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Expert Interview Myopia
Treatment of Myopia – Current Status and
An Expert Interview with Andrzej Grzybowski
Department of Ophthalmology, Poznan ’ City Hospital, Poland; Department of Ophthalmology, University of Warmia and Mazury,
Andrzej Grzybowski is Professor of Ophthalmology and Chair of Department of Ophthalmology, University of Warmia and Mazury, Olsztyn,
Poland and Head of Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland. He is active
in international scientific societies including EURETINA (Co-opted Board member), the American Academy of Ophthalmology (AAO;
International Fellow; member of the Global ONE Advisory Board and Museum of Vision’s Program Committee), the International Society
of Bilateral Cataract Surgeons, the International Council of Ophthalmology (programme coordinator for the World Council of Optometry
from 2011 to 2018), Cogan Society, the European Association for Vision and Eye Research (EVER), the European Society of Cataract and
Refractive Surgeons (ESCRS) (curator of ESCRS Archive), and representative of Poland at the International Society of Refractive Surgery
International Council. He became a lifelong member (chair LIV) of the European Academy of Ophthalmology) and its Treasurer. He has
organised sessions on myopia at major international ophthalmic meetings, EVER 2014, AAO 2016 and 2017, EURETINA 2017 and the
World Congress of Paediatric Ophthalmology and Strabismus 2017. Andrzej Grzybowski is on the Editorial Board of several international
medical, ophthalmic and historical journals, including Acta Ophthalmologica, Graefes’ Archive for Experimental and Clinical Ophthalmology,
Translational Vision Science and Technology and Neuro-Ophthalmology. He has been an active editor, editor-in-chief and author of more
than 350 peer-reviewed international publications (total impact factor higher than 700), and a reviewer for more than 20 journals.
Keywords Myopia, atropine, pirenzepine, fluid
misdirection syndrome, EURETINA
Disclosure: Andrzej Grzybowski has nothing to declare
in relation to this article. This is an expert interview and as
such has not undergone the journal’s standard peer
Authorship: All named authors meet the International
Committee of Medical Journal Editors (ICMJE) criteria for
authorship of this manuscript, take responsibility for the
integrity of the work as a whole, and have given final
approval to the version to be published.
Open Access: This article is published under the
Creative Commons Attribution Noncommercial License,
which permits any non-commercial use, distribution,
adaptation and reproduction provided the original
author(s) and source are given appropriate credit.
Received: 24 November 2017
Published Online: 22 December 2017
Citation: European Ophthalmic Review, 2017;11(2):85–6
Corresponding Author: Andrzej Grzybowski,
Department of Ophthalmology, Poznan ’ City Hospital,
3 Szwajcarska St, 361–285 Poznan ’ , Poland.
Support: No funding was received in the publication of
T he incidence of myopia is increasing and represents a major global economic and
social burden. 1 In addition to its disadvantages in terms of vision, myopia increases
the risk of myopic macular degeneration, retinal detachment, glaucoma and cataract
and is a leading cause of visual impairment and blindness worldwide. 2 Pharmacological,
environmental and optical interventions have been used to try to slow the progress of myopia.
While spectacles and contact lenses have a long history in controlling accommodative
responses, they do not slow progression. In an expert interview conducted at EURETINA 2017,
Andrzej Grzybowski of the Institute for Research in Ophthalmology, Poznan, Poland discusses
the current status of myopia and its treatment, as well as discussing new technologies aimed
at delaying progression of the condition.
Q: Why has the prevalence of myopia increased so much in
The modern rise in myopia mirrors a trend for children in many countries spending more time
engaged in reading, studying or glued to computers and smartphone screens. The evidence
suggests that these environmental factors changes play a significant role, particularly in East and
Southeast Asia. In some places, children cannot get enough outdoor light: there are too few hours
of daylight, the sun is too fierce or the cold too intense. 3,4
Q: What have been the most important advances in non-surgical
treatment for myopia in the last year?
High-dose atropine (1% and 0.5%), moderate-dose atropine (0.1%) and low-dose atropine (0.01%)
showed clear effects in myopia control (all with statistically significant effect). 5–7 With that the
preliminary results of ongoing studies regarding the efficacy of pirenzepine, increased light
exposure (e.g., using the Kurango study lamp) and 7-methylxantine are promising. 8
Q: What are the benefits and limitations of the use of atropine
eye drops for the treatment of myopia?
High-dose atropine was proved to be superior to other interventions. The side-effects might include
temporary stinging, blurred vision, pupil dilation and eye irritation, limiting a long-term application. 9
This leaves low-dose atropine, pirenzepine and soft contact lenses with myopia control features
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