Myopia Management Measurements
What to Measure, When to Follow-Up & How to Use Refractive Error to Discover Pre-Myopia

This Myopia Moment gives you a brief overview of the measurements to include in an eye examination of a child with myopia or at risk of developing myopia.
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This Myopia Moment gives you a brief overview of how often and what to check during a patient follow-up appointment. This document outlines best practices, however, please consider each family’s understanding, interest, willingness to follow treatment regimen, financial status, and time availability.
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Identifying children at risk of developing myopia can be done by evaluating risk factors such as family history of myopia, refractive error, lifestyle, certain vision disorders, and age of onset. Myopia can be predicted before onset in young children. This Myopia Moment provides a brief overview of how to use refractive error to evaluate pre-myopia in a child.
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Guidelines for Myopia Management

Brien Holden Vision Institute (2020)
Myopia management guidelines covering initial consultation, assessment of risk of onset and progression, treatment strategy and review procedure created by BHVI and the Shanghai Eye Disease Prevention and Treatment Centre, China.

Optical coherence tomographic findings in highly myopic eyes

Faghihi H et al. Journal of Ophthalmic and Vision Research (2010)
An Optical Coherence Tomography (OCT) study reviewing retinal changes in highly myopic eyes.

IMI – Defining and Classifying Myopia: A Proposed Set of Standards for Clinical and Epidemiologic Studies

Flitcroft DI et al. Investigative Ophthalmology & Visual Science (2019)
Whitepaper from the International Myopia Institute providing an evidence-based proposal for a standardized terminology around myopia and its primary ocular complications.

IMI – Clinical Management Guidelines Report

Gifford KL et al. Investigative Ophthalmology & Visual Science (2019)
Whitepaper outlines best practice for managing the pre- and progressing myope and gives an overview of evidence-based risk factors, selection of treatment strategies including how to manage myopia in children after diagnosis.

Diagnostic drugs

Lam C. Diagnostic drugs. In: Rosenfield ML, Logan NS, eds. Optometry: Science, Techniques and Clinical Management (2009).
Introduces the use of diagnostic drugs such as the use of tropicamide and cyclopentolate in a cycloplegic refraction.

Axial growth and refractive change in white European children and young adults: predictive factors for myopia

McCullough, S. et al. Scientific Reports (2020)
A study of white European children and their spherical equivalent refraction and axial elongation over time in combination with drivers for myopia such as myopic parents.

Estimation of ocular axial length from conventional optometric measures

Morgan et al. Contact Lens & Anterior Eye (2020)
Article presents a formula that can be used to measure the absolute axial length.

Ocular component growth curves among Singaporean children with different refractive error status

Wong HB et al. Investigative Ophthalmology & Visual Science (2010)
Study of the axial length and vitreous chamber in Singaporean children, the two ocular component showed different types of development across age groups.

WCO CooperVision® Myopia Management Navigator

Explore the interactive and educational resource for eye care practitioners worldwide

Soft Dual Focus or Multifocal Contact Lenses

Spectacle Lenses for Myopia Control

Orthokeratology

Atropine

When to wear it

Children who are physically active
Ideal for very young wearers
Children disliking glasses and/or inclined to not wearing them full-time

Considerations

Shown to improve confidence and ability to participate in activities.

Typically more availability for astigmats.

No wearing time during waking hours.

Optical correction is still needed.

* Excluding children frequently engaged in water sports.