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Eye exercises for myopia prevention and control: a comprehensive systematic review and meta-analysis of controlled trials

Eye volume 38, pages 473–480 (2024)Cite this article

Subjects

Abstract

Objectives

To evaluate the efficacy of eye exercises in preventing and controlling myopia.

Methods

We searched studies on eye exercises from nine Chinese and English databases from their inception to December 15, 2022. Using random-effect models and sensitivity/subgroup analyses, we estimated the effects of eye exercises compared to control on changes in three measures: visual acuity, refractive error (both quantified using standardized mean differences, SMDs), and protective/mitigating effects (assessed through risk ratios, RRs).

Results

Eleven studies were included in the meta-analysis, with 921 participants. Nine studies had some concerns of bias in at least two domains, and two studies had a high risk of bias in two domains. Seven studies used visual acuity to measure myopia; visual acuity declined after eye-exercise interventions (SMD = −0.67, 95% CI −1.28 to −0.07, Z = 2.17, P = 0.03) and the effect was not better than control (SMD = −0.50, 95% CI −1.16 to 0.16, Z = 1.49, P = 0.14). Two studies used refractive error to measure myopia; the effect of eye-exercise interventions did not differ from control (SMD = −1.74, 95% CI −6.27 to 2.79, Z = 0.75, P = 0.45). Seven studies reported on protective/mitigating effects; eye exercises exhibited a greater protective/mitigating effect than control (RR = 0.40, 95% CI 0.23–0.71, Z = 3.13, P < 0.01).

Conclusions

Overall, the results suggest that eye exercises have limited to no efficacy in preventing or controlling myopia progression. Until robust evidence supports their efficacy, available evidence suggests retiring the eye-exercise policy.

摘要

方法: 在九个主要中文和英文数据库里搜索与眼保健操相关的对照实验研究, 日期为从数据库建立起至2022年12月15日, 并使用荟萃分析 (随机效应模型和敏感性分析) 估计眼保健操相对对照组在三个近视指标上的效果, 即视敏度, 屈光误差 (均使用标准化均数差, SMD), 以及保护/缓解效果 (风险比, RR) 。

结果: 共有11项研究纳入了这个荟萃分析, 涉及921名参与者——有九项研究在至少两个方面有偏倚问题, 而有两项研究在两个方面有高偏倚风险。其中七项研究使用视敏度来评估近视: 眼保健操干预后, 视力下降了 (SMD = −0.67, 95% CI −1.28 to −0.07, Z = 2.17, P = 0.03), 且其效果并不优于对照组 (SMD = −0.50, 95% CI −1.16 to 0.16, Z = 1.49, P = 0.14) 。两项研究使用屈光误差来评估近视: 眼保健操干预的效果与对照组无异 (SMD = −1.74, 95% CI −6.27 to 2.79, Z = 0.75, P = 0.45) 。七项研究报告了保护/缓解效果: 眼保健操的保护/缓解效果优于对照组 (RR = 0.40, 95% CI 0.23–0.71, Z = 3.13, P < 0.01) 。

结论: 荟萃分析表明, 眼保健操在预防或控制近视进展方面的疗效有限或无效。因此, 在有充分证据支持其疗效之前, 建议停止继续实施眼保健操政策。

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Fig. 1: PRISMA Flowchart for the Study Selection Process.
Fig. 2: Forest Plots for the Four Comparisons.

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Data availability

This study is registered on the Open Science Framework. Extracted data and code are available online (https://osf.io/dr5jk/); additional requests may be made to the corresponding author.

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Acknowledgements

Yichen Wu and Xinran Ge contributed to the literature search, screening, and coding; and Xiani Jia contributed to the editing of a preliminary draft of methods and results.

Funding

The study was supported by the National Key R&D Program of China (STI2030-Major Projects+2021ZD0204200), National Natural Science Foundation of China (32071045), Guangdong Basic and Applied Basic Research Foundation (2019A1515110574), and Shenzhen Fundamental Research Program (JCYJ20210324134603010). The funding bodies had no role in the study design, data collection, analysis, and interpretation, report writing, or the decision to submit for publication.

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  1. These authors contributed equally: Feng Xiao, Weiye Cheng.

Authors and Affiliations

  1. The Chinese University of Hong Kong, Shenzhen, Shenzhen, China

    Zhicheng Lin, Feng Xiao & Weiye Cheng

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Contributions

ZL conceived and designed the study. WC and FX searched the literature and screened articles. FX and WC analyzed the data, constructed the table, and drew the figures under the supervision of ZL. ZL wrote the manuscript. FX and WC had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. FX and WC contributed equally to this work.

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Correspondence to Zhicheng Lin.

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Lin, Z., Xiao, F. & Cheng, W. Eye exercises for myopia prevention and control: a comprehensive systematic review and meta-analysis of controlled trials. Eye 38, 473–480 (2024). https://doi.org/10.1038/s41433-023-02739-x

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