About us |  Subscription |  Top cited articles |  e-Alerts  | Feedback |  Login   
  Home | Ahead of print | Current Issue | Archives | Search | Instructions Celebrating 60 Years   Print this article Email this article   Small font sizeDefault font sizeIncrease font size
 
 Official publication of All India Ophthalmological Society   Users Online: 49
  Search
 
   Next article
   Previous article 
   Table of Contents
  
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    [PDF Not available] *
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    Conclusions

 Article Access Statistics
    Viewed3792    
    Printed75    
    Emailed0    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal

 


 
ARTICLES
Year : 1983  |  Volume : 31  |  Issue : 6  |  Page : 741-743
 

Therapy of myopia


Chief Organiser & Prof of Opthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, A.I.I.MS., New Delhi & Adviser Ophthalmology, Government of India, Ministry of Health & Family Welfare, Nirman Bhavan, New Delhi, India

Correspondence Address:
Madan Mohan
Chief Organiser & Prof. of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, A.I.I.M.S., New Delhi 110029
India
Login to access the Email id


PMID: 6676257

Get Permissions

 



How to cite this article:
Mohan M. Therapy of myopia. Indian J Ophthalmol 1983;31:741-3

How to cite this URL:
Mohan M. Therapy of myopia. Indian J Ophthalmol [serial online] 1983 [cited 2014 Nov 23];31:741-3. Available from: http://www.ijo.in/text.asp?1983/31/6/741/29315


The treatment of myopia can be considered basically under two heads:

1. Preventive

2. Curative

Although the exact pathogenesis of myopia is not well understood, various factors consi­dered in this regard are:

1. Genetic factors.

2. Nutrition.

3. Febrile illnesses

4. Stress Physical & mental.

5. Early and excessive use of accommoda­tion.

Curative treatment of myopia can be dis­cussed under:

1. Optical

2. Medical

(i) Drugs

(ii) Physiological

3. Surgical

I shall be discussing some aspects of medical management of myopia. In the literature, var­ious drugs have been used for the treatment of myopia but none is known to have given statis­tically positive results. The drugs tried are:

1. Cycloplegics.

2. Pilocarpine.

3. S/C Saline.

4. Dionine.

5. Mercury salt solution.

6. Heparin.

7. Carbogens.

8. Vitamin A,C,D,E.

9. Minerals.

I shall like to discuss the role of physiologi­cal aspects in the causation and management of myopia. Various factors like ocular muscu­lar strains, excessive accommodation and im­proper posture during near work and rading, have been implicated in the causation and progression of myopia.

We undertook a study in rabbits to evaluate the role of the above factors in the pathogenesis of this conditions. Artificial myopia was produced in growing rabbits by raising the body temperature to 40°c for 30 mi­nutes and repeatedly elevating the intra ocular pressure to 40° of mercury by applying section cup at the limbus. The animals in which ex­perimental myopia was produced were di­vided into 5 groups as under:

Group I: Untreated control (three animals)

Group II: Treated control artificial myopia (A.M.) Five animals were subjected to the ar­tificial myopia (A.M.) procedure as described above.

Group III: A.M. and Tenotomy (five ani­mals) - Free tenotomy of all the rectus muscles was performed on both eyes immediately after the A.M. procedure.

Group IV A.M. and Resection (five ani­mals). Resection 3-5 mm of all the four recti was carried out immediately after the A.M. procedure.

Group V Dependent posture and A.M. Five animals were placed with their heads in depen­dent position in a specially designed box, in­clined at 6;° for 12 hrs. per day for 4 days and then subjected to the A.M. procedure.

The animals with any general or local pathology were excluded from study. The following parameters were used for the assess­ment of myopia.

1. Refraction under (Homatropine).

2. Keratometery.

3. Measurement of anetrior chamber depth.

4. Position of the lens.

Results

The average myopic changes reached a peak (-1.37 D) after 14 days and remained unal­tered thereafter upto 30 weeks. These results are statistically significant (P /0.001) when compared with rabbits in the untreated control group (1).

In Group III in which a free tenotomy of all four recti was performed in order to achieve the maximum relaxation, the average myopic change in refraction (-0.63 D) developed slowly reached peak after 21 days and thereaf­ter remained unaltered upto 6 months. These figures are significantly lower than those in GroupII (-0.63 S ± 0.07 S.E.M.) Vs. -1.37 D ± 0.05 (S. E. M.), P /0.001).

In Group IV in which resection of all four recti was carried out in order to increase their mechanical action on the glove, the average myopic change in refraction developed slowly and reached a peak (-1.90 D) after 12 days and remained unaltered thereafter upto 6 months.

Comparison of groups III and IV shows that resection of recti enhanced the production of artificial myopia while free tenotomy di­minished it (-0.63 D ± 0.07) (S.E.M.) vs. - 1.90 D ± 0.08 (S. E. M.), P /0.001) and suggest that the tone of extra-ocular muscles may play a significant role in the genesis of artificial myopia.

The changes in refraction in Group V in which the effect of dependant posture has been studied, revealed that the myopic changes developed slowly to reach a peak of - 2.00 D and remained unaltered thereafter upto 6 months. A set of readings in this group taken after initial maintenance in the depen­dent posture but before the A.M. procedure showed no change in refraction. However, when the animals were subjected to rise of body temperature and increase in the in­traocular pressure, significant degree of myopia was produced. The readings in Group V(-2.00 D ± 0.07) is significantly greater than -1.37 D ± 0.05 in Group II (P /0.001). It can be inferred from the above observation that de­pendent posture increased the production of experimental myopia.

Children with myopia of more than -1.0D and less than -3.0D with cyclinder not more 0.5D were selected for this study. Controlled group consisting of normal children chaving no refractive error.They were devided into three groups.

Group I Myopes using spectacles -40

Sub Group A. Put on treat- =20

ment

B. Not put on =20

treatment =20

Group 2 Mypes not using spectables -40

Sub Group A. Put on treat- =20

ment

B. Not put on =20

treatment =20

Group 3 Chiildren having no refrac- -40

tive error

Sub Group A. Put on treat- =20

ment

B. Not put on =20

treatment =20

The following daily schedule of medical treatment and exercises was prescribed to half the children in each group.

1. Early morning washing face and eyes.

2. Sun treatment in rising & setting sun for five minutes.

3. `Neck exercises for 5 minutes.

4. Eye exercise for 5 minutes (Pencil, short swing, long swing).

5. Palming for 5 minutes in between exer­cises and whenever eyes feel tired.

6. Diet (Protein 75 gm, Total 2000 calories).)

7. Proper posture & illumination 8. Honey eye drops 30%

9. Vitamins.

The children attended the hospital twice a week for doing the exercises under direct supervision. Various recommended drugs under Ayurveda and Bates system were in­cluded alongwith general physical and eye exercises. The purpose of the study was to see collectively if all these different measures con­tributre towards the prevention, arrest or re­versal of myopia.

Without going into the details of the methodology adopted of each factor, the re­sults at the end of 6 months follow up did not show any statistically significant difference in the refractive status in any of the children of the treated groupos. However, subjectively most of the children felt relieved of eye strain and other symptoms.


   Conclusions Top


Although the experimental evidence is in favour of the possible role of ocular muscle st­rain, excessive accommodation and depen­dent posture; avoidance of these factors and other exercises tried in the clinical study did not show any statistically significant results in a six months follow-up.




 

Top
Print this article  Email this article
Previous article Next article

    

© 2005 - Indian Journal of Ophthalmology
Published by Medknow

Online since 1st April '05