Axial length typically increases in children, and myopia control aims to slow this excessive growth. Can axial length regression or reduction be possible in myopia control? In this case study, an 8-year-old appears to show a large reduction in axial length. We investigate possible causes and provide clinical guidance on measurement accuracy.
Growth charts are commonly used in childhood health and are easily understood by parents. When applied to myopia management, axial length growth charts can allow individualized decisions on treatment strategy and efficacy. What charts are available now and how can you use them in practice? Here we explain how to use axial length growth charts from initial diagnosis to treatment strategy and long term monitoring.
Previous multi-ethnicity studies have shown ‘normal’ axial elongation in emmetropic children to be around 0.1mm / year. In this study, 700 Chinese schoolchildren with stable emmetropia showed 0.2mm per year axial elongation from age 7-11, which reduced with age and ceased at age 15. This appears higher than measured in Singaporean Chinese children in the SCORM study, 20 years ago.
Light-emitting glasses worn by young adults for 1-2 hours reduced axial length and increased choroidal thickness by around 20 microns compared to darkness. The study participants viewed a colour-muted television at 5m while indoors, and the changes regressed within 30 minutes. A future myopia treatment to increase ‘outdoor’ time?
What equipment do you need to get started with myopia management in practice? Here we take you through the recommendations of the International Myopia Institute Clinical Management Guidelines Report, with advice on testing and equipment required. There are also suggestions for how you can get started if you don’t have access to all the equipment described, plus what is ideal and what is necessary for best practice.
The value and importance of axial length measurement in myopia control is growing. As you offer myopia control to more patients, you could start to consider which instrument to use to measure axial length. How do ultrasound and interferometry instruments compare in accuracy? What about the new generation combination instruments? Here we address the practicalities of axial length measurement.
This case study describes two examples of myopia and axial length mismatch – a low myope with long eyes and high myope with short eyes. With axial length becoming more available and crucial in myopia management, it’s important to understand that the relationship between refraction and axial length isn’t always consistent. Find out more regarding the other ocular components that can influence refractive error.
Axial length (AXL) has been well established as the critical measurement in myopia control research. The measurement accuracy and link to disease risk make AXL increasingly important in a clinical setting. But what else should we measure in the myopic eye? Does the cornea change as well? Will we end up doing away with refraction? Read more on measuring the whole eye in myopia.
When is a hyperope actually a myope? This case presents an aphakic patient with Marfan syndrome and an extremely long axial length, who needs to be managed like a high myope. This post also discusses a variety of pharmacological approaches to myopia management, based on a fascinating case presented in the subsequent Facebook discussion.