Spring 2017

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CLSA EyeWitness Spring 2017 17 affects both vision and self-concept. Most people with nystagmus have vision limitations because the eyes continually sweep over what they are viewing, making it impossible to obtain a clear image. If a refractive error is found, contact lenses may be the most effective way of obtaining best-cor- rected vision. Myopia Control In 1962, George Jesson, OD present- ed his somewhat "controversial" lec- ture, "Orthofocus Techniques" at the International Society of Contact Lens Specialists meeting in Chicago. Later, Newton Wesley, OD, MD, sug- gested the word "orthokeratology" at the same meeting. Since that time, improvements in lens manufacturing, lens materials, fitting techniques and topography tools have allowed many individuals with myopia to function during the day without wearing their corrective glasses or contacts. The ap- plication of these specially designed lenses was later recognized by re- searchers as also slowing the progres- sion of myopia in children. Research- ers around the world now study this slowing of myopia in children in an ef- fort to combat the worldwide epidemic of eyes that develop nearsightedness in an effort to avoid the inherent dangers of an eye as it elongates. Earl Smith's work at the Universi- ty of Houston showed that the myopic eye continues to be stimulated to grow as a result of being hyperopic in the pe- ripheral retina. Ferree and Rand first proposed the finding of light rays not behind the peripheral retina. The application of special rigid lenses that compress the cen- tral epithelial cells and move them more pe- ripherally increases the bending of light to focus on the retina in the pe- ripheral area thus block- ing the stimulus for eye growth (Figure 1). All contact lens wear carries some de- gree of potential com- plications. The degree of potential complica- tions increases signifi- cantly with overnight wear. Eye care profes- sionals who perform modern day orthokera- tology should consider risks versus benefits as they discuss these spe- cial lens designs with parents. The parents of these patients should be informed of the importance of keeping the lenses clean, good hy- giene and on-going follow-up in order to minimize risk factors. In our prac- tice, caregivers are required to read and sign an informed consent docu- ment to assure their understanding of the potential risks and commit to partnership with us. In addition, the primary reason to offer the treatment is not good uncorrected vision during Fig. 1 Until we know more, the ophthalmic community should continue to advocate children spend some amount of time outdoors and less time with the cell phones. being equally focused across the plane of the retina in 1933. Another way to say it is the myopic eye is shorter in the peripheral than it is centrally. Myopic correction focuses light on the central retina (fovea) to improve vision. How- ever, myopic lens correction placed in front of the normally prolate cornea results in light rays that come to focus the day but the science of slowing the progression of myopia. Researchers may one day provide proven ways to avoid myopia. The most recent research published in Jan- uary of this year states that a myopic cell has been discovered in the retina. Scientists at Northwestern School of Medicine found this particular cell

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