February 2022 Virtual event Presentation

How to Monitor Children Undergoing Myopia Management

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By Thomas Aller, OD, FBCLA, United States

FAQ from the event

About the presentation

Learn about tools and strategies for monitoring the myopia progression of your patients, assessing the effectiveness of their treatments and modifying their treatments to maximize their effectiveness. Thomas Aller is a Visiting Scholar at UC Berkeley, a scientific and clinical advisor to Treehouse Eyes and consults with multiple companies developing devices and treatments for myopia.

What is the longest myopia management case you have?

Well, I do have some patients whom I have been treating for up to 30 years, though they were not necessarily in myopia management treatment during their mid years.

Do you routinely measure axial length on four to six year-olds irrespective of whether they are hyperopic, astigmatic and so forth?

Yes, I do. International Myopia Institute defines pre-myopia as when a child is failing to slow their decreasing hyperopia before reaching emmetropia. Especially, if I know the child has, for example, three siblingsĀ  that are all -5.00 D and he is already +0.5 D, I will definitely try to measure axial length. You may not get multiple measurements but even one is better than nothing.

Do you recommend backup spectacles for children in myopia control contact lenses? For example, if they have a 'bad contact lens day'?

Yes, they should have a pair of spectacles certainly. If they do not have a way to see without them, they will wear them when they should not. They will wear a torn lens, they will pick a lens from off the floor and so on. It’s almost a health & safety issue to have a set of reasonable backup spectacles. They will wear their contact lenses almost all the time anyway.

References

Brien Holden Vision Institute (BHVI) Myopia Calculator
https://bhvi.org/myopia-calculator-resources/

MyopiaProfile Myopia Risk Assessment Worksheet
https://www.myopiaprofile.com/product/myopia-risk-assessment/

Myopia Care Control Protocol https://www.myopiaprofile.com/product/myopia-risk-assessment/

CooperVision The Brilliant Futuresā„¢ Myopia Management Programme
https://coopervision.co.uk/brilliantfutures

Zadnik K, Mutti DO, Mitchell GL, Jones LA, Burr D, Moeschberger ML. Normal eye growth in emmetropic schoolchildren. Optom Vis Sci. 2004 Nov;81(11):819-28.
https://pubmed.ncbi.nlm.nih.gov/15545807/

Aller T et al Myopia management with naturalvue (etafilcon a) multifocal 1 day contact lenses: continuing evidence from clinical practice, CLAE vol 42, issue 6, supplement 1, E24, December 2019. https://www.contactlensjournal.com/article/S1367-0484(19)30431-X/fulltext

Chamberlain P, Peixoto-de-Matos SC, Logan NS, Ngo C, Jones D, Young G. A 3-year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optom Vis Sci. 2019 Aug;96(8):556-567. https://pubmed.ncbi.nlm.nih.gov/31343513/

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Video title slide: How to identify children at risk of developing myopia
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Video title slide: how to monitor children undergoing myopia management
Play Video about Video title slide: how to monitor children undergoing myopia management

Presented by Thomas Aller

Learn about tools and strategies for monitoring the myopia progression of your patients, assessing the effectiveness of their treatments and modifying their treatments to maximize their effectiveness.

Mitigation
Measurement
Management
Myopia Management perspectives - a research blog series

Learn how to recognize risks of developing myopia in children based on presenting refractive status, axial length, and family history and to implement a clinical management protocol.

Prepared by the World Council of Optometry Myopia Management Resource Committee 2023.
The World Council of Optometry Myopia Management Standard of Care initiative is a collaborative partnership between World Council of Optometry and CooperVision.

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.