The progression of corrected myopia

  • Antonio MedinaEmail author
Basic Science



This study seeks to demonstrate the existence of a feedback loop controlling myopia by comparing the prediction of a feedback model to the actual progression of corrected myopia. In addition to theoretical results, confirming clinical data are presented.


The refraction of 13 continuously corrected myopic eyes was collected over a period of time ranging from 4 to 9 years from the time of their first correction. Refractive data was collected in an optometry office from myopic young subjects from the general population in Boston. Subjects were myopes, ages 2 to 22 at the time of first correction selected randomly from a larger population. All individuals were fully corrected with lenses; new lenses were prescribed every time that their myopia increased by 0.25 diopters or more. Subjects wore their spectacle lenses during the followed period.


Subjects exhibit a linear time course of myopia progression when corrected with lenses. The observed rate of myopia increase is 0.2 to 1.0 diopters/year, with a mean correlation coefficient r  = −0.971, p < 0.005.


This report establishes that feedback control theory applies to the clinical phenomenon of progressive myopia. Continuous correction of myopia results in a linear progression that increases myopia. The Laplace transformation of temporal refractive data to the s-domain simplifies the study of myopia and emmetropia. The feedback transfer function predicts that continuous correction of myopia results in a linear progression because continuous correction opens the feedback loop. This prediction is confirmed with all subjects.


Emmetropia Emmetropization Refraction Laplace transform Feedback Myopia 


Conflict of interest statement

The author certifies that he has NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.


  1. 1.
    Pan C, Ramamurthy D, Saw SM (2012) Worldwide prevalence and risk factors for myopia. Ophthalmic Physiol Opt 32:3–16PubMedCrossRefGoogle Scholar
  2. 2.
    Medina A (1987) A model for emmetropization: predicting the progression of ametropia. Ophthalmologica 194:133–139PubMedCrossRefGoogle Scholar
  3. 3.
    Medina A (1987) A model for emmetropization: The effect of corrective lenses. Acta Ophthalmol 65:565–571CrossRefGoogle Scholar
  4. 4.
    Meyer C, Mueller MF, Duncker GI, Meyer HG (1999) Experimental animal models are applicable to human juvenile-onset myopia. Surv Ophthalmol 4:93–102CrossRefGoogle Scholar
  5. 5.
    Medina A, Fariza E (1993) Emmetropization as a first-order feedback system. Vis Res 33(1):21–26Google Scholar
  6. 6.
    Zhao H, Wang R, Wu M, Jiang J (2011) Dynamic changes of ocular biometric parameters: a modified form-deprivation myopia model of young guinea pigs. Int J Ophthalmol 4:484–488PubMedCentralPubMedGoogle Scholar
  7. 7.
    Raviola E, Wiesel TN (1985) An animal model of myopia. N Engl J Med 312(25):1609–1615PubMedCrossRefGoogle Scholar
  8. 8.
    Greene PR, Guyton DL (1986) Time course of rhesus lid-suture myopia. Exp Eye Res 42:529–534PubMedCrossRefGoogle Scholar
  9. 9.
    Hoyt CS, Stone RD, Fromer C, Billson FA (1981) Monocular axial myopia associated with neonatal eyelid closure in human infants. Am J Ophthalmol 9:197–200CrossRefGoogle Scholar
  10. 10.
    Ray WA, O'Day DM (1985) Statistical analysis of multi-eye data in ophthalmic research. Inv Ophthalmol Vis Sci 26:1186–1188Google Scholar
  11. 11.
    Goss DA (1987) Linearity of refractive change in childhood myopia progression. Am J Optom Physiol Opt 64:775–780PubMedCrossRefGoogle Scholar
  12. 12.
    Oakley KH, Young FA (1975) Bifocal control of myopia. Am J Optom Physiol Opt 52:738–764CrossRefGoogle Scholar
  13. 13.
    Chung K, Mohidin N, O'Leary DJ (2002) Undercorrection of myopia enhances rather than inhibits myopia progression. Vision Res 42(22):2555–2559PubMedCrossRefGoogle Scholar
  14. 14.
    Adler D, Millodot M (2006) The possible effect of undercorrection on myopic progression in children. Clin Exp Optom 89(5):315–321PubMedCrossRefGoogle Scholar
  15. 15.
    Leung JT, Brown B (1999) Progression of myopia in Hong Kong Chinese schoolchildren is slowed by wearing progressive lenses. Optom Vis Sci 76(6):346–354PubMedCrossRefGoogle Scholar
  16. 16.
    Berntsen DA, Sinnott LT, Mutti DO, Zadnik K (2012) A randomized trial using progressive addition lenses to evaluate theories of myopia progression in children with a high lag of accommodation. Inv Ophthalmol Vis Sci 53:640–649CrossRefGoogle Scholar
  17. 17.
    Vasudevana B, Esposito C, Petersona C, Coronado C, Ciuffreda K (2014) Under-correction of human myopia – is it myopigenic?: a retrospective analysis of clinical refraction data. J Optom 07:147–152Google Scholar
  18. 18.
    Goss DA (1994) Effect of spectacle correction on the progression of myopia in children — a literature review. J Am Optom Assoc 65:117–128PubMedGoogle Scholar
  19. 19.
    Ong E, Grice K, Held R, Thorn F, Gwiazda J (1999) Effects of spectacle correction on the progression of myopia in children. Optom Vis Sci 76(6):363–369PubMedCrossRefGoogle Scholar
  20. 20.
    The COMET Group (2013) Myopia stabilization and associated factors among participants in the Correction of Myopia Evaluation Trial (COMET). Invest Ophthalmol Vis Sci 54:7871–7883PubMedCentralCrossRefGoogle Scholar
  21. 21.
    Pärssinen O, Kauppinen M, Viljanen A (2014) The progression of myopia from its onset at age 8–12 to adulthood and the influence of heredity and external factors on myopic progression. A 23-year follow-up study. Acta Ophthalmol 92(8):730–739PubMedCrossRefGoogle Scholar
  22. 22.
    Flitcroft DI (2014) Emmetropisation and the aetiology of refractive errors. Eye 28:169–179PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Massachusetts Institute of TechnologyResearch Laboratory of ElectronicsCambridgeUSA
  2. 2.Multivision ResearchCosta MesaUSA

Personalised recommendations