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Purpose: To evaluate the effect of parental myopia on eye size and growth in Chinese children., Methods: A school-based, cross-sectional survey was performed in Chinese children 5 to 16 years of age. A longitudinal cohort study was conducted 1 year later. The effects of parental myopia, parental education level, and near work performed by the child on the refractive error and ocular biometry of the child were assessed., Results: There were 7560 children enrolled in the initial study (response rate: 76.3%). One year later, 4468 children (response rate: 75.9%) in the original cohort (with the exception of those who had completed primary schooling) were evaluated, to determine eye growth. Although children with a stronger parental history of myopia tended to be less hyperopic before the onset of myopia (spherical equivalent refraction [SER] = 0.43 D, 0.67 D, and 0.68 D in children with two, one, and no myopic parents respectively; P = 0.007), the axial lengths did not follow the same pattern (axial length [AL] = 23.11, 23.07, and 23.15 mm; P = 0.429). Eye growth and myopic shift in refraction occurred more rapidly among children with a stronger parental history of myopia (annual AL growth/myopia progression = 0.37 mm/-0.22 D, 0.26 mm/-0.07 D, and 0.20 mm/-0.02 D in children with two, one, and no myopic parents, respectively; P < 0.001)., Conclusions: Ocular biometric data in Chinese children suggest that parental history of myopia influences the growth rate of the eye, rather than its size before the onset of myopia, as previously reported in Caucasian children. Further longitudinal studies involving children of different ethnicities are warranted.

Purpose: To study the safety and efficacy of topical 1% atropine eye ointment in retarding myopic progression in children with moderate to severe myopia., Methods: This was an interventional control study. Children (aged 5-10 years) with myopia of -3.00 diopters (D) or more were treated with 1% atropine ointment once daily for 1 year. Baseline and regular assessments of refractive errors by cycloplegic autorefraction and of axial length were done by ultrasound biometry, and the results were compared with data of control subjects., Results: Twenty-three children (mean age: 7.4 +/- 1.6 years) with moderate to severe myopia, being treated in the Hong Kong Eye Hospital of the Chinese University of Hong Kong, were recruited into the atropine group, and 23 children from the same eye clinic were matched with the study subjects with respect to age, sex, and initial spherical equivalent refraction, as controls. The initial refractive errors were -5.18 +/- 2.05 D and -5.12 +/- 2.33 D in the atropine and the control groups, respectively (P = 0.934). Myopic progression was significantly less (P = 0.005) in the atropine group (+0.06 +/- 0.79 D) than in the control group (-1.19 +/- 2.48 D). Axial length increase was also significantly smaller in the atropine group (0.09 +/- 0.19 mm) than in the control group (0.70 +/- 0.63 mm) (P = 0.004). One child (4.3%) developed an allergic reaction. No other major adverse effects related to the treatment were noted., Conclusion: Topical 1% atropine ointment is a safe and effective treatment for retarding myopic progression in moderate to severe myopia. Further large-scale randomised controlled study with longer follow-up seems warranted., ((c) Japanese Ophthalmological Society 2007.)

Purpose: To study refraction and axial length changes after cataract extraction and primary intraocular lens (IOL) implantation in children younger than 1 year of age., Setting: Two regional hospitals., Methods: After determining the IOL power for emmetropia, 80% of the value was used to choose the IOL for implantation to counter anticipated myopic shift with age. The main outcome measures were changes in refraction and axial length 3 years after surgery., Results: Thirty-four eyes of 20 children (mean age 6.7 months +/- 3.9 [SD]) were studied. Refraction in the immediate postoperative period was +4.53 +/- 1.45 diopters (D). Three years after surgery, the mean refraction was -2.49 +/- 3.08 D (P<.001). Twenty-two eyes (64.7%) had surgery during the first 6 months of life (group 1) and had a shorter axial length at surgery (mean 18.92 +/- 1.32 mm) compared with 12 eyes (35.3%) that received surgery between 7 and 12 months (group 2, mean 20.29 +/- 1.00 mm) (P = .007). However, the final axial length was greater in group 1 (mean 22.67 +/- 1.04 mm) than in group 2 (mean 21.23 +/- 0.26 mm) (P = .019)., Conclusions: Primary IOL implantation is an option for children having cataract surgery in the first year of life. Significant myopic shifts occurred, and this seemed to be more pronounced in younger children. It appears that rethinking current strategies for IOL power calculation may be required to achieve more optimal refractive outcomes.

Purpose: To evaluate parental history of myopia as a predictor of refractive error and eye size in Chinese pre-school children., Methods: A total of 514 pre-school children (aged 2.3--6.4 years) were examined. Parental history of myopia, amount of near work performed, refractive status and ocular biometry were recorded., Results: There was no significant difference in spherical equivalent refraction (SER) among children with no myopic parents (mean+0.94+/-0.05 D), one myopic parent (mean+0.77+- 0.07 D) and two myopic parents (mean+0.79+/- 0.12 D) (p=0.102) after controlling for age and amount of near work. Further, children with more myopic parents did not have longer eyeballs (p=0.335)., Conclusions: In this study in Chinese pre-school children, parental history of myopia was not found to be associated with a myopic refractive error or increased eyeball length. Further studies with larger sample sizes would help to confirm these results.

Introduction: Myopia is the most common eye disorder especially in Asia. However, the information on myopic progression and ocular growth among preschool children, who undergo rapid changes, is limited. The aim of this study was to determine the prevalence, incidence of myopia and myopic progression among preschool children in Hong Kong., Materials and Methods: A kindergarten was randomly chosen in Hong Kong, China. Preschool children aged 2 to 6 years attending the selected kindergarten were invited to participate. One hundred and eight children completed the 5-year cohort study. Refractive error and axial ocular dimensions were the main outcome measures., Results: A total of 255 preschool children with a mean age of 4.96 (SD, 0.90) years were examined in the initial examination. Only 4.6% children had myopia of at least -0.50 D. The prevalence of myopia increased almost 10-fold to 43.5% after 5 years in the final examination. The annual incidence of myopia was 8.2%. The mean increase in axial length was 1.72 mm (SD, 0.80 mm) over the 5-year period (P < 0.001). The lens thickness decreased significantly from 3.80 mm (SD, 0.37 mm) to 3.74 mm (SD, 0.51 mm) whereas the vitreous chamber depth increased significantly from 15.01 mm (SD, 0.68 mm) to 16.42 mm (SD, 0.88 mm) (both P < 0.001). Children who were younger or were less hypermetropic at the initial examination was having greater myopic progression (P = 0.015, P < 0.001 respectively)., Conclusion: This is the first prospective study to investigate the myopic progression and ocular growth among preschool children. Hong Kong has a high prevalence of myopia even in preschool children. They also experience a significant myopic shift and ocular growth. Further studies on the prevention of myopic development or progression should be targeted on this population.

Purpose: To evaluate the safety and efficacy of "needleless" regional anesthesia via the sub-Tenon's route without adjunct facial nerve or subconjunctival block for vitreoretinal surgery., Methods: Forty-eight consecutive patients were included and studied prospectively. The number, time, and volume of anesthetic solutions given were recorded. Any complications such as severe intraocular pressure rise or orbital hemorrhage were noted. Within 24 hours after surgery, the patients were asked to grade their level of pain during the procedure using a standard 10-point visual analog scale. The use of postoperative analgesic agents was recorded from the nurses' notes. Patient demography, number of previous vitreoretinal operations, preoperative diagnosis, and operative procedures performed were recorded., Results: Thirty-seven (77%) patients needed only one or two infiltrations of anesthetic solution (range 1-5, mean 2.1). Ninety-two percent of patients reported a pain score of 0-2 on the visual analog scale (range 0-5, mean 1.17). Ninety percent of patients required no analgesic or just acetaminophen for the control of postoperative pain. The other patients received a single dose or multiple doses of codeine. All patients had adequate akinesia and anesthesia. No complications were encountered., Conclusion: Needleless regional anesthesia appears to be safe and effective and can thus be considered as an alternative method of anesthesia in suitable vitreoretinal cases.