The Science
Behind

In 1675, Sir Isaac Newton wrote:

"If I have seen further it is by standing
on the shoulders of giants."

In developing each mEYE® report we are relying on research conducted over many decades by thousands of researchers worldwide. Over 30,000 research papers on myopia alone are listed on PubMed®, the world’s largest medical science database.

Harnessing advanced data science tools, Ocumetra translates findings from peer-reviewed research, incorporating over a million data points on refractive development, eye growth, myopia-related eye disease, and vision impairment to craft highly personalized mEYE reports for each child examined.

Centile Charts

Loughman J, Saunders KJ, Harrington S, Flitcroft DI. Asian and Western refractive centile curves from meta-analysis of population refraction data. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4245.

McCullough S, Adamson G, Breslin KMM, McClelland JF, Doyle L, Saunders KJ. Axial growth and refractive change in white European children and young adults: predictive factors for myopia. Sci Rep. 2020 Sep 16;10(1):15189. doi: 10.1038/s41598-020-72240-y. PMID: 32938970; PMCID: PMC7494927.

Harrington SC, Stack J, Saunders K, et al. Refractive error and visual impairment in Ireland schoolchildren. Br J Ophthalmol 2019; 103: 1112–1118.

Flitcroft D.I, Loughman, Arumugam B, Bradley A, Chamberlain P. Centile-based analysis of refractive development in the MiSight® 1 day Myopia Control trial.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1372.

Vitale S, Sperduto RD, Ferris FL. Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Arch Ophthalmol 2009; 127: 1632–9.

Tideman JWL, Polling JR, Vingerling JR, et al. Axial length growth and the risk of developing myopia in European children. Acta Ophthalmol 2018; 96: 301–309.

Truckenbrod C, Meigen C, Brandt M, et al. Reference curves for refraction in a German cohort of healthy children and adolescents. PLoS One 2020; 15: e0230291.

Yoon KC, Choi W, Lee HS, Kim SD, Kim SH, Kim CY, Park KH, Park YJ, Baek SH, Song SJ, Shin JP, Yang SW, Yu SY, Lee JS, Lim KH, Oh KW, Kang SW. An Overview of Ophthalmologic Survey Methodology in the 2008-2015 Korean National Health and Nutrition Examination Surveys. Korean J Ophthalmol. 2015 Dec;29(6):359-67.

Kim DH, Lim HT. Myopia Growth Chart Based on a Population-Based Survey (KNHANES IV-V): A Novel Prediction Model of Myopic Progression in Childhood. J Pediatr Ophthalmol Strabismus 2019; 56: 73–77.

Sanz Diez P, Yang LH, Lu MX, et al. Growth curves of myopia-related parameters to clinically monitor the refractive development in Chinese schoolchildren. Graefe’s Arch Clin Exp Ophthalmol 2019; 257: 1045–1053.

He M, Huang W, Zheng Y, et al. Refractive error and visual impairment in school children in rural southern China. Ophthalmology 2007; 114: 374–82.

Li T, Jiang B, Zhou X. Axial length elongation in primary school-age children: a 3-year cohort study in Shanghai. BMJ Open 2019; 9: e029896.

Li Y, Liu J, Qi P. The increasing prevalence of myopia in junior high school students in the Haidian District of Beijing, China: A 10-year population-based survey. BMC Ophthalmol 2017; 17: 88.

Vision simulator

Blendowske R. Unaided visual acuity and blur: A simple model. Optom Vis Sci 2015; 92: e121-125

Strasburger H, Bach M, Heinrich SP. Blur Unblurred—A Mini Tutorial. i-Perception. March 2018. doi:10.1177/2041669518765850

Raasch, T. Spherocylindrical Refractive Errors and Visual Acuity. Optometry and Vision Science: 1995; 72(4):272-275

How could myopia management help?

Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, Smith W, Mitchell P. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. 2008 Aug;115(8):1279-85. doi: 10.1016/j.ophtha.2007.12.019. Epub 2008 Feb 21. PMID: 18294691.

Wu P, Chen C, Chang L, Niu Y, Chen M, Liao L, Rose K, Morgan I, Increased Time Outdoors Is Followed by Reversal of the Long-Term Trend to Reduced Visual Acuity in Taiwan Primary School Students, Ophthalmology 2020 127; 1462-1469.

Xiong S, Sankaridurg P, Naduvilath T, Zang J, Zou H, Zhu J, Lv M, He X, Xu X. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review. Acta Ophthalmol. 2017 Sep;95(6):551-566. doi: 10.1111/aos.13403.

Németh J, Tapasztó B, Aclimandos WA, et al. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. European Journal of Ophthalmology. 2021;31(3):853-883. doi:10.1177/1120672121998960

Kate L. Gifford, Kathryn Richdale, Pauline Kang, Thomas A. Aller, Carly S. Lam, Y. Maria Liu, Langis Michaud, Jeroen Mulder, Janis B. Orr, Kathryn A. Rose, Kathryn J. Saunders, Dirk Seidel, J. Willem L. Tideman, Padmaja Sankaridurg; IMI – Clinical Management Guidelines Report. Invest. Ophthalmol. Vis. Sci. 2019;60(3):M184-M203.

Foreman, J., Salim, A. T., Praveen, A., Fonseka, D., Ting, D. S. W., He, M. G., … & Dirani, M. (2021). Association between digital smart device use and myopia: a systematic review and meta-analysis. The Lancet Digital Health, 3(12), e806-e818.

Media Use in School-Aged Children and Adolescents. Pediatrics November 2016; 138 (5): e20162592.

Physical activity and exercise guidelines

O’Donoghue L, Kapetanankis VV, McClelland JF, et al. (2015) Risk Factors for Childhood Myopia: Findings from the NICER Study. Invest Ophthalmol Vis Sci. 56:1524-30

Morgan IG, Wu P-C, Ostrin L, et al. IMI risk factors for myopia. Invest Ophthalmol Vis Sci. 2021;62(5):3.1

Myopia progression and treatment effectiveness

Moore M, Loughman J, Butler JS, et al. Application of big-data for epidemiological studies of refractive error. PLoS One; 16. Epub ahead of print 1 April 2021. DOI: 10.1371/JOURNAL.PONE.0250468.

Loughman J, Moore M, Flitcroft DI. Myopia Progression Centiles from Real World Data: An Ecologically Valid Tool for Myopia Treatment Efficacy Monitoring?. Invest. Ophthalmol. Vis. Sci. 2020;61(7):79.

Polling JR, Klaver C, Tideman JW. Myopia progression from wearing first glasses to adult age: the DREAM Study. Br J Ophthalmol 2021; bjophthalmol-2020-316234.

He M, Ge J, Zheng Y, Huang W, Zeng J (2006) The Guangzhou Twin Project. Twin Res Hum Genet 9: 753–757.

Zhou WJ, Zhang YY, Li H, et al. Five-year progression of refractive errors and incidence of myopia in school-aged children in Western China. J Epidemiol 2016; 26: 386–395.

Guo Y, Liu LJ, Tang P, et al. Outdoor activity and myopia progression in 4-year follow-up of Chinese primary school children: The Beijing Children Eye Study. PLoS One; 12. DOI: 10.1371/journal.pone.0175921.

Huang J, Wen D, Wang Q, et al. Efficacy comparison of 16 interventions for myopia control in children: A network meta-analysis. Ophthalmology 2016; 123: 697–708.

Chamberlain P, Peixoto-de-Matos SC, Logan NS, et al. A 3-year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optom Vis Sci 2019; 96: 556–567.

Flitcroft D.I, Loughman, Arumugam B, Bradley A, Chamberlain P. Centile-based analysis of refractive development in the MiSight® 1 day Myopia Control trial.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1372.

Bao J, Huang Y, Li X, et al. Spectacle Lenses With Aspherical Lenslets for Myopia Control vs Single-Vision Spectacle Lenses: A Randomized Clinical Trial. JAMA Ophthalmol. 2022;140(5):472–478. doi:10.1001/jamaophthalmol.2022.0401

The importance of lifestyle

Bullimore MA, Ritchey ER, Shah S, Leveziel N, Bourne RRA, Flitcroft DI. The Risks and Benefits of Myopia Control. Ophthalmology 2021; 128(11):1561-1579.

Tideman JWL, Snabel MCC, Tedja MS, et al. Association of Axial Length With Risk of Uncorrectable Visual Impairment for Europeans With Myopia. JAMA Ophthalmol 2016; 134: 1355.

Ramakrishnan R, Nirmalan PK, Krishnadas R, et al. Glaucoma in a Rural Population of Southern India: The Aravind Comprehensive Eye Survey. Ophthalmology 2003;110:1484-90.

Pan CW, Cheung CY, Aung T, et al. Differential Associations of Myopia with Major Age-Related Eye Diseases: The Singapore Indian Eye Study. Ophthalmology 2013;120:284-91.

Xu L, Wang Y, Wang S, et al. High Myopia and Glaucoma Susceptibility the Beijing Eye Study. Ophthalmology 2007;114:216-20.

Chon B, Qiu M, Lin SC. Myopia and Glaucoma in the South Korean Population. Invest Ophthalmol Vis Sci 2013;54:6570-7.

Qiu M, Wang SY, Singh K, Lin SC. Association between Myopia and Glaucoma in the United States Population. Invest Ophthalmol Vis Sci 2013;54:830.

Shen L, Melles RB, Metlapally R, et al. The Association of Refractive Error with Glaucoma in a Multiethnic Population. Ophthalmology 2016;123:92-101.

Grødum K, Heijl A, Bengtsson BB. Refractive error and glaucoma. Acta Ophthalmol Scand 2001; 79: 560–566.

Wong TY, Foster PJ, Johnson GJ, Seah SK. Refractive Errors, Axial Ocular Dimensions, and Age-Related Cataracts: The Tanjong Pagar Survey. Invest Ophthalmol Vis Sci 2003;44:1479-85.

Wong TY, Klein BE, Klein R, et al. Refractive Errors and Incident Cataracts: The Beaver Dam Eye Study. Invest Ophthalmol Vis Sci 2001;42:1449-54.

Chang MA, Congdon NG, Bykhovskaya I, et al. The Association between Myopia and Various Subtypes of Lens Opacity: See (Salisbury Eye Evaluation) Project. Ophthalmology 2005;112:1395-401.

Ogawa A, Tanaka M. The Relationship between Refractive Errors and Retinal Detachment–Analysis of 1,166 Retinal Detachment Cases. Jpn J Ophthalmol 1988;32:310-5.

Zou H, Zhang X, Xu X, et al. Epidemiology Survey of Rhegmatogenous Retinal Detachment in Beixinjing District, Shanghai, China. Retina 2002;22:294-9.

Risk Factors for Idiopathic Rhegmatogenous Retinal Detachment. The Eye Disease Case-Control Study Group. Am J Epidemiol 1993;137:749-57.

Bohringer HR. Statistics on the Frequency and Risks on Retinal Detachment. Ophthalmologica 1956;131:331-4.

Perkins ES. Morbidity from Myopia. Sight Sav Rev 1979;49:11-9.

Burton TC. The Influence of Refractive Error and Lattice Degeneration on the Incidence of Retinal Detachment. Trans Am Ophthalmol Soc 1989;87:143-55; discussion 55-7.

Mitry D, Charteris DG, Yorston D, et al. The Epidemiology and Socioeconomic Associations of Retinal Detachment in Scotland: A Two-Year Prospective Population-Based Study. Invest Ophthalmol Vis Sci 2010;51:4963-8.

Liu HH, Xu L, Wang YX, et al. Prevalence and Progression of Myopic Retinopathy in Chinese Adults: The Beijing Eye Study. Ophthalmology 2010;117:1763-8.

Centile Charts

Centile charts have been a standard part of monitoring children’s height and weight for over a 100 years and their application to monitor spectacle prescription and eye growth uses the same principles.

A centile value shows where a child is compared to boys or girls of the same age
In general, children tend to follow whichever centile they are on, if nothing else changes in their lives
Centiles can be used to determine where a child’s prescription may end up. They are a useful guide, and perhaps the best tool we have, but they are not a perfect prediction. Some children will end up higher and some lower than their expected adult values, the aim of treatment is to shift this centile position so that their expected adult prescription and eye length is lower.

Vision simulator

This part of the tool simulates expected vision quality with either glasses/contact lenses and without glasses/contact lenses (uncorrected vision). While a myopic child’s vision with glasses/contact lenses should remain good, their uncorrected vision will worsen with increasing myopia. At low levels of myopia, preserving uncorrected vision quality is one of the goals of treatment to ensure a child is less dependent on their glasses/contact lenses for daily life.

How could myopia management help?

All available myopia management options have been tested in clinical trials comparing them to conventional single vision glasses. We express the benefits of these treatments in terms of the probability of significant changes in glasses strength. For lower levels of myopia, we assess the risk of developing related eye diseases, and for higher levels, the risk of future visual impairment. The benefits are based on average reported outcomes from current treatments.

Myopia progression and treatment effectiveness

New options and insights into treatment effectiveness can change fairly quickly as research continues to grow. We consistently review new evidence regarding treatments including how well they work and incorporate that information if necessary into each report. Your link or QR-code will always show the most up to date treatment information.

The importance of lifestyle

A vast amount of research has looked at how our behaviour and lifestyle growing up, affects our eyes. We have tried to distill this into the most important messages, that can help to not only delay the onset of myopia in children but also maximize how well their chosen treatment could work for them.

Want to know more?

For a complete list of references used in the development of our tools, please get in touch at info@ocumetra.com

The Science Behind

Centile Charts

Vision simulator

How could myopia management help?

Myopia progression and treatment effectiveness

The importance of lifestyle

Want to know more?

Let's talk!

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The Science
Behind