Myopia in research and clinical practice

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1*Pennsylvania College of Optometry at Salus University, Eye- and Vision Center Optometrie Cagnolati GmbH

There are few other topics that are currently of such great interest to scientists and clinicians in ophthalmology and optometry as much as myopia. As myopia is known to be associated with secondary diseases, the subject of myopia control has long been of scientific relevance. In this context, the Swiss ophthalmologist Sidler-Huguenin should be mentioned, who already discussed the question "Can myopia be stopped?" at the beginning of the 20th century.1 Current and previous strategies designed to prevent the progression of myopia include optical and pharmacological methods. Atropine was first discussed more than 100 years ago in the context of myopia control. In 1965, Francis A. Young published an interesting paper on the possible effect of atropine on the progression of myopia in monkeys.3 Due to a large number of clinical studies worldwide, especially in the last 20 years, low-dose atropine, contact lenses (orthokeratology and special multifocal contact lenses) and multifocal spectacle lenses are now recognized as evidence-based methods to reduce myopia progression in children.4

The influence of light on the cause and treatment of myopia has also been studied for years.5,6,7 One of the first scientists to deal intensively on the development and treatment of myopia in connection with the influence of light was the Austrian ophthalmologist Friedrich Trichtel, who in two remarkable books developed the "light-stress theory of myopia development".8,9  Although Trichtel's ideas were first discussed increasingly in the German- and English- language literature, with a few exceptions they are rarely found in the current literature on myopia.10
Various light therapy methods as a potential intervention to slow progression of myopia have been in clinical use for some time or are currently being studied. These include the controversially discussed low-level red light therapy (LLRL) for myopia control and blue light stimulation of the blind spot, which we report on in the current OCL.

Based on the first use of the term myopia by the Greek philosopher Aristotle in the fourth century BC, the complex of the development and treatment of myopia has not yet been finally explained.
For this reason, the OCL Editorial Board is pleased to once again publish 4 articles in this OCL issue, which are dealing with the topic of myopia from different perspectives.

"There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance." (Hippocrates). With the thoughts of the Greek physician Hippocrates of Kos, born in 460 BC, I wish all OCL readers new insights into myopia.

[1] Greef, R. (1933). Das rechtsichtige und fehlsichtige Auge. In: Der Augenoptiker, II. Band: Das menschliche Auge (eds. H. Pistor und R. Greef), Panses Verlag, Weimar, pp. 156-220.

[2] Tscherning, M. (1904). Physiological Optics (trans. C. Weiland). The Keystone, Philadelphia, second edition.

[3] Young, F. A. (1965). The effect of Atropine on the Development of Myopia in monkeys. Am. J. Optom. Arch. Am. Acad. Optom., 42, 439-449.

[4] Dhiman, R., Rakheja, V., Gupta, V.,
Saxena, R. (2022). Current concepts in the management of childhood myopia. Indian J. Ophthalmol., 70, 2800-2815.

[5] Rucker, F. (2019). Monochromatic and white light and the regulation of eye growth. Exp. Eye Res., 184, 172-182.

[6] Zhang, P., Zhu, H. (2022). Light Signaling and Myopia Development: A Review. Ophthalmol. Ther., 11, 939-957.

[7] Gisbert, S., Wahl, S., Schaeffel, F. (2022). Impact of cone abundancy ratios and light spectra on emmetropization in chickens. Exp. Eye Res., 219, 109086.

[8] Trichtel, F. (1983). Das Licht und die Pathologie des Auges. Verlag Wilhelm Maudrich; Wien-München-Bern.

[9] Trichtel, F. (1986). Zur Entstehung und Therapie der Myopieentwicklung. Ferdinand Enke Verlag; Stuttgart.

[10] Wildsoet, C. F., Chia, A., Cho, P., Guggen­heim, J. A., Polling, J. R., Read, S., Sankaridurg, P., Saw, S. M., Trier, K., Walline, J. J., Wu, P. C., Wolffsohn, J. S. (2019). IMI – Interventions Myopia Institute: Interventions for Controlling Myopia Onset and Progression Report. Invest. Ophthalmol. Vis. Sci., 60, M106-M131.