About

Jeffrey J. Walline, OD PhD, is the Associate Dean of Academic Affairs at The Ohio State University College of Optometry. He received his Doctor of Optometry degree from the University of California, Berkeley School of Optometry and his Master’s and PhD degrees from The Ohio State University College of Optometry. Dr. Walline has led several pediatric contact lens studies and serves as the Study Chair of the Bifocal Lenses In Nearsighted Kids (BLINK and BLINK2) Studies, which are sponsored by the National Eye Institute (NEI) and focus on soft multifocal contact lens myopia control. He is also the Co-Chair of the Delaying the Onset of Nearsightedness Until Treatment (DONUT) Study, an NEI-sponsored planning grant aimed at exploring whether low concentration atropine can delay myopia onset. His research and clinical interests include contact lens fitting, myopia management, and pediatric eye care, with numerous contributions to the scientific literature and chapters in professional texts. Dr. Walline has received multiple awards recognizing his excellence in optometric education, research, and clinical practice, including the Optometric Educator of the Year in 2024 and the Distinguished Professor of Optometry and Vision Science in 2023.

Research topics

• Medicine
• Optometry
• Ophthalmology
• Environmental health
• Artificial Intelligence
• Computer Science
• Surgery
• Internal medicine
• Economics
• Psychiatry
• Composite material
• Materials science
• Optics

Selected publications

• Compensation for axial elongation during multifocal soft contact lens wear: Results from the BLINK study

  Optometry and Vision Science · 2026-03-01

  articleOpen access

  PURPOSE: To determine the effect of +2.50 D add multifocal soft contact lenses (MFSCLs) compared to +1.50 D add and single vision contact lenses (SVCLs) on the relationship between axial elongation and myopia progression. METHODS: Individual estimates of D/mm were derived from the CLEERE Study, then applied to data from 289 participants in the BLINK Study to determine the portion of axial elongation that either contributed (uncompensated elongation) or did not contribute to myopia progression (compensated elongation). BLINK participants had myopia between -0.75 D and -5.00 D and were 7-11 years of age when enrolled in a 3-year clinical trial of multifocal contact lens myopia control. Cycloplegic refractive error was measured under tropicamide cycloplegia with the Grand Seiko WAM-5500 Binocular Autorefractor/Keratometer and axial length was measured using the Lenstar LS 900. RESULTS: The majority of the inhibition of axial elongation during myopia control with +2.50 D add MFSCLs was inhibition of uncompensated elongation. Over 3 years, axial elongation was less in +2.50 D add MFSCLs (0.39 mm) compared to SVCLs (0.62 mm) by 0.23 mm (95% CI: 0.14, 0.33), split between 0.17 mm (95% CI: 0.091, 0.26) of uncompensated elongation and 0.055 mm (95% CI: 0.013, 0.097) of compensated elongation. Inhibition of compensated elongation only occurred in the first year of the study. Total axial elongation over 3 years would need to be reduced to 0.17 mm (0.45 mm less than 0.62 mm) to result in no myopia progression. CONCLUSIONS: Optical myopia control with multifocal contact lenses has a small but significant effect on the compensation for elongation from changes in the optical components of the eye. As a result, myopia control must set an aggressive therapeutic target if the goal is slowing axial elongation to the point of no net myopia progression.

  PublisherDOI

• Axial Growth and Myopia Progression After Discontinuing Soft Multifocal Contact Lens Wear

  JAMA Ophthalmology · 2025-01-16 · 5 citations

  letterOpen access

  Importance: For myopia control to be beneficial, it would be important that the benefit of treatment (slowed eye growth) is not lost because of faster than normal growth (rebound) after discontinuing treatment. Objective: To determine whether there is a loss of treatment effect (rebound) after discontinuing soft multifocal contact lenses in children with myopia. Design, Setting, and Participants: The Bifocal Lenses in Nearsighted Kids 2 (BLINK2) cohort study involved children with myopia (aged 11-17 years at BLINK2 baseline) who completed the BLINK Study randomized clinical trial. Enrollment was from September 2019 through January 2021; follow-up was completed in January 2024. In the BLINK2 Study, all children wore high-add (+2.50 diopter [D]) multifocal soft contact lenses for 2 years and single-vision soft contact lenses during the third year to determine if rebound occurred. Exposure: High-add multifocal soft contact lenses and single-vision soft contact lenses. Main Outcomes and Measures: Eye length (optical biometry) and refractive error (cycloplegic autorefraction) were measured annually. Results: Of 248 participants enrolled in BLINK2, 235 completed the study. The median age at the baseline visit was 15 years (range, 11-17 years); 146 participants (59%) were female, and 102 (41%) were male. At baseline for BLINK2, mean (SD) axial length and spherical equivalent refractive error were 25.2 (0.9) mm and -3.40 (1.40) D, respectively. After participants switched from multifocal to single-vision contact lenses, axial elongation increased by 0.03 mm per year (95% CI, 0.01 to 0.05) regardless of their original BLINK treatment assignment (P = .81). There was also an increase in myopia progression after switching to single-vision lenses of -0.17 D per year (95% CI, -0.22 to -0.12) that did not depend on the original BLINK treatment assignment (P = .57). There continued to be a difference in axial length and refractive error throughout BLINK2 based on the BLINK Study treatment assignment with the original high-add group having shorter eyes and less myopia than the original medium-add (+1.50 D) and single-vision groups. Conclusions and Relevance: The BLINK2 Study found no evidence of a loss of treatment effect after discontinuing multifocal contact lenses in older teenagers. These data suggest eye growth and myopia progression returned to faster but age-expected rates and support continuing multifocal lenses until cessation of elongation and progression.

  PublisherOA PDFDOI

• Interventions for myopia control in children: a living systematic review and network meta-analysis

  Cochrane Database of Systematic Reviews · 2025-02-13 · 27 citations

  reviewOpen accessSenior author

  RATIONALE: The increasing prevalence of myopia is a growing global public health problem, in terms of rates of uncorrected refractive error and significantly, an increased risk of visual impairment due to myopia-related ocular morbidity. Interventions to slow its progression are needed in childhood, when myopia progression is most rapid. This is a review update, conducted as part of a living systematic review. OBJECTIVES: To assess the comparative efficacy and safety of interventions for slowing myopia progression in children using network meta-analysis (NMA). To generate a relative ranking of interventions according to their efficacy. To produce a brief economic commentary, summarising economic evaluations. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, and three trial registers. The latest search date was 19 February 2024. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) of optical, pharmacological, light therapy and behavioural interventions for slowing myopia progression in children, up to 18 years old. OUTCOMES: Critical outcomes were progression of myopia (mean difference (MD) in the change in spherical equivalent refraction (SER, dioptres (D)), and axial length (AL, mm) in the intervention and control groups at one year or longer), and difference in the change in SER and AL following cessation of treatment (rebound). RISK OF BIAS: We assessed the risk of bias (RoB) for SER and AL using the Cochrane RoB 2 tool. SYNTHESIS METHODS: We followed standard Cochrane methods. We rated the certainty of evidence using the GRADE approach for change in SER and AL at one and two years. We used the surface under the cumulative ranking curve (SUCRA) to rank the interventions for all available outcomes. INCLUDED STUDIES: We included 104 studies (40 new for this update) that randomised 17,509 children, aged 4 years to 18 years. Most studies were conducted in China or other Asian countries (66.3%), and North America (14.4%). Eighty-four studies (80.8%) compared myopia control interventions against inactive controls. Study durations ranged from 12 months to 48 months. SYNTHESIS OF RESULTS: Since most of the networks in the NMA were poorly connected, our estimates are based on direct (pairwise) comparisons, unless stated otherwise. The median change in SER for controls was -0.65 D (55 studies, 4888 participants; one-year follow-up). These interventions may reduce SER progression compared to controls: repeated low intensity red light (RLRL: MD 0.80 D, 95% confidence interval (CI) 0.71 to 0.89; SUCRA = 93.8%; very low-certainty evidence); high-dose atropine (HDA (≥ 0.5%): MD 0.90 D, 95% CI 0.62 to 1.18; SUCRA = 93.3%; moderate-certainty evidence); medium-dose atropine (MDA (0.1% to < 0.5%): MD 0.55 D, 95% CI 0.17 to 0.93; NMA estimate SUCRA = 75.5%; low-certainty evidence); low dose atropine (LDA (< 0.1%): MD 0.25 D, 95% CI 0.16 to 0.35; SUCRA = 53.2%; very low-certainty evidence); peripheral plus spectacle lenses (PPSL: MD 0.45 D, 95% CI 0.16 to 0.74; SUCRA = 50.2%; very low-certainty evidence); multifocal soft contact lenses (MFSCL: MD 0.27 D, 95% CI 0.18 to 0.35; SUCRA = 49.9%; very low-certainty evidence); and multifocal spectacle lenses (MFSL: MD 0.14 D, 95% CI 0.08 to 0.21; SUCRA = 30.8%; low-certainty evidence). The median change in AL for controls was 0.33 mm (58 studies, 9085 participants; one-year follow-up). These interventions may reduce axial elongation compared to controls: RLRL (MD -0.33 mm, 95% CI -0.37 to -0.29; SUCRA = 98.6%; very low-certainty evidence); HDA (MD -0.33 mm, 95% CI -0.35 to -0.30; SUCRA = 88.4%; moderate-certainty evidence); MDA (MD -0.24 mm, 95% CI -0.34 to -0.15; NMA estimate SUCRA = 75.8%; low-certainty evidence); LDA (MD -0.10 mm, 95% CI -0.13 to -0.07; SUCRA = 36.1%; very low-certainty evidence); orthokeratology (ortho-K: MD -0.18 mm, 95% CI -0.21 to -0.14; SUCRA = 79%; moderate-certainty evidence); PPSL (MD -0.13 mm, 95% CI -0.21 to -0.05; SUCRA = 52.6%; very low-certainty evidence); MFSCL (MD -0.11 mm, 95% CI -0.13 to -0.09; SUCRA = 45.6%; low-certainty evidence); and MFSL (MD -0.06 mm, 95% CI -0.09 to -0.04; SUCRA = 26.3%; low-certainty evidence). Ortho-K plus LDA probably reduces axial elongation more than ortho-K monotherapy (MD -0.12 mm, 95% CI -0.15 to -0.09; SUCRA = 81.8%; moderate-certainty evidence). At two-year follow-up, change in SER was reported in 34 studies (3556 participants). The median change in SER for controls was -1.01 D. The ranking of interventions to reduce SER progression was close to that observed at one year; there were insufficient data to draw conclusions on cumulative effects. The highest-ranking interventions were: HAD (SUCRA = 97%); MDA (NMA estimate SUCRA = 69.8%); and PPSL (SUCRA = 69.1%). At two-year follow-up, change in AL was reported in 33 studies (3334 participants). The median change in AL for controls was 0.56 mm. The ranking of interventions to reduce axial elongation was similar to that observed at one year; there were insufficient data to draw conclusions on cumulative effects. The highest-ranking interventions were: ortho-K plus LDA (SUCRA = 94.2%); HAD (SUCRA = 96.8%); and MDA (NMA estimate SUCRA = 88.4%). There was limited evidence on whether cessation of myopia control therapy increases progression beyond the expected rate of progression with age. Adverse events and treatment adherence were not consistently reported. Two studies reported quality of life, showing little to no difference between intervention and control groups. We were unable to draw firm conclusions regarding the relative costs or efficiency of different myopia control strategies in children. AUTHORS' CONCLUSIONS: Most studies compared pharmacological and optical treatments to slow the progression of myopia with an inactive comparator. These interventions may slow refractive change and reduce axial elongation, although results were often heterogeneous. Less evidence is available for two years and beyond; uncertainty remains about the sustained effect of these interventions. Longer term and better quality studies comparing myopia control interventions alone or in combination are needed, with improved methods for monitoring and reporting adverse effects. FUNDING: Cochrane Eyes and Vision US Project is supported by grant UG1EY020522, National Eye Institute, National Institutes of Health. REGISTRATION: The previous version of this living systematic review is available at doi: 10.1002/14651858.CD014758.pub2.

  PublisherOA PDFDOI

• Letter to the editor: Seeing the evidence for myopia control interventions: Looking through the lens of a Cochrane living systematic review

  Optometry and Vision Science · 2025-08-05

  letter
  PublisherDOI

• Myopia Correction, Myopia Control and Myopia Management: Definitions and Recommended Usage

  Investigative Ophthalmology & Visual Science · 2025-06-12 · 2 citations

  articleOpen access

  FIGURE. Representation of the relationship among myopia management

  PublisherOA PDFDOI

• Contributors

  Elsevier eBooks · 2025-07-25

  book-chapterOpen access
  PublisherDOI

• Three-Year Change in Subfoveal Choroidal Thickness and Area With Multifocal Contact Lens Wear in the Bifocal Lenses in Nearsighted Kids (BLINK) Study

  Investigative Ophthalmology & Visual Science · 2025-05-02 · 5 citations

  articleOpen access

  Purpose: To evaluate changes in subfoveal choroidal thickness and area in children wearing soft multifocal contact lenses (MFCLs) for myopia control. Methods: Analyses included 281 myopic children aged 7 to 11 years in the Bifocal Lenses in Nearsighted Kids (BLINK) Study randomly assigned to wear single vision contact lenses (SVCLs), +1.50 D add, or +2.50 D add center-distance MFCL. Subfoveal choroidal thickness and choroidal area were measured using spectral-domain optical coherence tomography before and after 2 weeks of lens wear, and then annually for 3 years. Repeated measures linear regression was used to determine the effect of contact lens wear on the choroid and test the association between choroidal changes and axial elongation. Results: After initiating contact lens wear, mean ± SE subfoveal choroidal thickness and choroidal area increased in the +2.50 D MFCL group compared with the SVCL group by 8 ± 3 µm (P = 0.003) and 0.07 ± 0.02 mm2 (P = 0.002), a difference maintained throughout the 3-year study (P ≥ 0.55). Increased choroidal thickness and area after 2 weeks in the +2.50 D MFCL group vs. SVCL group were associated with less axial elongation over 3 years (β = -0.0058 mm/µm and -0.947 mm/mm2; P = 0.02 and P = 0.006; 20% and 29% of total treatment effect, respectively). Conclusions: The choroid increased in subfoveal thickness and area after 2 weeks of +2.50 D MFCL wear, which was maintained for 3 years and was associated with slower axial elongation. However, only a portion of the treatment effect can be accounted for by the choroidal parameters.

  PublisherOA PDFDOI

• Frequency of retinal findings after 8 years in the Bifocal Lenses in Nearsighted Kids ( <scp>BLINK</scp> ) Study

  Ophthalmic and Physiological Optics · 2025-06-13

  articleOpen access

  PURPOSE: The purpose of the study is to report the frequency of retinal findings in myopic children and determine the association with the amount of myopia or axial length. DESIGN: The BLINK study was a myopia control, multi-centre randomised clinical trial following myopic children with multifocal soft contact lenses. PARTICIPANTS: Children aged 7-11 years with myopia (sphere) from -0.75 to -5.00 D and 1.00 D cylinder or less at baseline who completed the final BLINK2 study visit (n = 235). METHODS: Children had an annual dilated fundus examination. Retinal findings were classified into three main categories: vitreous, peripheral retina and other retinal findings, and further subdivided into 17 subcategories. MAIN OUTCOME MEASURES: Frequencies were calculated. Groups used median splits of spherical equivalent refractive error and axial length, and differences were assessed using chi-squared tests. Incidence was calculated. RESULTS: Overall, 186/235 (79.1%) participants had at least one retinal finding and 81/235 (34.5%) participants had at least one vitreous or peripheral retinal finding that could increase the risk of sight-threatening complications. One participant had a retinal detachment. The incidence of any retinal finding in those with no previous findings was 12.5/100 person-years (95% confidence interval = 10.2-15.0). Peripheral retinal finding incidence was 2.4/100 person-years (1.8-3.2), while the vitreous finding incidence was 1.7/100 person-years (1.2-2.4). At each dilated examination, at least 7.2% of participants had a newly documented finding. Sex, age, spherical equivalent refractive error and axial length were not associated with differences in findings (all p ≥ 0.08). CONCLUSION: Almost 80% of children with juvenile-onset myopia had a documented retinal finding, which was not associated with the amount of myopia or axial length. Almost 35% had a vitreous or peripheral retina finding that could increase the risk for potential sight-threatening complications, which warrants routine dilation and close follow-up to monitor for retinal changes.

  PublisherOA PDFDOI

• Myopia management and treatment methods: Spectacles, specialty contact lenses, and environmental factors

  Elsevier eBooks · 2025-07-25

  book-chapter1st authorCorresponding
  PublisherDOI

• Peripheral Defocus, Pupil Size, and Axial Eye Growth in Children Wearing Soft Multifocal Contact Lenses in the BLINK Study

  Investigative Ophthalmology & Visual Science · 2023-11-01 · 16 citations

  articleOpen access

  Purpose: The purpose of this study was to evaluate the relationship between peripheral defocus and pupil size on axial growth in children randomly assigned to wear either single vision contact lenses, +1.50 diopter (D), or +2.50 D addition multifocal contact lenses (MFCLs). Methods: Children 7 to 11 years old with myopia (-0.75 to -5.00 D; spherical component) and ≤1.00 D astigmatism were enrolled. Autorefraction (horizontal meridian; right eye) was measured annually wearing contact lenses centrally and ±20 degrees, ±30 degrees, and ±40 degrees from the line of sight at near and distance. Photopic and mesopic pupil size were measured. The effects of peripheral defocus, treatment group, and pupil size on the 3-year change in axial length were modeled using multiple variables that evaluated defocus across the retina. Results: Although several peripheral defocus variables were associated with slower axial growth with MFCLs, they were either no longer significant or not meaningfully associated with eye growth after the treatment group was included in the model. The treatment group assignment better explained the slower eye growth with +2.50 MFCLs than peripheral defocus. Photopic and mesopic pupil size did not modify eye growth with the +2.50 MFCL (all P ≥ 0.37). Conclusions: The optical signal causing slower axial elongation with +2.50 MFCLs is better explained by the lens type worn than by peripheral defocus. The signal might be something other than peripheral defocus, or there is not a linear dose-response relationship within treatment groups. We found no evidence to support pupil size as a criterion when deciding which myopic children to treat with MFCLs.

  PublisherDOI

Recent grants

• NIH Grant K23EY000383

  NIH · $532k · 2004

• Short term training: Professional Students in Optometry Schools

  NIH · $1.3M · 1998–2030

• Soft Bifocal Contact Lens Myopia Control - Study Chair

  NIH · $742k · 2014–2019

• NIH Grant K08EY000383

  NIH · $88k · 2002

• Examination of Myopia Progression and Consequences and Mechanism of Soft Multifocal Contact Lens Myopia Control

  NIH · $678k · 2014–2026

Frequent coauthors

• Donald O. Mutti

  99 shared

• Lisa Jones

  72 shared

• Marjorie Rah

  54 shared

• Lisa A. Jones‐Jordan

  SUNY College of Optometry

  52 shared

• David A. Berntsen

  University of Houston

  46 shared

• Karla Zadnik

  45 shared

• Loraine T. Sinnott

  SUNY College of Optometry

  36 shared

• Michelle E. Tarver

  United States Food and Drug Administration

  25 shared

Labs

• Karla Zadnik Academic Research in OptometryPI

Education

• Ph.D., Vision Science

  The Ohio State University

  2002

• M.S., Vision Science

  The Ohio State University

  1998

• B.S., Biology

  The Ohio State University

  1996

Awards & honors

• Optometric Educator of the Year: 2024
• Distinguished Professor of Optometry and Vision Science: 202…
• Donald Korb Award from the Contact Lens and Cornea Section o…
• Max Schapero Memorial Award from the Cornea, Contact Lens, a…
• Gas Permeable Lens Institute Practitioner of the Year: 2020