Axial Length

Myopia Management in the netherlands: advice and outcomes from a new protocol

The Erasmus Medical Group in the Netherlands set out four steps in their myopia management protocol: providing visual environment advice, identifying high-risk myopes by axial length and treating them with atropine 0.5%, managing other myopes with optical treatments or lower-concentration atropine, and ceasing treatment in the late teens once axial length is stable. The described use of axial length percentile growth charts for diagnosis, choice of treatment, monitoring and cessation is a world-first.

Is axial length regression possible?

Axial length typically increases in children, and myopia control aims to slow this excessive growth. Can axial length regression or reduction be possible in myopia control? In this case study, an 8-year-old appears to show a large reduction in axial length. We investigate possible causes and provide clinical guidance on measurement accuracy.

Is it really fast progressing myopia, or something else?

In this case, a 14-year-old was found to be far less myopic than their refraction and terrifyingly fast progression suggested, thanks to careful diagnosis. Learn what didn’t add up and how utilizing technology o measure the ocular components helped to solve the puzzling clinical case.

how to use growth chart

How to Use Axial Length Growth Charts

Growth charts are commonly used in childhood health and are easily understood by parents. When applied to myopia management, axial length growth charts can allow individualized decisions on treatment strategy and efficacy. What charts are available now and how can you use them in practice? Here we explain how to use axial length growth charts from initial diagnosis to treatment strategy and long term monitoring.

Learning more about ‘normal’ axial elongation in emmetropic children

Previous multi-ethnicity studies have shown ‘normal’ axial elongation in emmetropic children to be around 0.1mm / year. In this study, 700 Chinese schoolchildren with stable emmetropia showed 0.2mm per year axial elongation from age 7-11, which reduced with age and ceased at age 15. This appears higher than measured in Singaporean Chinese children in the SCORM study, 20 years ago.

Light-emitting glasses alter axial length and choroidal thickness in young adults

Light-emitting glasses worn by young adults for 1-2 hours reduced axial length and increased choroidal thickness by around 20 microns compared to darkness. The study participants viewed a colour-muted television at 5m while indoors, and the changes regressed within 30 minutes. A future myopia treatment to increase ‘outdoor’ time?

Tools myopia management

Getting started in myopia management: what equipment do I need?

What equipment do you need to get started with myopia management in practice? Here we take you through the recommendations of the International Myopia Institute Clinical Management Guidelines Report, with advice on testing and equipment required. There are also suggestions for how you can get started if you don’t have access to all the equipment described, plus what is ideal and what is necessary for best practice.

Choosing an instrument to measure axial length

The value and importance of axial length measurement in myopia control is growing. As you offer myopia control to more patients, you could start to consider which instrument to use to measure axial length. How do ultrasound and interferometry instruments compare in accuracy? What about the new generation combination instruments? Here we address the practicalities of axial length measurement.

A mismatch between myopia and axial length

This case study describes two examples of myopia and axial length mismatch – a low myope with long eyes and high myope with short eyes. With axial length becoming more available and crucial in myopia management, it’s important to understand that the relationship between refraction and axial length isn’t always consistent. Find out more regarding the other ocular components that can influence refractive error.

Measuring the whole eye in myopia

Axial length (AXL) has been well established as the critical measurement in myopia control research. The measurement accuracy and link to disease risk make AXL increasingly important in a clinical setting. But what else should we measure in the myopic eye? Does the cornea change as well? Will we end up doing away with refraction? Read more on measuring the whole eye in myopia.