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PURPOSE: To evaluate the efficacy of a myopia control spectacle lens (DIMS) at slowing the progression of myopia in a population of European children in comparison with 0.01% atropine and combined DIMS and atropine. METHODS: The study was a non-randomised experimenter-masked prospective controlled observational study of individuals aged 6-18 years with progressing myopia but no ocular pathology. Participants were allocated, according to patient/parent choice, to receive 0.01% atropine eyedrops, DIMS (Hoya® MiyoSmart®) spectacles, combined atropine+DIMS or single vision spectacle lenses (control group). The key outcome variables, cycloplegic autorefraction spherical equivalent refraction (SER) and axial length (AL), were measured at baseline and after three, six, and 12 months. RESULTS: Of the 146 participants (mean age 10.3y ±3.2), 53 received atropine, 30 DIMS spectacles, 31 atropine+DIMS, and 32 single vision control spectacles. Generalized linear mixed model analysis revealed for SER, whilst controlling for age and SER at baseline, at each stage all treatment groups had significantly reduced progression compared with the control group (p<0.016). For AL, whilst controlling for baseline age and AL, at 6 and 12 months all treatment groups had significantly less progression than the control group (p<0.005). For SER only, in pairwise comparisons at 12 months the atropine+DIMS group had significantly reduced progression compared with the DIMS only and Atropine only groups (p<0.001). CONCLUSION: In a European population, DIMS and atropine are effective at reducing myopia progression and axial elongation in progressing myopia and are most successful at reducing myopia progression when used in combination.

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Purpose: This research investigated the reported optometric prescribing criteria of Israeli optometrists. Methods: An online questionnaire based on previous studies was distributed via email and social networking sites to optometrists in Israel. The questionnaire surveyed the level of refractive error at which respondents would prescribe for different types of refractive error at various ages with and without symptoms. Results: 124 responses were obtained, yielding a response rate of approximately 12-22%, 92% of whom had trained in Israel. For all refractive errors, the presence of symptoms strongly influenced prescribing criteria. For example, for 10-20 year old patients the degree of hyperopia for which 50% of practitioners would prescribe is +0.75D in the presence of symptoms but twice this value (+1.50D) in the absence of symptoms. As might be expected, optometrists prescribed at lower degrees of hyperopia for older compared with younger patients. There was a trend for more experienced practitioners to be less likely to prescribe for lower degrees of myopia and presbyopia. Practitioner gender, country of training, the type of practice environment, and financial incentives were not strongly related to prescribing criteria. Conclusions: The prescribing criteria found in this study are broadly comparable with those in previous studies and with published prescribing guidelines. Subtle indications suggest that optometrists may become more conservative in their prescribing criteria with experience (AU)

Objetivo: Este estudio investigó los criterios de prescripción optométrica reportados por los optometristas israelíes. Métodos: Se distribuyó un cuestionario online basado en estudios previos, utilizando el correo electrónico y las redes sociales, a los optometristas de Israel. Dicho cuestionario sondeaba el nivel de error refractivo para el cual los encuestados realizarían prescripciones, para los diferentes tipos de error refractivo, a diversas edades y con variedad de síntomas. Resultados: Respondieron 124 personas, obteniéndose un índice de respuesta de aproximadamente el 12-22%. El 92% de los participantes se había formado en Israel. En hipermetropía, la presencia de síntomas influyó considerablemente en los criterios de prescripción. Por ejemplo, para pacientes de 10-20 años de edad, el grado de hipermetropía para el cual el 50% de los facultativos realizaría una prescripción sería de +0,75D en presencia de síntomas, pero se duplicaría este valor (+1,50D) en ausencia de ellos. Como cabría esperar, los optometristas prescribirían a personas mayores grados más bajos de hipermetropía, en comparación a las personas jóvenes. Los facultativos más experimentados reflejaron una tendencia de menor probabilidad de prescripción cuanto menor fuera el grado de miopía y presbicia. El sexo del facultativo, el país de formación, el tipo de entorno de práctica, y los incentivos financieros no guardaron una relación sólida con los criterios de prescripción. Los criterios de prescripción hallados en este estudio son ampliamente comparables a los de los estudios previos y a los de las guías publicadas. Conclusiones: Los criterios de prescripción optométrica en Israel pueden compararse a las recomendaciones de las guías publicadas por país de formación de los facultativos, profesional, género, o entorno laboral. Existen débiles indicadores que sugieren que los optometristas pueden volverse más conservadores, en cuanto a criterios de prescripción, con la experiencia (AU)

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PURPOSE: This research investigated the reported optometric prescribing criteria of Israeli optometrists. METHODS: An online questionnaire based on previous studies was distributed via email and social networking sites to optometrists in Israel. The questionnaire surveyed the level of refractive error at which respondents would prescribe for different types of refractive error at various ages with and without symptoms. RESULTS: 124 responses were obtained, yielding a response rate of approximately 12-22%, 92% of whom had trained in Israel. For all refractive errors, the presence of symptoms strongly influenced prescribing criteria. For example, for 10-20 year old patients the degree of hyperopia for which 50% of practitioners would prescribe is +0.75 D in the presence of symptoms but twice this value (+1.50 D) in the absence of symptoms. As might be expected, optometrists prescribed at lower degrees of hyperopia for older compared with younger patients. There was a trend for more experienced practitioners to be less likely to prescribe for lower degrees of myopia and presbyopia. Practitioner gender, country of training, the type of practice environment, and financial incentives were not strongly related to prescribing criteria. CONCLUSIONS: The prescribing criteria found in this study are broadly comparable with those in previous studies and with published prescribing guidelines. Subtle indications suggest that optometrists may become more conservative in their prescribing criteria with experience.

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