Journal
OPTOMETRY AND VISION SCIENCE
Volume 88, Issue 9, Pages 1029-1044Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/OPX.0b013e3182279cfa
Keywords
myopia; hyperopia; emmetropization; myopia progression; peripheral refraction; animal models
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Funding
- National Eye Institute, National Institutes of Health, Bethesda, MD [EY 03, 611, EY 07, 551]
- Vision Cooperative Research Centre
- UH Foundation
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It is well established that refractive development is regulated by visual feedback. However, most optical treatment strategies designed to reduce myopia progression have not produced the desired results, primarily because some of our assumptions concerning the operating characteristics of the vision-dependent mechanisms that regulate refractive development have been incorrect. In particular, because of the prominence of central vision in primates, it has generally been assumed that signals from the fovea determine the effects of vision on refractive development. However, experiments in laboratory animals demonstrate that ocular growth and emmetropization are mediated by local retinal mechanisms and that foveal vision is not essential for many vision-dependent aspects of refractive development. However, the peripheral retina, in isolation, can effectively regulate emmetropization and mediate many of the effects of vision on the eye's refractive status. Moreover, when there are conflicting visual signals between the fovea and the periphery, peripheral vision can dominate refractive development. The overall pattern of results suggests that optical treatment strategies for myopia that take into account the effects of peripheral vision are likely to be more successful than strategies that effectively manipulate only central vision. (Optom Vis Sci 2011; 88: 1029-1044)
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