Workfromanimalmodelssuggeststhatretinaldefocus(orvisualblur)initiatesasignalingcascadethatleadstoanumberofcellularandbiochemicalchangesintheretinaandtheretinalpigmentepithelium(RPE),whichsignalchangestothechoroid,andeventuallythesclera,leadingtoalterationsintheoverallgrowthandrefractivestateoftheeye(Fig.4.7).Theretinaisanintegralpartofthisvisualsignalingasitisthefirstlayerofphotosensoryneuronsthatdetectdefocus.Furthermore,ocular
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