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      Myopia: its historical contexts

      review-article
      1 , 2 , 3
      The British Journal of Ophthalmology
      BMJ Publishing Group
      history of myopia, accommodation, myopia classification

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          Abstract

          Worldwide, and especially in Asia, myopia is a major vision-threatening disorder. From AD 1600 on, to prevent myopia, authors warned against near work without sufficient pauses. There was an abundance of theories about the causes of myopia, the most common one being the necessity of extra convergence on nearby work with thickened extraocular muscles and elevated intraocular pressure. Ocular tenotomies against myopia were in vogue for a while. Axial lengthening of the eye in myopia was mentioned around 1700, but it took 150 years to become accepted as the most prevalent sign of high myopia. In 1864, a lucid concept of myopia and other ametropias arose through a clear separation between accommodation and refraction. Posterior staphyloma was known around 1800 and its association with myopia became evident some 30 years later. There still seems to be no generally accepted classification of myopia and particularly not of degenerative or pathologic myopia. This review focuses on myopia from 350 BC until the 21st century and on the earliest writings on the histology of eyes with posterior staphyloma. A proposal for myopia classification is given.

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          Most cited references23

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          The posterior staphyloma of pathologic myopia.

          R B Curtin (1976)
          A total of 250 myopic patients with posterior staphyloma affecting one or both eyes received a complete ocular examination including binocular indirect ophthalmoscopy, refraction, and axial length measurement. Ten types of staphyloma were noted; five primary and five compound. The primary staphyloma involved the posterior pole (Type I), macular area (Type II), peripapillary area (Type III), the fundus nasal to the disc (Type IV) and the area below the disc (Type V). Compound staphylomas consisted of combined primary staphylomas or distinctive and complex variations of a primary staphyloma, usually Type I. This type also was found to have the greatest prevalence of all ten types. Patients in this group had a 19% incidence of legal blindness with 34.5% of staphylomatous eyes having a vision of 20/200 or less. A remarkably wide range of refractions and axial lengths were found for each staphyloma type. These results indicate the importance of the staphyloma in the diagnosis and prognosis of pathologic myopia. It also offers an improved basis for genetic studies of this disease.
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            Normal and staphylomatous sclera of high myopia. An electron microscopic study.

            The posterior sclera of three normal eyes and five staphylomatous, myopic eyes was examined by electron microscopy. The following notable differences were found in myopic sclera: a predominantly lamellar, collagen fiber bundle arrangement; a reduction in the diameter of the fibrils; a greater dispersion for the range of fibril diameters; an increase in unusual star-shaped fibrils on cross section; and a greater prevalence of fibril groups with uniform but extremely fine diameters. These findings essentially agree with those in other studies of the myopic sclera. The ultramicroscopic changes encountered inpathologic myopia are judged to be compatible with an abnormal proteoglycan composition of the interfibrillary substance in the ectatic sclera.
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              Scleral changes in pathological myopia.

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                Author and article information

                Journal
                Br J Ophthalmol
                Br J Ophthalmol
                bjophthalmol
                bjo
                The British Journal of Ophthalmology
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0007-1161
                1468-2079
                August 2018
                3 February 2018
                : 102
                : 8
                : 1021-1027
                Affiliations
                [1 ] departmentDepartment of Retinal Signal Processing , Netherlands Institute for Neuroscience , Amsterdam, The Netherlands
                [2 ] departmentDepartment of Ophthalmology , Academic Medical Center , Amsterdam, The Netherlands
                [3 ] departmentDepartment of Ophthalmology , Leiden University Medical Center , Leiden, The Netherlands
                Author notes
                [Correspondence to ] Professor Paulus T V M de Jong, Department of Retinal Signal Processing, Netherlands Institute for Neuroscience, KNAW, Amsterdam 1105 BA, The Netherlands; p.dejong@ 123456nin.knaw.nl
                Article
                bjophthalmol-2017-311625
                10.1136/bjophthalmol-2017-311625
                6059036
                29437569
                9bf20484-4dea-4202-8d0c-05df3bb9c4cf
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

                History
                : 17 November 2017
                : 03 January 2018
                Categories
                Review
                1506
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                Ophthalmology & Optometry
                history of myopia,accommodation,myopia classification
                Ophthalmology & Optometry
                history of myopia, accommodation, myopia classification

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