia is the most common refractive error throughout the world. Exact and relative etiologies of myopia have not been investigated in detail, although the high prevalence rate of myopia in school children has been well documented. Patients with myopia must endure the physical and financial burden of spectacles or contact lenses throughout their lives. The National Eye Institute estimated that the costs of refractive eye examinations amount to $1 billion annually, with another $1.5 billion spent on eyeglasses each year. The age of onset of myopia is frequently between 5 to 15 years. There has been a dramatic increase in the prevalence rates of myopia over the past decades in Korea and other parts of Asia. The prevalence rate was 8~15% in 1970s, 23% in 1980s, 38% in 1990s, and 46.2% in 2000s in Korean school children. The remarkable increase in Asian school children suggests that life style risk factors during the school periods may have a great impact on the development of school myopia and the overall population prevalence rate of myopia. Because the gene pool has not changed significantly over the past decades, the rapid increase of the prevalence rates of myopia has been attributed to increases in near-work activities and environmental factors. Atropine is effective in preventing myopia by a non-accommodative mechanism. Atropine is a broad-band muscarinic antagonist that binds to all five identified muscarinic receptors. Animal and clinical studies have shown that the M1-selective muscarinic antagonist, pirenzepine, is effective in reducing axial length enlargement and preventing myopia.

Keyword

Prevalence rate; Atropine; Pirezepine; Myopia

MeSH Terms

Age of Onset
Animals
Asia
Asian Continental Ancestry Group
Atropine
Child
Contact Lenses
Eyeglasses
Gene Pool
Humans
Korea
Life Style
Myopia*
National Eye Institute (U.S.)
Pirenzepine
Prevalence
Receptors, Muscarinic
Refractive Errors
Risk Factors
Atropine
Pirenzepine
Receptors, Muscarinic

Reference

1. Tano Y. Pathologic myopia: Where are we now. Am J Ophthalmol. 2002. 134:645–660.

2. National Advisory Eye Council. Strabismus and Amblyopia Panel. Vision Research: A National Plan;1983-1987. 1987. Washington DC: National Institutes of Health.

3. Lin LL, Shih YF, Tsai CB, Chen CJ, Lee LA, Hung PT, Hou PK. Epidemiologic study of ocular refraction among schoolchildren in Taiwan. Optom Vis Sci. 1999. 76:275–281.

4. Lin Lk, Chen CJ, Hung PT, Ko LS. National-wide survey of myopia among schoolchildren in Taiwan. Acta Ophthalmol. 1988. 185:S. 29–33.

5. Saw SM, Katz J, Schein OD, Chew SJ, Chan TK. Epidemiology of myopia. Epidemiol Rev. 1996. 18:175–187.

6. Saw SM, Tong L, Chua WH, Chia KS, Koh D, Tan DT, Katz J. Incidence and progression of myopia in Singaporean school children. Invest ophthalmol Vis Sci. 2005. 46:51–57.

7. Saw SM, Hong RZ, Zhang MZ, Fu ZF, Ye M, Tan D, Chew SJ. Near-work activity and myopia in rural and urban schoolchildren in China. J Pediatr Ophthalmol Strabismus. 2001. 38:149–155.

8. Tan NW, Saw SM, Lam DS, Cheng HM, Rajan U, Chew SJ. Temporal variations in myopia progression in Singaporean children within an academic year. Optom Vis Sci. 2000. 77:465–472.

9. Kim SH, Kim SM. Survey on causative factors responsible for the school myopia. J Korean Ophthalmol Soc. 1977. 18:45–49.

10. Ji NC, Yoon WJ, Lee JS. A survey of the refractive state of elementary school children in rural area. J Korean Ophthalmol Soc. 1997. 38:458–465.

11. Hong JS, Koo KL, Lee HY. Survey on the refractive status of primary school children with subnormal visual acuity. J Korean Ophthalmol Soc. 1999. 40:3168–3173.

12. Kang JE, Jun RM, Lee HJ, et al. Distribution of refractive errors and quantified optometric values in urban elementary fourth graders in Korea. J Korean Ophthalmol Soc. 2004. 45:1141–1149.

13. Kirby AW, Sutton L, Weiss H. Elongation of cat eyes following neonatal lid sutures. Invest Ophthalmol Vis Sci. 1982. 22:274–277.

14. Rabin J, Van Sluyters RC, Malach R. Emmetropization: A vision-dependent phenomenon. Invest Ophthalmol Vis Sci. 1981. 20:561–564.

15. Gross DA, Criswell MH. Myopia development in experimental animal. Am J Optom Physiol Optics. 1983. 60:250–268.

16. Christensen AM, Wallmann J. Evidence that increased scleral growth underlies visual deprivation myopia in chicks. Invest Ophthalmol Vis Sci. 1991. 32:2143–2150.

17. Hoyt CS, Stone RD, Fromer C, Billdon FA. Monocular axial myopia associated with neonatal eyelid closure in human infants. Am J Ophthalmol. 1981. 91:197–200.

18. Raviola E, Weisel TN. An animal model of myopia. N Engl J Med. 1985. 312:1615.

19. Brecha N, Karten HJ, Laverack C. Enkephalin-containing amacrine cells in the avian retina: immunohistochemical localization. Proc Natl Acad Sci. 1979. 76:3010–3014.

20. Karten HJ, Brecha N. Localization of substance-p immunoactivity in amacrine cells of the retina. Nature. 1980. 283:87–88.

21. Iuvone PM, Galli CL, Garrison-Gund CK, Neff NH. Light stimulates tyrosine hydroxylase activity and dopamine synthesis in retinal amacrine neurons. Science. 1978. 202:901–902.

22. Min BM, Lee CH, Lee YH, et al. The effect of Bromocriptine on the inhibition of eyeball growth at various concentration in myopic chicken model. J Korean Ophthalmol Soc. 1996. 37:2104–2110.

23. Kim JC, Koo BS. A study of prevailing features and causes of myopia and visual impairment in urban school children. J Korean Ophthalmol Soc. 1988. 29:165–181.

24. Kang SH, Kim PS, Choi DG. Prevalence of myopia in 19-year-old Korean males: The relationship between the prevalence and education or urbanization. J Korean Ophthalmol Soc. 2004. 45:2082–2087.

25. Sorsby A. Refraction. Ophthalmic genetics. 1970. 2nd ed. London: Butterworths;38–51.

26. Zadnik K, Satariano WA, Mutti DO, shdtz RI, Adams AJ. The effect of parental history of myopia on children\'s eye size. JAMA. 1994. 271:1323–1327.

27. Pacella R, McLellan J, Grice K, Del Bono EA, Wiggs JL, Gwiazda JE. Role of genetic factors in the etiology of juvenilenset myopia based on a longitudinal study of refractive error. Optom Vis Sci. 1999. 76:381–386.

28. Edward MH. Effect of parental myopia on the development of myopia in Hong Kong Chineses. Ophthalmic Physiol Optics. 1998. 18:477–483.

29. Sorsby A, Sheridan M, Leary GA. Refraction and its components in twins. 1962. London: Med Res Counc Spec Tep Ser.

30. Chen CJ, Cohen BH, Diamond EL. Genetic and environmental effects on the development of myopia in Chinese twin children. Ophthalmic Pediatr Genet. 1985. 6:113–119.

31. Wong L, Coggon D, Cruddas M, Hwang CH. Education, reading, and familial tendency as risk factors for myopia in Hong Kong fishermen. J Epidemiol Community Health. 1993. 47:50–53.

32. Kelly TS. Myopia or expansion glaucoma. Doc Ophthalmol Proc Series. 1981. 28:109–116.

33. Coleman DJ. Unified model for accommodative mechanism. Am J Ophthalmol. 1970. 69:1063–1079.

34. Young F. The development and control of myopia in human and subhuman primates. Contacto. 1975. 19:16–31.

35. Abraham SV. Control of myopia with tropicamide. J Pediatr Ophthalmol. 1967. 4:10–22.

36. Green PR. Mechanical consideration in myopia: relative effects of accommodation, convergence, intraocular pressure, and extraocular muscle. Am J Optom Physiol Optics. 1980. 57:902–914.

37. Blegvad O. Om myopiens progression. Ugeskr Laeger. 1918. 80:287–298.

38. Rogenberg T, Goldschmidt E. The onset and progression of myopia in Danish school children. Doc Ophthalmol. 1981. 28:33–39.

39. Mäntyjärvi MI. Predicting of myopia progression in school children. J Pediatr Ophthalmol Strabismus. 1985. 22:71–75.

40. Kim SY, Min BM. Myopic progression according to the age of onset in childhoods. J Korean Ophthalmol Soc. 1998. 39:721–727.

41. Bedrossian RH. The effect of atropine on myopia. Ann Ophthalmol. 1971. 3:891–891.

42. Kennedy RH. Progression of myopia. Trans Am Ophthalmol Soc. 1995. 93:755–800.

43. McBrien NA, Moghaddam HO, Reeder AP. Atropine reduces experimental myopia and eye enlargement via a nonaccommodative mechanism. Invest Ophthalmol Vis Sci. 1993. 34:205–215.

44. Wang IJ, ShihYF , Tseng HS, Huang SH, Lin LL, Hung PT. The effect of intravitreal injection of atropine on the proliferation of scleral chondrocyte in vivo. J Ocul Pharmacol Ther. 1998. 14:337–343.

45. Lind GJ, Chew SJ, Marzani D, Wallman J. Muscarinic acetylcholine receptor antagonists inhibit chick scleral chondrocytes. Invest Ophthalmol Sci Vis. 1998. 39:2217–2231.

46. Choi TH, Jeong JW, Choi YY. The effect of atropine on myopic progression in children. J Korean Ophthalmol Soc. 2005. 46:1189–1195.

47. Siatkowski RM, Cotter S, Miller JM, Scher CA, Crockett RS, Novack GD. US Pirenzepine Study Group. Safety and efficacy of 2% pirenzepine ophthalmic gel in children with myopia. Arch Ophthalmol. 2004. 122:1667–1674.