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The scoping review on eye exercise for myopia in children was aimed to provide an evidence-informed overview to highlight the role of exercises for myopia in children. This helps in the treatment of myopia and to improve the visual health in easy and better way. More high quality research articles are needed to prove the effort of exercise on myopia in children.
Physiotherapy and Occupational Therapy Journal / Volume 8 Number 1 / January - March 2015
Physiotherapy and Occupational Therapy Journal
Volume 8 Number 1, January - March 2015
Review Article
© Red Flower Publication Pvt. Ltd.
A Scoping Literature Review on Effects of Eye Exercises
for Myopia in Children
Author Affilation: *,**Post Graduate student, ***Assistant
Professor, ****Profe ssor, and Princ ipal, Maha rishi
Markandeshwar Institute of Physiotherapy and Rehabilitation,
Maharishi Ma rkande shwar University, Mul lana-13 3207.
Haryana, India.
Reprint Request: Vencita Priyanka Aranha, Post Graduate
student researcher, Maharishi Markandeshwar Institute of
Physiotherapy and Rehabilitation, Maharishi Markandeshwar
University, Mullana-133207. Ambala, Haryana, India.
© Red Flower Publication Pvt. Ltd.
The scoping review on eye exercise for myopia in children was aimed to provide an evidence-informed
overview to highlight the role of exercises for myopia in children. This helps in the treatment of myopia
and to improve the visual health in easy and better way. More high quality research articles are needed
to prove the effort of exercise on myopia in children.
Keywords: Pediatric Myopia; Pediatric Visual Rehabilitation; Oculomotor Rehabilitation.
Rahul Pandey*, Vencita Priyanka Aranha**, Asir John Samuel ***, Senthil P. Kumar
Myopia is the commonest type of refractive error
in eye where the light from infinity will focus in front
of retina rather than focusing on the retina leads to
blurring of image. Myopia is derived from Greek word
muópia which means “trying to see like a blot”, and
also called as shortsightedness. Shiny et al [1]
described the eye with myopia as “one for which the
punctum remotum is a short distance off, sometimes
only a little inches from the eye”, and also says
myopia is “one in which the images focus in front of
the retina while eye at rest”.
The preponderance of shortsightedness varies by
country and by indigenous assortment, reaching as
high as 70-90% in some Asian populations [2]. Near
epidemic levels of myopia of up to 80% have been
reported in countries such as Hong Kong, Taiwan,
Singapore and Japan [3-5]. In Europe and America,
its preponderance varies between 30-40%, while in
Africa 10-20% of the population is affected.
Shortsightedness affects 25% of the population in
United States. The prevalence of myopia in India is
45% [6-8]. Available treatment option for myopia are
optical correction, pharmaceutical treatment like
cycloplegic promoters, vision therapy,
orthokeratology, refractive surgeries like (radial
keratotomy, excimer laser photorefractive
keratectomy), osteopathy, yoga therapy and aerobic
exercise therapy [9]. These treatment choices have
many problems like post-operative complication,
cosmetic problem, eye infection, the daily use of
spectacles may limits their daily activities such play,
dance, and even other activities specially in children.
The simple eye exercise will be more beneficial for
the treatment of myopia in children
Exercise therapy for eye is not a new approach. In
fact, vision workout and treatment approach have
been around for years. The designs of these treatment
or eye exercises aids in conquer different visual
disorders including binocular function. Not all the
treatment methods have been proven effective by
exercises. In this study we explored the research
articles from the pubmed and Cochrane library for
eye exercises and myopia in children and all available
articles selected for review.
Exercises and Myopia
Samia [10] have done a randomized clinical trial
on myopia with 15 female aged between 12 to 15 years
in Saudi Arabia and the results of the study showed
that there is improvement in visual acuity in subjects
with myopia. These results suggest that clinicians
should consider the use of eye exercises as a way of
improving visual acuity for adolescents suffering
from myopia.
Physiotherapy and Occupational Therapy Journal / Volume 8 Number 1 / January - March 2015
Pandey et. al. / A Scoping Literature Review on Effects of Eye Exercises for Myopia in Children
Rathod et al [11] performed research work on
myopia in thirty subjects, age ranging between 18-25
years. Subjects were randomly assigned in to two
group that is Group A (Experimental Group) and
Group B (Control group). Group A received Eye
focusing exercises 10 repetition 3 sets daily for
4 weeks with standard care and the control group
does not received any exercises except standard care
for myopia for 4 weeks. The results show that, the
eye exercises are effective in improving near point
convergence in myopia but the improvement of visual
acurity was not statistically significant
Gosewade et al [12] have conducted a study on
the effect of eye exercise techniques along with
kapalbharti pranayama on Visual Reaction Time
(VRT). 60 participants with an age group of 18–30
years were divided into two equal groups (study
group and control group) containing 30 subjects
(18 male and 12 female) each. VRT of all
participants were taken prior to the study. Eight
weeks of regular eye exercise techniques and
kapalbharti pranayama was trained for the study-
group subjects whereas the control-group subjects
were not practiced any eye exercises techniques.
After 8 weeks VRT was measured again. The result
shows there was significant decrease in the VRT
after intervention in study group and there were
not any changes noticed in VRT of control group.
They concluded that the simple eye exercises along
with pranayama helps in improvement of visual
reaction time.
Gopinathan et al [13] have performed a research
and they were aimed to evaluate the role of eye
exercises and Trataka Yoga Kriya on Ammetropia
and Presbyopia. 66 patients were divided under
two main groups with four sub groups of
refractive error like shortsightdness, hyperopia,
astigmatism, and presbyopia, respectively,
(Group A – 32 patients, Group B – 34 patients) by
random sampling method. Group A subjects were
asked to perform eye exercises daily once for
3 weeks. Group B subjects were instucted to
perform Trataka Yoga Kriya once at daily (either
in morning or in evening) for 3 weeks. The
prescribed eye exercises were Sunning, Eye wash,
Palming, Candle light reading, Shifting and
Swinging, Playing with ball, Vaporization and Cold
pad. The subjects were observed for 1 month in order
to see any adverse effects of the therapy. The study
suggests that there was one line rectification in
Snellen’s chart reading and concluded that a non-
medicinal, inexpensive, relaxation approaches can
rectify the quality of vision, by which it discursively
review the betterment of the disease status.
The available treatment option for myopia have
many consequences like cosmetic problems, eye
strain, asthenopic symptoms, post LASIK infection,
postoperative infection, recurrence of refractive error
etc. to overcome from these consequences the eye
exercise can provide beneficial therapeutic effect for
the treatment or prevention of the development of
myopia without any consequences. Limitation of this
review is lack of systemic review and lack of clinical
In these literature reviews we found that how eye
exercises are effective in the treatment of myopia. But
there are only three cochrane and two pubmed
indexed researches are published till date. The
intension of this review is focused to emphasize the
research for the treatment of myopia with exercise in
future days. So that myopia can be treated in a better
and easy way.
Conflict of Interest
Non declared
1. Shiny G, Joseph BB. Study on the prevalence and
underlying factors of myopia among the students
of a medical college in Kerala. Int J Med Res
Health Sci 2014; 3:3 30-7.
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Vis Sci 2009; 86: 624-8.
3. Ahmed I, Mian S, Mudasir S, Andrabi KI.
Prevalence of myopia in students of srinagar city
of kashmir, India. Int J Health Sci (Qassim) 2008;
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4. Wong TY, Foster PJ, Hee J, Ng TP, Tielsch JM,
Chew SJ, Johnson GJ, Seah SK.Prevalence and
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in Singapore. Invest Ophthalmol Vis Sci 2000;
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Pokharel GP, Sanga L, Bachani D.Refractive error
in children in an urban population in New Delhi.
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Physiotherapy and Occupational Therapy Journal / Volume 8 Number 1 / January - March 2015
Pandey et. al. / A Scoping Literature Review on Effects of Eye Exercises for Myopia in Children
6. Chalasani S, Jampala VK and Nayak P, Myopia
among Medical Students-A Cross Sectional Study
in a South Indian Medical College, Al Ameen
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7. Kathrotia RG, Dave AG, Dabhoiwala ST, Patel
ND, Rao PV and Oommen ER, Prevalence and
progression of refractive errors among medical
students, Indian Journal of Physiology and
Pharmacology 2012; 56: 284–87.
8. Sood RS, Sood A; Prevelance of Myopia among the
Medical Student in Western India vis-à-vis the
East Asian epidemic: IOSR-JDMS 2014; 13: 65-
9. Verhoeven VJ, Wong KT, Buitendijk GH, Hofman
A, Vingerling JR, Klaver CC.Visual consequences
of refractive errors in the general population.
Ophthalmology 2015; 122: 101-9.
10. Mohamed Samia AAR. Vision Therapy-Based
Program for Myopia Control in Adolescents.
Middle-East J Sci Res 2013; 13: 390-6.
11. Rathod VJ, Desai DP, Alagesan J. Effect of eye
exercise on myopia-Randomized controlled
study. J Pharm Biomed Sci 2011; 10: 1-4.
12. Gosewade NB, Shende VS, Kashalikar SJ. Effect
of Various Eye Exercise Techniques along with
Pranayama on Visual Reaction Time: A Case
Control Study. J Clin Diagn Res 2013; 7: 1870-3.
13. Gopinathan G, Dhiman KS, Manjusha R. A
clinical study to evaluate the efficacy of Trataka
Yoga Kriya and eye exercises (non-
pharmocological methods) in the management
of Timira (Ammetropia and Presbyopia). Ayu
2012; 33: 543-6.
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... Although some people believe that Chinese eye exercises may not be associated with the prevalence of myopia in children, others believe that the prevalence of myopia may be higher if children do not perform eye exercises. Some studies show that 90% of Chinese children do eye exercises every day, but they do not perform them correctly (13,14). Most Chinese children cannot find accurate acupoints around their eyes, and they do not have accurate exercise pressure and operation skills. ...
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Objective This study aims to summarize the relevant evidence on the association between eye exercises and myopia in children and adolescents in China.Methods The meta-analysis pooled the results of 12 studies, with a total of 134,201 participants. Another five studies (no OR for myopia as an outcome and meeting inclusion criteria) were reported in the systematic review. We searched PubMed, Web of Science, CNKI, Wan Fang, and reference lists of retrieved studies. Association estimates were pooled using random-effects meta-analyses. Odds ratios (ORs) and 95% confidence intervals (CIs) for eye exercises and myopia were pooled from a meta-analysis.ResultsAfter standardizing the reference values, a pooled OR of the univariate analysis showed a 24% reduction in myopia in children and adolescents who performed eye exercises (OR = 0.76; 95% CI: 0.62–0.89). After adjusting the covariate, a pooled OR of multiple logistic analysis for myopia (OR = 0.87; 95% CI: 0.72–1.02) showed that there is no significance between eye exercises and myopia. However, in subgroup studies of the multivariate analysis, the large sample (OR = 0.84; 95% CI: 0.74–0.94) and Chinese database (OR = 0.80; 95% CI: 0.67–0.93) subgroup showed modest protective effects. In addition, five studies in the systematic review also evaluated the risk of myopia events, and Chinese eye exercises had a modest protective effect on myopic control, but the incorrect performance of and attitude toward eye exercises posed negative effects on their eyesight health.Conclusion Chinese eye exercises have a modest protective effect on myopic control, but considering that the incorrect performance of and attitude toward eye exercises have a significant influence on the effect of eye exercises, the effect of eye exercises may not be enough to prevent the progress of myopia in the long term, and more standardized eye exercises need to be conducted.
Full-text available
In this study, ancient texts and contemporary research findings are analysed to gain a better understanding of Yoga-based ocular exercise (Trataka). Our search terms included Trataka, yogic visual concentration, yoga eye exercise and Yoga ocular exercise. Based on the inclusion and exclusion criteria, a search of references published between 1924 and August 2021 yielded 22 articles. The limited studies demonstrated a positive effect on the regulation of autonomic functions, the enhancement of cognitive functions, the reduction of eye-related discomfort and ailments, and the enhancement of happiness and mental calmness. Regarding myopia and refractive error, trataka had no impact. The method itself was not consistent across all of the studies, and it differed from the scriptural description. The researcher has included a number of modifications and additions to the traditional methods. This technique's authenticity must be preserved. The internal mechanism of trataka is concerned with the process of attention and guides the practitioner to the higher levels of yogic state.
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Background: Few decades earlier, wearing spectacles was a province of adults over 40 years of age. Now we see more children and adolescents with spectacles/contact lenses. Various studies in Asian population show a dramatic increase in refractive error, especially myopia among school and college students. More advanced levels of education like medical education that involves extensive near work such as reading and writing have been repeatedly associated with greater myopia prevalence Objective: To study the prevalence and the underlying factors of myopia in MBBS students of a Medical college in Kerala. Research methodology: One hundred and sixty two MBBS students (2009 – 2012 batches) were examined. 40 students were selected from each class by systematic random sampling technique, their visual acuity was checked using Snellen’s Chart and Diopters were obtained. Details of factors were obtained using a questionnaire. Results: Prevalence of myopia was observed as 39.5%. First and second year students had a greater percentage of myopia with 40% & 52.5% respectively. 40.6% of myopics had positive family history of myopia (p = 0.003). Duration of TV watching and computer use showed a significant relation with myopia. (p = 0. 033, 0.009). Reading hours, type of light used, playing or texting with cell phone and sleeping habits of students were not significant. Conclusion: Prevalence of myopia was high among medical students (39.5%). Significance of genetic predisposition was well appreciated in our study.
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Objective To study the frequency and causes of visual impairment in relation to refractive error. Design Population-based cohort study. Participants A total of 6597 participants from Rotterdam Study I (baseline and 4 follow-up examinations) and 2579 participants from Rotterdam Study II (baseline and 2 follow-up examinations), all 55 years or older, were included. Methods Participants underwent an extensive ophthalmic examination, including best-corrected visual acuity and objective refraction, fundus photography, visual field perimetry, and optical coherence tomography imaging of macula and optic disc. We calculated cumulative risks and odds ratios of visual impairment for various refractive error categories and determined causes by using all screening information as well as medical records. Main Outcome Measures Unilateral and bilateral low vision (World Health Organization [WHO] criteria, VA <0.3 and VA ≥0.05; United States (US) criteria, VA <0.5 and VA ≥0.1) and blindness (WHO criteria, VA <0.05; US criteria, VA<0.1). Results Cumulative risks of visual impairment ranged from virtually 0 in all refractive error categories at 55 years of age to 9.5% (standard error, 0.01) for emmetropia and 15.3% (standard error, 0.06) for high hyperopia to 33.7% (standard error, 0.08) for high myopia at 85 years of age. The major causes of visual impairment in highly hyperopic persons were age-related macular degeneration (AMD), cataract, and combined causes (each 25%); in highly myopic persons, the major cause was myopic macular degeneration (38.9%). The major causes of visual impairment for the other refractive error categories were AMD and cataract. Compared with those with emmetropia, those with high myopia had a significantly increased lifetime risk of visual impairment; those with −6 diopters (D) or less and −10 D or more had an odds ratio (OR) risk of 3.4 (95% confidence interval [CI], 1.4–8.2) of visual impairment; those with less than −10 D had an OR of 22.0 (95% CI, 9.2–52.6). Conclusions Of all refractive errors, high myopia has the most severe visual consequences. Irreversible macular pathologic features are the most common cause of visual impairment in this group.
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Introduction: We depend on eyesight more than any other of our senses to maneuver through the space around us. In a fraction of a second, our eyes work with our brain to tell us the size, shape, colour, and texture of an object. Our eyes are body's most highly developed sensory organs. The use of computers and television in the era of information technology has given new heights to the professional success rate and it saves time but on the other hand, it has led to an increase in the number of patients with ocular complaints. Aims: The objective of the study was to study the effect of eye exercise techniques along with kapalbhati pranayama on Visual Reaction Time (VRT). Material & methods: Total 60 subjects in an age group of 18-30 were recruited in the study. All the subjects were divided into two equal groups (study group and control group) containing 30 subjects (18 male & 12 female) each. Both the male and female subjects were selected on the basis of their voluntary involvement. Visual reaction time for red and green light was recorded from all 60 subjects before the start of the study. Study group subjects were trained to practice various eye exercise techniques and kapalbhati pranayama for 8 weeks regularly whereas control group were busy with their routine activities. After 8 weeks, visual reaction time was measured for red and green light from all 60 subjects. Statistical analysis: Data expressed as Mean ± S.D, Student t -test was applied for analysis of data, p value <0.05 is taken as statistically significant. Results: Statistical analysis of data shows that there is a significant decrease in the visual reaction time for red and green light after intervention in study group (p value <0.05). Whereas there is no significant decrease in VRT in control group (p value >0.05). Conclusion: The results of our study suggest that simple eye exercises along with pranayama helps in improvement of visual reaction time.
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Timira is a disease that can be attributed to wide range of clinical conditions starting from mild blurring of vision and having potential risk of permanent vision loss. According to the involvement of Dhatus (body elements) the condition can be grouped into two stages. The initial stage or Uttana, where the involvement of Dhatus is limited to Rasa, Rakta (blood), and Mamsa Dhatu (muscle tissue). When the Doshas are localized in the first and second Patala refractive error do happen and in presbyopia more emphasis is given to Mamsa Dhatu. In this study only Uttana stage of Timira was considered. The clinical study was done on 66 patients of Timira in two groups of four sub groups each of myopia, hypermetropia, astigmatism, and presbyopia. Group A was subjected to eye exercises (Bates method) and Group B was subjected to Trataka Yoga Kriya. After the enrolment of patients for this study, signs and symptoms were assessed both subjectively and objectively before, during, and after treatment. The study indicates that subjectively there are significant results in both the groups but objectively there is not much improvement.
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Vision therapy and rehabilitation have been used to successfully treat a wide range of visual disorders for over 90 years. Eye exercises are considered as one of the vision therapy-based program. Myopia as a refractive defect of the eye could be controlled through the use of vision therapy. The purpose of this study was to investigate the effectiveness of specifically designed eye exercises program on myopia control for Saudi female adolescents. Fifteen female students were recruited from two schools in Riyadh city. They ranged in age from 12 to15 years. A program of eye exercises was practiced by all subjects for six weeks. Visual acuity was measured by the use of an auto refraction device before and after six weeks of training. The results revealed a significant improvement of visual acuity in both right (p=0.028) and left eyes (p= 0.020) indicating that eye exercises as vision therapy-based program could improve visual acuity for female adolescents with myopia.
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Myopia is a common ocular disorder. Prevalence data with regard to myopia is scarce in India and almost nonexistent in Kashmir. To determine the prevalence of myopia in Srinagar City and to evaluate risk factors associated with the disease. 38 schools in the Srinagar were selected randomly and students were examined by our optometrist team. Children with refractive error of -0.25 D to -5.9 D were considered myopic, while those with -6 D and above were considered high myopic. χ2 Tests were used as appropriate to test whether potential risk factors were significantly associated with myopia. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated for risk factors that were independently associated with myopia in this population. A total of 4,360 students of mean age 12.11 (95% confidence interval [CI] = 11.99 - 12.22: range, 7-18) participated in the study. Myopia was found in 4.74% students. Increasing age was associated with the increased risk of having myopia. Girl students were more likely to have myopia than boys (OR = 1.52). The prevalence of myopia among girls was more than that of boys. Students from low socioeconomic conditions were having higher prevalence of myopia than their counterparts from higher socioeconomic counterparts. Reduced vision because of myopia is an important health problem in students in Srinagar City. Most of these students do not have the necessary correction spectacles. Effective strategies are needed to eliminate the cause of a significant visual problem.
Objective: A systematic cross-sectional study conducted in a South-Indian Medical College to establish refractive errors as a plebeian problem in young medical students. Background: Increase in myopia prevalence rates posing a threat to the health and economy of the developing countries. There is ample evidence in the ophthalmic literature to support the classic view of association of myopia with the learned people. However, there are also suggestions in regard to the role of environmental, nutritional, hereditary and work associations for this dramatic increase in myopia. Method: In the present study, the medical students of NRI Medical College were studied for their refractive errors. In addition, their gender distributions, heights, weights, body mass indices were also studied in a batch-wise manner. Information about the refractive errors of eye of their parents are gathered through interviewing these medial students. Results and Conclusion: Our observations suggest that – (a) myopia is the predominant refractive errors among the medical students; (b) the numbers of myopic students in a batch of medical students are increasing year by year; (c) there is no apparent bias towards either gender and (d) majority of the parents of myopic medical students are also found to be myopic.