Chinese Eye Exercises and Myopia Development in School Age Children: A Nested Case-control Study

Meng-Tian Kang, Shi-Ming Li, Xiaoxia Peng, Lei Li, Anran Ran, Bo Meng, Yunyun Sun, Luo-Ru Liu, He Li, Michel Millodot, Ningli Wang, Meng-Tian Kang, Shi-Ming Li, Xiaoxia Peng, Lei Li, Anran Ran, Bo Meng, Yunyun Sun, Luo-Ru Liu, He Li, Michel Millodot, Ningli Wang

Abstract

Chinese eye exercises have been implemented in China as an intervention for controlling children's myopia for over 50 years. This nested case-control study investigated Chinese eye exercises and their association with myopia development in junior middle school children. Outcome measures were the onset and progression of myopia over a two-year period. Cases were defined as 1. Myopia onset (cycloplegic spherical equivalent ≤ -0.5 diopter in non-myopic children). 2. Myopia progression (myopia shift of ≥1.0 diopter in those who were myopic at baseline). Two independent investigators assessed the quality of Chinese eye exercises performance at the end of the follow-up period. Of 260 children at baseline (mean age was 12.7 ± 0.5 years), 201 were eligible for this study. There was no association between eye exercises and the risk of myopia-onset (OR = 0.73, 95%CI: 0.24-2.21), nor myopia progression (OR = 0.79, 95%CI: 0.41-1.53). The group who performed high quality exercises had a slightly lower myopia progression of 0.15 D than the children who did not perform the exercise over a period of 2 years. However, the limited sample size, low dosage and performance quality of Chinese eye exercises in children did not result in statistical significance and require further studies.

Figures

Figure 1. Flow chart of subjects in…
Figure 1. Flow chart of subjects in the nested case-control study.
Figure 2. Annual change in axial length…
Figure 2. Annual change in axial length and spherical equivalent refraction with different qualities of eye exercises performance.
Error bars mean standard error.

References

    1. Saw S. M., Gazzard G., Shih-Yen E. C. & Chua W. H. Myopia and associated pathological complications. Ophthalmic Physiol Opt. 25, 381–391, 10.1111/j.1475-1313.2005.00298.x (2005).
    1. Li S. M. et al.. Design, methodology and baseline data of a school-based cohort study in Central China: the Anyang Childhood Eye Study. Ophthalmic Epidemiol. 20, 348–359, 10.3109/09286586.2013.842596 (2013).
    1. Therodore G. Primary care optometry 5th ED, (eds Kathy Folk) Ch. 6, 99–101 (Butterworth-Heinemann, 1989).
    1. Li S. M. et al.. Near work related parameters and myopia in Chinese children: the Anyang Childhood Eye Study. PLoS One 10, e0134514, 10.1371/journal.pone.0134514 (2015).
    1. Li S. M. et al.. Time Outdoors and Myopia Progression Over 2 Years in Chinese Children: The Anyang Childhood Eye Study. Invest Ophthalmol Vis Sci. 56, 4734–4740, 10.1167/iovs.14-15474 (2015).
    1. Tan N. W. et al.. Temporal variations in myopia progression in Singaporean children within an academic year. Optom Vis Sci. 77, 465–472 (2000).
    1. Li S. M. et al.. Atropine slows myopia progression more in Asian than white children by meta-analysis. Optom Vis Sci 91, 342–350, 10.1097/opx.0000000000000178 (2014).
    1. Li S. M. et al.. Multifocal versus single vision lenses intervention to slow progression of myopia in school-age children: a meta-analysis. Surv Ophthalmol. 56, 451–460, 10.1016/j.survophthal.2011.06.002 (2011).
    1. Li S. M. et al.. Efficacy, Safety and Acceptability of Orthokeratology on Slowing Axial Elongation in Myopic Children by Meta-Analysis. Curr Eye Res. 1–9, 10.3109/02713683.2015.1050743 (2015).
    1. Zhang X. Are Chinese eye exercises ineffective? No. Family Science and Health 9, 24–25 (2012).
    1. Wang X. Are eye exercises effective? available at: 2014-10/23/content_1646450.htm, (Date of access: 23 Oct. 2014) (2014).
    1. Chen J., Lu Y., Huang Y. & Lin R. Literature Study on the Regularity of Acupoints Selection for the Treatment of Myopia [J]. Journal of Traditional Chinese Medicine 16, 029 (2011).
    1. Rosenfarb A. Healing Your Eyes with Chinese Medicine: Acupuncture, Acupressure & Chinese Herbs Ch. 1, 1–9 (North Atlantic Books, 2007).
    1. Field T. Massage therapy, acupressure, and reflexology Ch. 4, 43–52 (American Psychological Association, 2009).
    1. Evans M. Are eye exercises harming Chinese students vision? available at: (Date of access: 22nd July 2012) (2012).
    1. Lin Z. et al.. Eye exercises of acupoints: their impact on refractive error and visual symptoms in Chinese urban children. BMC Complement Altern Med. 13, 306, 10.1186/1472-6882-13-306 (2013).
    1. Xie H. L., Xie Z. K., Zhou F. & Hu L. Myopia prevalence and influencing factor analysis of primary and middle school students in our country. Zhonghua Yi Xue Za Zhi. 93, 999–1002 (2013).
    1. Zhong P. W. K., Zhang C. & Bin Z. The epidemiological investigation of myopia in junior students. Prac J Med Pharm. 21, 10.14172/j.cnki.issn1671-4008.2004.06.055 (2004).
    1. Zhang D. H. T. Study on the effect of attitude to eye exercise on vision. Chin J School Doctor 20, 501–505 (2006).
    1. Wang Xiaoxiao W. J. Investigation and analysis on health care knowledge attitude and behavior of university students for myopua. Chinese General Nursing 9, 2257 (2011).
    1. Riqiang Xiong Q. L. A survey of incorrect eye exercises among students Chin J School Doctor 22 (2001).
    1. Li S. M. et al.. Efficacy of Chinese eye exercises on reducing accommodative lag in school-aged children: a randomized controlled trial. PLoS One 10, e0117552, 10.1371/journal.pone.0117552 (2015).
    1. Fu J. et al.. Prevalence of amblyopia and strabismus in a population of 7th-grade junior high school students in Central China: the Anyang Childhood Eye Study (ACES). Ophthalmic Epidemiol. 21, 197–203, 10.3109/09286586.2014.904371 (2014).
    1. Li S. M. et al.. Paraxial Schematic Eye Models for 7- and 14-Year-Old Chinese Children. Invest Ophthalmol Vis Sci. 56, 3577–3583, 10.1167/iovs.15-16428 (2015).
    1. Li S. M. et al.. Distribution of ocular biometry in 7- and 14-year-old Chinese children. Optom Vis Sci. 92, 566–572, 10.1097/opx.0000000000000570 (2015).
    1. Parssinen O. & Lyyra A. L. Myopia and myopic progression among schoolchildren: a three-year follow-up study. Invest Ophthalmol Vis Sci. 34, 2794–2802 (1993).
    1. He M. et al.. Effect of time spent outdoors at school on the development of myopia among children in China: a randomized clinical trial. JAMA 314, 1142–1148 (2015).
    1. Zhao R., H. X.-G. & Zhu J.-f. Beliefs and behavior related to Chinese students eye exercises among primary and secondary school teachers and students in Shanghai. Chinese Journal of School Health 33, 3 (2012).
    1. Xiong R. L. Q. Survey on the nonstandard performance of Chinese eye exercises in children. Chinese Journal of School Health 22, 1 (2001).
    1. Ip J. M. et al.. Role of near work in myopia: findings in a sample of Australian school children. Invest Ophthalmol Vis Sci. 49, 2903–2910, 10.1167/iovs.07-0804 (2008).
    1. Huang C. Y., Hou C. H., Lin K. K., Lee J. S. & Yang M. L. Relationship of lifestyle and body stature growth with the development of myopia and axial length elongation in Taiwanese elementary school children. Indian J Ophthalmol. 62, 865–869, 10.4103/0301-4738.141047 (2014).
    1. Rose K. A. et al.. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology 115, 1279–1285, 10.1016/j.ophtha.2007.12.019 (2008).
    1. Wu P. C., Tsai C. L., Wu H. L., Yang Y. H. & Kuo H. K. Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology 120, 1080–1085, 10.1016/j.ophtha.2012.11.009 (2013).

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi