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With the marked recent increases in myopia prevalence, robust and biologically\u2010based clinical therapies to normalize refractive development in childhood are needed. Here, we review classic and contemporary literature about how circadian biology might provide clues to develop a framework to improve the understanding of myopia etiology, and possibly lead to rational approaches to ameliorate refractive errors developing in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent findings<\/jats:title>\n                    <jats:p>\n                      Increasing evidence implicates diurnal and circadian rhythms in eye growth and refractive error development. In both humans and animals, ocular length and other anatomical and physiological features of the eye undergo diurnal oscillations. Systemically, such rhythms are primarily generated by the \u2018master clock\u2019 in the surpachiasmatic nucleus, which receives input from the intrinsically photosensitive retinal ganglion cells (ip\n                      <jats:styled-content style=\"fixed-case\">RGC<\/jats:styled-content>\n                      s) through the activation of the photopigment melanopsin. The retina also has an endogenous circadian clock. In laboratory animals developing experimental myopia, oscillations of ocular parameters are perturbed. Retinal signaling is now believed to influence refractive development; dopamine, an important neurotransmitter found in the retina, not only entrains intrinsic retinal rhythms to the light:dark cycle, but it also modulates refractive development. Circadian clocks comprise a transcription\/translation feedback control mechanism utilizing so\u2010called clock genes that have now been associated with experimental ametropias. Contemporary clinical research is also reviving ideas first proposed in the nineteenth century that light exposures might impact refraction in children. As a result, properties of ambient lighting are being investigated in refractive development. In other areas of medical science, circadian dysregulation is now thought to impact many non\u2010ocular disorders, likely because the patterns of modern artificial lighting exert adverse physiological effects on circadian pacemakers. How, or if, such modern light exposures and circadian dysregulation contribute to refractive development is not known.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>The premise of this review is that circadian biology could be a productive area worthy of increased investigation, which might lead to the improved understanding of refractive development and improved therapeutic interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.12453","type":"journal-article","created":{"date-parts":[[2018,4,25]],"date-time":"2018-04-25T01:16:56Z","timestamp":1524619016000},"page":"217-245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":215,"title":["Circadian rhythms, refractive development, and myopia"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8850-1907","authenticated-orcid":false,"given":"Ranjay","family":"Chakraborty","sequence":"first","affiliation":[{"name":"College of Nursing and Health Sciences Flinders University Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Ostrin","sequence":"additional","affiliation":[{"name":"University of Houston College of Optometry Houston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora L.","family":"Nickla","sequence":"additional","affiliation":[{"name":"New England College of Optometry Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Michael","family":"Iuvone","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine Atlanta USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Machelle T.","family":"Pardue","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Georgia Institute of Technology Atlanta USA"},{"name":"Atlanta VA Center for Visual and Neurocognitive Rehabilitation Decatur USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Stone","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Medicine Philadelphia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,4,24]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"The Myopias: Basic Science and Clinical Management","author":"Curtin 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