Most clinicians are aware of myopia risk factors such as family history and visual environment, but how about axial length? This article explores how we can use the current axial length value, change in axial length, axial length growth charts, and another metric, the axial-length-to-corneal-radius (AL/CR ratio), to predict risk of a child developing myopia.
Managing unilateral myopia with high astigmatism is complex, especially with reduced acuity. Is myopia control the best approach? Myopia correction versus myopia control is discussed in this case, along with further assessments and considerations in management.
The COVID-19 pandemic saw widespread home confinement, increased screen time in children with home-based learning, and decreased time spent outdoors. Several recent publications have explored the impact of this period of time on the incidence and progression of myopia, lifestyle behaviours, digital eye strain, myopia treatment efficacy and more. What should we now monitor and discuss with our young myopic patients in the post-COVID world?
A vision-screening program was able to provide data before and after Chinese schoolchildren were confined to home learning during the COVID-19 pandemic. Overall, more hours were spent indoors and less time was spent outdoors during this time, across all age groups. The younger schoolchildren had increased incidence of myopia and faster progression, whereas an increase in the prevalence of high myopia was found in the older children.
This study reports two year results from a randomized clinical trial examining myopia control spectacle lenses with highly aspherical lenslets (HAL) or slightly aspherical lenslets (SAL). The findings showed the HAL lens controlled refractive and axial progression by 50-55% and SAL by around 30% over two years. Read more about the outcomes and comparisons to other myopia control spectacles here.
The MiSight 1 day clinical trial is the longest in soft lens myopia control, showing efficacy in children and teens in up to 6 years of wear. The first three years showed a 50-60% axial length and refractive efficacy. In the second three years, all control group children were switched to MiSight and showed axial growth similar to children under continued treatment, indicating benefits for commencing wear in children and teens alike.
This study investigated the accuracy of the Brien Holden Vision Institute (BHVI) myopia calculator in predicting myopia progression. The extent of myopia progression over 1-2 years in children corrected with single vision spectacles was accurately predicted by the BHVI myopia calculator in 32-38% of 7-13 year old Hong Kong children. Around one-third progressed more and one-third progressed less than the range predicted by the calculator.
This meta-analysis investigated the effectiveness of orthokeratology in controlling the progression of anisomyopia (unilateral myopia or bilateral anisomyopia) in Chinese children. Total anisomyopia decreased at 2-year follow up, indicating orthokeratology may be a safe clinical method to slow myopia progression coupled with reducing interocular axial length difference.
Children aged 6 to 8 years old in China were found to experience a mean -0.30D myopic shift and a significant increase in myopia prevalence during a 5-month long COVID-19 home confinement period. Due to their age and corresponding critical stage in visual development, the change in the children’s environment and lifestyle may have been more responsible for their increased myopia than the increased online learning.
This multi-ethnic study found that parental myopia was a risk factor for myopia development in pre-school age children. The age the parents became myopic themselves had a dose-dependent effect in their children if both parents had onset of myopia before age 12. Eye care practitioners can use this to identify which children may benefit from early myopia treatment intervention.
