Myopia Measurement
Patient Follow-Up

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. Please refer to the source references for more details
FOLLOW UP FREQUENCY & WHAT TO CHECK

The frequency of follow-ups will vary depending on treatment.

You will also want to complete the following during each appointment, though specific treatments will require additional examinations:

At each follow-up:
  • Check case history
  • Any issues related to treatment including adherence to wear time
  • Corrected far visual acuity
  • Over-refraction
At 6-month follow-up:
  • Cycloplegic refraction (if available)
  • Axial length measurement (if available)
At 1 year follow-up:
  • Complete eye examination including eye health and fundus check
SOFT CONTACT LENSES
FREQUENCY OF FOLLOW-UP:

1 week » 1 month » 6 months » 1 year

Thorough slit lamp exam of the anterior segment at each appointment

ORTHOKERATOLOGY
FREQUENCY OF FOLLOW-UP:

1 day » 1 week » 1 month » 3 months » 6 months » 1 year

Corneal tomography or topography, if available, at each appointment

SPECTACLE LENSES FOR MYOPIA CONTROL
FREQUENCY OF FOLLOW-UP:
1 month » 6 months » 1 year
ATROPINE
FREQUENCY OF FOLLOW-UP:

1 day » 1 week » 1 month » 3 months » 6 months » 1 year

Check pupil size, intraocular pressure and sensitivity to bright light at each appointment

If myopia continues to progress more than expected, consider the following:

  • Was the baseline refraction accurate? Was the patient cyclopleged? 
  • Is the axial length change in line with expectations? 
  • Are parents and the child following treatment instructions?
  • If not following treatment instructions, consider whether current control modality is best suited to lifestyle and needs.
If myopia stabilizes, continue to follow up every 6 months.

Ideally, myopia controlling spectacles and contact lens wear should continue until end of childhood (18 years)*, and possibly into adulthood, to avoid any progression.

While there are no established guidelines for when to cease using atropine, eye care practitioners should consider alternative treatments after two years of atropine use.

More Myopia Moments

Measurement

What to Measure during Myopia Management

Measurement

Using Refractive Error to Monitor Myopia

Prepared by the World Council of Optometry Myopia Management Resource Committee 2021. The World Council of Optometry Myopia Management Standard of Care initiative is supported by a grant from CooperVision.
  • Brian Holden Vision Institute: Guidelines for Myopia Management, June 2020.
  • Cooper Vision: Misight 1 Day (omafilcon a). Soft (hydrophilic) contact lenses for daily wear. Professional fitting and information guide, November 2019
  • Gifford KL / Myopiaprofile.com: Myopia Management in Practice, June 2021.
  • Gifford KL et al. IMI – Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci. 2019;60(3):M184-M203.
  • Wong HB, Machin D, Tan SB, Wong TY, Saw SM. Ocular component growth curves among Singaporean children with different refractive error status. Invest Ophthalmol Vis Sci. 2010; 51: 1341–1347
  • Myopia appears to progress fastest in preteenagers after which it slows down, Gifford et all (2019).

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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.