Temporal integration of visual signals in lens compensation (a review).

Postnatal eye growth is controlled by visual signals. When wearing a positive lens that causes images to be focused in front of the retina (myopic defocus), the eye reduces its rate of ocular elongation and increases choroidal thickness to move the retina forward to meet the focal plane of the eye. When wearing a negative lens that causes images to be focused behind the retina (hyperopic defocus), the opposite happens. This review summarizes how the retina integrates the constantly changing visual signals in a non-linear fashion to guide eye growth in chicks: (1a) When myopic or hyperopic defocus is interrupted by a daily episode of normal vision, normal vision is more effective in reducing myopia caused by hyperopic defocus than in reducing hyperopia caused by myopic defocus; (1b) when the eye experiences alternating myopic and hyperopic defocus, the eye is more sensitive to myopic defocus than to hyperopic defocus and tends to develop hyperopia, even if the duration of hyperopic defocus is much longer than the duration of myopic defocus; (2) when the eye experiences brief, repeated episodes of defocus by wearing either positive or negative lenses, lens compensation depends on the frequency and duration of individual episodes of lens wear, not just the total daily duration of lens wear; and (3) further analysis of the time constants for the hypothesized internal emmetropization signals show that, while it takes approximately the same amount of time for the signals to rise and saturate during lens-wearing episodes, the decline of the signals between episodes depends strongly on the sign of defocus and the ocular component. Although most extensively studied in chicks, the nonlinear temporal integration of visual signals has been found in other animal models. These findings may help explain the complex etiology of myopia in school-aged children and suggest ways to slow down myopia progression.