Eight Myopia Mysteries (plus eight more!)


This open-access continuing education article I authored was published in Australian professional journal Mivision in December 2018. It describes that while there's a lot we know about myopia control - the imperative to reduce lifelong risk of vision impairment; that numerous options are available; and that the sooner we start the better - it is imperative for the clinician to understand the difference between clinical observations and the evidence base.

This article is organised into eight 'myopia mysteries':

  1. What drives myopia development and progression? Is it actually about relative peripheral defocus or not?
  2. Do progressive and bifocal spectacles work?
  3. Is low dose atropine useful?
  4. Which add should you use in multifocal soft contact lenses?
  5. Are multifocal soft lenses better than OK for low myopes?
  6. Do smaller OK treatment zones give better myopia control?
  7. Could binocular vision influence contact lens efficacy?
  8. Does adding atropine increase efficacy?

This article groups common clinical treatments in an effort to explore what we do and don’t know regarding myopia control efficacy. It highlights the need to balance the available evidence with emerging knowledge when discussing options for myopia control with patients and their carers.

Published at a similar time, and a fantastic companion to this piece, is Noel Brennan and Xu Cheng's article in Eye and Contact Lens, entitled Commonly Held Beliefs About Myopia That Lack a Robust Evidence Base. Addressing 10 common misconceptions, two overlap with the above but a further eight include mythbusting undercorrection; consistency of percentage treatment effect; the effect of hand-held digital devices; that time outdoors slows myopia progression; the mechanism of outdoor time benefits; subclassifications of myopia and identifying pre-myopia.