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Dispersion impairments are a well-known limitation in data center communications, limiting both the usable data rates and reaches. Several companies today adopt silicon photonics as a core technology in their transceiver products. This presents an opportunity for silicon photonics-based dispersion management technologies to be integrated with the transceiver transmitter or receiver. In this manuscript, we present a ring-resonator based, tunable dispersion compensation device, providing dispersion ranging as wide from + 12.9 × 103ps/nm to -12.3 × 103ps/nm. Thermo-optic tuning from 20°C to 70°C is demonstrated to allow continuous wavelength tuning across 200â GHz. High-speed experiments using 25 Gb/s non-return-to-zero data propagating through 20â km of single mode fiber show that a significant improvement in the eye diagram is achieved after compensation with the ring-resonator device. We demonstrate a significant improvement in the BER from 10-3 to 10-11 for data rates of 25 and 25.78125 Gb/s.
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We report on the design and experimental demonstration of a broadband silicon polarization beam splitter (PBS) with a high extinction ratio (ER)≥30 dB. This was achieved using triple-bent-waveguide directional coupling in a single PBS, and cascaded PBS topology. For the single PBS, the bandwidths for an ER≥30 dB are 20 nm for the quasi-TE mode, and 70 nm for the quasi-TM mode when a broadband light source (1520-1610 nm) was employed. The insertion loss (IL) varies from 0.2 to 1 dB for the quasi-TE mode and 0.2-2 dB for the quasi-TM mode. The cascaded PBS improved the bandwidth of the quasi-TE mode for an ER≥30 dB to 90 nm, with a low IL of 0.2-2 dB. To the best of our knowledge, our PBS system is one of the best broadband PBSs with an ER as high as â¼42 dB and a low IL below 1 dB around the central wavelength, and experimentally demonstrated using edge-coupling.
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Multiplexing of optical modes in waveguides is demonstrated using coupled vertical gratings. The device utilizes sinusoidally corrugated waveguides of different widths with a period designed to multiplex information at 1.55 µm. The design, fabrication and characterization of devices is performed. Multiplexing of modes is demonstrated in optical structures which support 3 and 5 quasi-TE modes. The design utilizes counter-propagating modes in periodic structures, thus enabling the device to combine its mode division multiplexing capabilities with wavelength division multiplexing functionalities to further augment the multiplexing capacity of the device.
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A 1 by 4 wavelength division multiplexer with 0.5nm bandwidth and no free spectral range limitation is demonstrated on silicon. The device utilizes wide bandwidth filters cascaded with ring resonators in order to select specific ring resonator modes and route each resonant mode to a separate port. This technology will enable dense wavelength division multiplexing covering the C - and L - bands with up to 100 10GB/s channels separated by 100GHz to be implemented for optical interconnects applications. A 1 by 4 wavelength division multiplexer with 3dB channel bandwidths as small as 0.5nm and 1dB insertion loss are demonstrated with 16dB inter-channel crosstalk suppression. A second wavelength division multiplexer scheme with four channels, each spaced 0.5nm apart without any free spectral range limitations is also demonstrated using wide bandwidth filters centered at the same wavelength to select resonances from four different ring resonators with slightly different widths.
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The simultaneous generation of second and third order dispersion is demonstrated using nonlinearly chirped silicon waveguide gratings. The nonlinearly chirped gratings are designed to generate varying signs and magnitudes of group velocity dispersion and dispersion slope. The design, fabrication, and experimental characterization of the silicon waveguide gratings are performed. Second order dispersion as high as -2.3 X 106 ps/nm²/km and third order dispersion as high as 1.2 X 105 ps/nm²/km and as low as 1.2 X 104 ps/nm²/km is demonstrated at 1.55 µm.
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This paper reviews recent work in the area of silicon photonic devices and circuits for monolithic and heterogeneous integration of circuits and systems on a chip. In this context, it presents fabrication results for producing low-loss silicon waveguides without etching. Resonators and add-drop distributed filters utilizing sidewall modulation fabricated in a single lithography and etching step are demonstrated. It also presents an optical pulse compressor that monolithically integrates self-phase modulation and anomalous dispersion compensation devices on a silicon chip. As an example of heterogeneous integration, we demonstrate vertical emitting metallo-dielectric nanolasers integrated onto a silicon platform. Future research directions toward large-scale photonic circuits and systems on a chip also are discussed.
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We demonstrate an add/drop filter based on coupled vertical gratings on silicon. Tailoring of the channel bandwidth and wavelength is experimentally demonstrated. The concept is extended to implement a 1 by 4 wavelength division multiplexer with 6 nm channel separation, 3 nm bandwidth, a flat top response with < 0.8 dB ripple within the 3 dB passband, 1 dB insertion loss and 16 dB crosstalk suppression. The device is ultracompact, having a footprint < 2 X 10(-9)/2.
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Dispositivos Ópticos , Refratometria/instrumentação , Silício/química , Telecomunicações/instrumentação , Desenho Assistido por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , MiniaturizaçãoRESUMO
OBJECTIVE: To evaluate the degree of agreement in first-trimester nasal bone assessment in a group of sonographers before and after training, using a semi-quantitative scoring system. METHODS: Four sonographers who routinely perform first-trimester screening were first shown 46 images from both normal and trisomy 21 pregnancies. For each image, they were asked to score from 0 (disagree) to 3 (agree) on five different criteria that were deemed important in nasal-bone assessment, including image size, plane and visibility of nasal bone. A training program was then conducted, and a repeat exercise was carried out using the same 46 images. Finally, in a third exercise, images from 42 patients were presented, some having more than one image. The sonographers were required to give one overall nasal-bone score for each patient. In each exercise interobserver agreement was evaluated by intraclass correlation coefficient (ICC). RESULTS: Before training, the sonographers agreed reasonably well on the five proposed criteria (ICC, 0.752), with some disagreement on their perceived image quality. The training program further improved the agreement (ICC, 0.790), particularly on whether the nasal bone was the biggest and brightest echogenic component. Agreement was excellent when they were asked to give one overall score on the nasal bone based on multiple images from one patient (ICC, 0.929). CONCLUSION: The proposed scoring system can be used to improve consistency and reliability in first-trimester nasal-bone assessment.
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Síndrome de Down/diagnóstico por imagem , Osso Nasal/diagnóstico por imagem , Primeiro Trimestre da Gravidez , Ultrassonografia Pré-Natal/métodos , Síndrome de Down/embriologia , Feminino , Humanos , Osso Nasal/embriologia , Variações Dependentes do Observador , Gravidez , Garantia da Qualidade dos Cuidados de Saúde , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Infrared (IR)-emitting RE doped materials have been extensively used to fabricate active components of integrated optical devices in various fields, such as fiber amplifiers, telecommunications, optoelectronics, and waveguides. Among various RE elements, trivalent erbium ions (Er 3+) are of great interest since their emissive behavior span the low loss telecommunication window of 1300-1650 nm. In this paper, we report two types of polymeric waveguide amplifiers. 8 cm long, lithographically patterned spiral waveguides provide 8 dB of gain using a 980 nm pump power of 95 mW. Gain is observed from 1530 to 1590 nm. We further report the first demonstration of polymeric waveguide amplifiers fabricated using 3D printing methods based on two-photon lithography, paving the way for rapid prototyping of active 3D printed devices and active photonic devices which may transcend planar limitations.
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The aim of this retrospective study was to describe the oral procedures used in osteo-odonto-keratoprosthesis (OOKP) surgery, and the demographics and oral findings of candidate patients in Singapore. The OOKP procedure utilizes an autologous tooth-bone complex to mount a poly-methylmethacrylate optical cylinder, as an artificial cornea, stabilized by an overlying autologous buccal mucosal graft. Consecutive patients referred over 3 years for dental evaluation prior to OOKP surgery were included. A total of 21 patients underwent oral clinical and radiographic evaluation. The aetiology of blindness included Stevens-Johnson's syndrome (11 cases), chemical burns (9 cases) and multiple failed corneal grafts (1 case). Evaluation revealed that 12 patients were suitable for OOKP surgery, 8 were at risk of complication or failure and 1 had no usable teeth. Fourteen patients have undergone unilateral OOKP Stage 1 surgery successfully. Complications included fracture of a tooth from its lingual bone necessitating the harvesting of a second tooth (1 case), oronasal perforation (1 case), exposure of adjacent roots (5 teeth), lower lip paresthesia (2 cases) and submucosal scar band formation in the buccal mucosal graft donor site (10 cases). Thirteen patients have completed Stage 2 surgery, with attainment of their best possible visual potential following OOKP surgery.
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Processo Alveolar/transplante , Bioprótese , Cegueira/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Implantes Orbitários , Raiz Dentária/transplante , Adolescente , Adulto , Cegueira/reabilitação , Transplante Ósseo/métodos , Córnea/patologia , Córnea/cirurgia , Opacidade da Córnea/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Oftalmológicos/métodos , Osteotomia/métodos , Desenho de Prótese , Implantação de Prótese/métodos , Procedimentos de Cirurgia Plástica/métodos , Refração Ocular , Estudos RetrospectivosRESUMO
Ring resonators on silicon rich nitride for potential use as rare-earth doped amplifiers pumped at 1310 nm with amplification at telecommunications-band are designed and characterized. The ring resonators are fabricated on 300 nm and 400 nm silicon rich nitride films and characterized at both 1310 nm and 1550 nm. We demonstrate ring resonators exhibiting similar quality factors exceeding 10,000 simultaneously at 1310 nm and 1550 nm. A Dysprosium-Erbium material system exhibiting photoluminescence at 1510 nm when pumped at 1310 nm is experimentally demonstrated. When used together with Dy-Er co-doped particles, these resonators with similar quality factors at 1310 nm and 1550 nm may be used for O-band pumped amplifiers for the telecommunications-band.
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CMOS platforms operating at the telecommunications wavelength either reside within the highly dissipative two-photon regime in silicon-based optical devices, or possess small nonlinearities. Bandgap engineering of non-stoichiometric silicon nitride using state-of-the-art fabrication techniques has led to our development of USRN (ultra-silicon-rich nitride) in the form of Si7N3, that possesses a high Kerr nonlinearity (2.8 × 10-13 cm2 W-1), an order of magnitude larger than that in stoichiometric silicon nitride. Here we experimentally demonstrate high-gain optical parametric amplification using USRN, which is compositionally tailored such that the 1,550 nm wavelength resides above the two-photon absorption edge, while still possessing large nonlinearities. Optical parametric gain of 42.5 dB, as well as cascaded four-wave mixing with gain down to the third idler is observed and attributed to the high photon efficiency achieved through operating above the two-photon absorption edge, representing one of the largest optical parametric gains to date on a CMOS platform.
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BACKGROUND: Pterygium is a fibrovascular overgrowth from the conjunctiva onto the cornea. The pathogenesis of this common ocular surface disorder is not well understood and the only treatment is surgical removal. METHODS: DNA microarray analysis of primary pterygium tissue was carried out using uninvolved conjunctiva tissue as a comparison for gene expression levels. Real time polymerase chain reaction (PCR) was used to verify the mRNA level of expression for genes changed in pterygium. Western blot analysis and immunohistochemistry showed protein expression levels and the tissue distribution. RESULTS: Microarray analysis revealed that mRNA levels of a number of genes were changed in primary pterygium. In particular the gene for insulin-like growth factor binding protein-3, (IGFBP3), which modulates the effects of insulin-like growth factor on cells was significantly decreased. Both the message and protein expression of IGFBP3 in pterygium were decreased compared to normal, uninvolved conjunctiva. CONCLUSION: Decreased levels of IGFBP3 protein have been strongly correlated with the presence of cancer. Identification of the low level of expression of IGFBP3 in pterygium suggests that the pathway controlling cell proliferation has lost an important control mechanism, which may explain the continued growth of pterygium.
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Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/biossíntese , Pterígio/metabolismo , Adulto , Western Blotting , Regulação para Baixo , Feminino , Humanos , Proteína 2 de Ligação a Fator de Crescimento Semelhante à Insulina/biossíntese , Proteína 2 de Ligação a Fator de Crescimento Semelhante à Insulina/genética , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/genética , Masculino , Pessoa de Meia-Idade , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Reação em Cadeia da Polimerase/métodos , RNA Mensageiro/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodosRESUMO
AIM: To determine the association of spherical equivalent (SE) with low uncorrected visual acuity (VA) along with a proposed definition for myopia using logMAR VA >0.3 as the criteria. METHODS: 1334 Chinese schoolchildren (mean age 7.8; range 7-9 years) were enrolled in the study after those who had hyperopia > or =+2.00 dioptres (D) and astigmatism > = -2.00 D were excluded. Uncorrected logMAR VA was measured for both eyes. Cycloplegia autorefraction was achieved by the instillation of three drops of 1% cyclopentolate 5 minutes apart. The average of five successful consecutive refraction and keratometry readings were obtained with calibrated Canon RK5 autokeratorefractometers by well trained optometry students, at least 30 minutes after the instillation of the third drop of cyclopentolate. SE cut-off points (-0.25 D, -0.5D, -0.75 D, -1.0 D) were evaluated. RESULTS: Using different SE cut-off points, the myopia prevalence rates of this sample of schoolchildren varied from 45.8% (SE at least -0.25 D) to 30.7% (SE at least -1.0 D). The cut-off point of > or =-0.75 D had a sensitivity and specificity of 91.8% (95% CI, 89.2 to 94.4) and 93.7% (95% CI, 92.1 to 95.3), respectively, to predict low vision defined as uncorrected logMAR VA > 0.3 (either eye). The next best cut-off point of -0.5D had a higher sensitivity (93.3%), but lower specificity (87.9%). CONCLUSIONS: The cut-off points of -0.75D and -0.5D in SE refraction are appropriate for the prediction of uncorrected logMAR VA worse than 0.3, which is the criterion for the US common state adult driver licensing standard.
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Miopia/diagnóstico , Acuidade Visual , Criança , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Miopia/epidemiologia , Miopia/fisiopatologia , Optometria/métodos , Singapura/epidemiologiaRESUMO
AIM: To compare the prevalences of refractive errors in Malay, Chinese and Indian children in Malaysia and Singapore. METHODS: Children aged 7-9 years from three schools in the Singapore Cohort study of the Risk factors for Myopia (n = 1962) and similarly aged children from a random cluster sample in the metropolitan Kuala Lumpur area in the Malaysia Refractive Error Study in Children (n = 1752) were compared. Cycloplegic autorefraction was conducted in both countries. RESULTS: The prevalence of myopia (spherical equivalent of at least -0.5 diopters (D) in either eye) was higher in Singapore Malays (22.1%) than in Malays in Malaysia (9.2%; 95% confidence interval (CI) 11.2 to 14.7; p<0.001). Similarly, Singapore Chinese (40.1%) had higher prevalences than Malaysian Chinese (30.9%; 95% CI 1.5 to 16.9). Singapore Indians had a higher prevalence (34.1%) than Malaysian Indians (12.5%; 95% CI 17.4 to 25.9). The multivariate odds ratio of astigmatism (cylinder at least 0.75 D in either eye) in Singapore Malays compared with Malaysian Malays was 3.47 (95% CI 2.79 to 4.32). Ethnicity-specific hyperopia rates did not differ in Singapore and Malaysia. CONCLUSION: The ethnicity-specific prevalences of myopia in Singapore Malays, Chinese and Indians are higher than those in Malaysian Malays, Chinese and Indians. As Malays, Chinese and Indians in Malaysia have genetic make-up similar to that of Malays, Chinese and Indians in Singapore, environmental factors may contribute to the higher myopia rates.
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Erros de Refração/etnologia , Povo Asiático/estatística & dados numéricos , Astigmatismo/etnologia , Criança , Escolaridade , Feminino , Humanos , Hiperopia/etnologia , Malásia/epidemiologia , Masculino , Miopia/etnologia , Prevalência , Singapura/epidemiologia , População Branca/estatística & dados numéricosRESUMO
AIM: To evaluate the use of human serum (HS) in supporting the in vitro and in vivo proliferation of human conjunctival epithelial cells, and compare it with fetal bovine serum (FBS) and bovine pituitary extract (BPE). METHODS: Conjunctival epithelial cells were cultivated in media supplemented with HS (5%, 10%), FBS (5%, 10%), and BPE (70 microg/ml, 140 microg/ml). The colony forming efficiency (CFE), bromodeoxyuridine (BrdU) ELISA proliferation assay, and cell generations were analysed. Cells were evaluated for keratin (K4, K19, and K3) and MUC5AC expression by immunostaining and RT-PCR. Conjunctival equivalents constructed on amniotic membranes were transplanted onto severe combined immune deficient (SCID) mice for 10 days and analysed histologically. RESULTS: The proliferation assays of HS supplemented cultures (CFE, 6.7% (SD 1.8%); BrdU absorbance, 0.86 (0.16)) were comparable to FBS supplemented (CFE, 9.3% (1.8%); BrdU absorbance, 1.11 (0.18)) and BPE supplemented cultures (CFE, 5.9 (1.5); BrdU absorbance, 0.65 (0.12)). Goblet cell densities for HS, FBS, and BPE supplemented media were 52 cells/cm(2), 60 cells/cm(2), and 50 cells/cm(2), respectively. HS supplemented cultures formed stratified epithelial sheets in vivo following transplantation. CONCLUSIONS: The proliferative capacity of conjunctival epithelial cells cultivated in HS supplemented cultures was comparable to FBS and BPE supplemented cultures. The elimination of animal material from the culture system is advantageous when cultivating cells for clinical transplantation.
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Túnica Conjuntiva/citologia , Células Epiteliais/citologia , Soro , Engenharia Tecidual/métodos , Animais , Bromodesoxiuridina , Bovinos , Técnicas de Cultura de Células/métodos , Diferenciação Celular , Divisão Celular , Tamanho Celular , Túnica Conjuntiva/metabolismo , Túnica Conjuntiva/transplante , Meios de Cultura , Células Epiteliais/metabolismo , Células Epiteliais/transplante , Células Caliciformes/citologia , Humanos , Queratinas/metabolismo , Camundongos , Camundongos SCID , Microscopia de Contraste de Fase , Mucina-5AC , Mucinas/metabolismo , Células-TroncoRESUMO
AIMS: To assess the longitudinal changes in biometric parameters and associated factors in young myopic children aged 7--9 years followed prospectively in Singapore. METHODS: Children aged 7--9 years from three Singapore schools were invited to participate in the SCORM (Singapore Cohort study Of the Risk factors for Myopia) study. Yearly eye examinations involving biometry measures were performed in the schools. Only myopic children (n=543) with 3 year follow up data were included in this analysis. RESULTS: The 3 year increases in axial length, anterior chamber depth, lens thickness, vitreous chamber depth, and corneal curvature were 0.89 mm, -0.02 mm, -0.01 mm, 0.92 mm, and 0.01 mm, respectively. Children who were younger, female, and who had a parental history of myopia were more likely to have greater increases in axial length. After adjustment for school, age, sex, race, parental myopia and reading in books per week, the age (p<0.001), sex (p=0.012), and parental myopia (p=0.027) remained significantly associated with the 3 year change in axial length. Reading in books per week, however, was not associated with axial length change. Children with faster rates of progression of myopia had greater increases in axial length (Pearson correlation coefficient (r)=-0.69) and vitreous chamber depth (r=-0.83). CONCLUSIONS: The 3 year change in axial length of Singapore children aged 7--9 years at baseline was high and greater in younger children, females, and children with a parental history of myopia. Myopia progression was driven largely by vitreous chamber depth increase.
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Olho/crescimento & desenvolvimento , Miopia/fisiopatologia , Câmara Anterior/crescimento & desenvolvimento , Câmara Anterior/patologia , Biometria/métodos , Criança , Progressão da Doença , Métodos Epidemiológicos , Olho/patologia , Feminino , Humanos , Cristalino/crescimento & desenvolvimento , Cristalino/patologia , Masculino , Miopia/genética , Miopia/patologia , Corpo Vítreo/crescimento & desenvolvimento , Corpo Vítreo/patologiaRESUMO
AIM: To examine the relation between exposure to passive parental smoke and myopia in Chinese children in Singapore. METHODS: 1334 Chinese children from three schools in Singapore were recruited, all of whom were participants in the Singapore Cohort study Of the Risk factors for Myopia (SCORM). Information on whether the father or mother smoked, number of years smoked, and the number of cigarettes smoked per day during the child's lifetime were derived. These data were correlated with contemporaneously obtained data available in SCORM. The children's cycloplegic autorefraction, corneal curvature radius, and biometry measures were compared with reported parental smoking history. RESULTS: There were 434 fathers (33.3%) and 23 mothers (1.7%) who smoked during their child's lifetime. There were no significant trends observed between paternal smoking and refractive error or axial length. After controlling for age, sex, school, mother's education, and mother's myopia, children with mothers who had ever smoked during their lifetime had more "positive" refractions (adjusted mean -0.28 D v -1.38 D) compared with children whose mother did not smoke (p = 0.012). CONCLUSIONS: The study found no consistent evidence of association between parental smoking and refractive error. There was a suggestion that children whose mothers smoked cigarettes had more hyperopic refractions, but the absence of a relation with paternal smoking and the small number of mothers who smoked in this sample preclude definite conclusions about a link between passive smoking exposure and myopia.
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Pais , Erros de Refração/etiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Criança , China/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , Miopia/epidemiologia , Miopia/etiologia , Erros de Refração/epidemiologia , Singapura/epidemiologia , Fatores SocioeconômicosRESUMO
AIM: To determine the prevalence rates and major contributing causes of low vision and blindness in adults in a rural setting in Indonesia METHODS: A population based prevalence survey of adults 21 years or older (n=989) was conducted in five rural villages and one provincial town in Sumatra, Indonesia. One stage household cluster sampling procedure was employed where 100 households were randomly selected from each village or town. Bilateral low vision was defined as habitual VA (measured using tumbling "E" logMAR charts) in the better eye worse than 6/18 and 3/60 or better, based on the WHO criteria. Bilateral blindness was defined as habitual VA worse than 3/60 in the better eye. The anterior segment and lens of subjects with low vision or blindness (both unilateral and bilateral) (n=66) were examined using a portable slit lamp and fundus examination was performed using indirect ophthalmoscopy. RESULTS: The overall age adjusted (adjusted to the 1990 Indonesia census population) prevalence rate of bilateral low vision was 5.8% (95% confidence interval (CI) 4.2 to 7.4) and bilateral blindness was 2.2% (95% CI 1.1 to 3.2). The rates of low vision and blindness increased with age. The major contributing causes for bilateral low vision were cataract (61.3%), uncorrected refractive error (12.9%), and amblyopia (12.9%), and the major cause of bilateral blindness was cataract (62.5%). The major causes of unilateral low vision were cataract (48.0%) and uncorrected refractive error (12.0%), and major causes of unilateral blindness were amblyopia (50.0%) and trauma (50.0%). CONCLUSIONS: The rates of habitual low vision and blindness in provincial Sumatra, Indonesia, are similar to other developing rural countries in Asia. Blindness is largely preventable, as the major contributing causes (cataract and uncorrected refractive error) are amenable to treatment.
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Cegueira/epidemiologia , Baixa Visão/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Cegueira/etiologia , Catarata/complicações , Catarata/epidemiologia , Feminino , Humanos , Indonésia/epidemiologia , Degeneração Macular/complicações , Degeneração Macular/epidemiologia , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Prevalência , Erros de Refração/complicações , Erros de Refração/epidemiologia , Saúde da População Rural , Distribuição por Sexo , Baixa Visão/etiologiaRESUMO
Previous studies have evaluated the efficacy of several interventions to decrease the progression of myopia. These include devices that alter the perception of the visual environment and pharmacological treatments. There is no conclusive evidence thus far that alteration of the pattern of spectacle wear, bifocals, ocular hypotensives, or contact lenses retards the progression of myopia. Several randomised clinical trials have demonstrated that the rate of progression of myopia is lower in children given atropine eye drops than those given placebo. However, atropine is associated with short term side effects such as photophobia and possible long term adverse events including light induced retinal damage and cataract formation. Other more selective antimuscarinic agents such as pirenzipine are presently being evaluated. Further well conducted randomised clinical trials with large sample sizes and adequate follow up designed to evaluate treatments to retard the progression of myopia should be conducted, since the identification of an effective intervention may have a greater public health impact on the burden and morbidity from myopia than the few treatments currently available.