This cohort study from Australia reported a 14% incidence (onset) of myopia between ages 20 and 28, with almost 40% of myopes progressing by at least 0.50D. Axial length increase was also demonstrated. Risk factors were related to ethnicity, sex, sun exposure and parental myopia but not education level. This data advocates for active myopia management throughout the 20s.
Prediction modelling for future myopic progression was found to be more accurate when factors such as age, sex and ethnicity were considered, rather than prior progression. Myopia management should be initiated when myopia is apparent regardless of prior progression, rather than waiting to assess the progression rate.
The SCORM study analyzed the relationship between myopia progression a year after baseline and subsequent 2-year progression for myopic Singaporean children. Progression and age at baseline were found to be strongly associated with subsequent progression. However, they were shown to have limited predictive values and other factors are likely to determine future progression.
This study investigated the accuracy of using pre-treatment axial elongation and changes in refractive sphere in predicting myopia control success in orthokeratology. Axial length was the more accurate method for categorisation of slow, moderate or rapid progression, and fast progressors benefited the most from ortho-k wear.
Orthokeratology is effective for myopia control but is it suitable for a child with trichiasis and corneal staining? This case compiles the treatment suggestions for managing a young myopic patient with trichiasis from the Facebook community, with a focus on safety.
Does pupil size affect myopia control efficacy when fitting soft contact lenses or orthokeratology for myopia control? This case study explores the relationship between pupil size, various optic designs and how both vision and myopia outcomes could be impacted.
What is the relationship between pupil size and myopia management? As the pupil controls the light input to the retina, does pupil size influence myopia risk or the response to myopia treatments? This review covers atropine’s influence on pupil size, the relationship with treatment zone size in orthokeratology, combination treatments and advice on normal outcomes.
The axial length growth trajectories modelled in this study revealed that regardless of a child’s age, a myopic shift of at least -0.85D and/or 0.74mm over three years suggests future myopia development. Read more about specific risk factors for younger children, and other ocular component findings in this large study of European children.
In this case study, a child with myopia appears to have progressed 2.50D in a year. Axial length measurement provided invaluable data to validate this refractive shift – read more about the case and how the patient was managed.
Slowing axial length growth is the key goal of myopia management. In this case, parents finally agreed to myopia management once they understood their child’s axial length measurement.
Read how to communicate with parents about axial length, to support your recommendations.
