This case study explores clinical data for a 7-year-old child whose refractive error and axial length is changing at an alarming rate. How can we best determine the rate of progression and set our management plans, using axial length?
If your patient is a unilateral myope, sometimes the myopic eye is the easier one to manage! This case study explores the options to appropriately diagnose, track and manage the non-myopic eye in a unilateral myope – where the non-myopic eye seems to be progressing faster than the myopic eye treated with orthokeratology.
Most clinicians are aware of myopia risk factors such as family history and visual environment, but how about axial length? This article explores how we can use the current axial length value, change in axial length, axial length growth charts, and another metric, the axial-length-to-corneal-radius (AL/CR ratio), to predict risk of a child developing myopia.
Myopia which onsets in childhood usually stabilizes in the early twenties. How should we manage adult-onset myopia and progression? This case investigates factors, diagnostic measurements and management of adult-onset myopia.
How would you manage a progressing myope with early keratoconus? In this case, refractive progression of myopia was not just due to axial elongation, and astute repeated measurement of both the corneal curvature and axial length helped with accurate diagnosis.
Measuring the cornea in myopes is crucial to understanding their clinical picture and even their profile of myopia risk. Flat corneas can mask an axial length which is longer than expected for the patient’s refraction. Learn more in this clinical case study.
What amount of axial length growth be expected in myopes versus emmetropes, and how can you tell if your myopia control treatment is working? This important clinical reference provides all this information and more on axial growth in younger and older children, emmetropes and myopes, and even data on typical myopia stabilization.
The Erasmus Medical Group in the Netherlands set out four steps in their myopia management protocol: providing visual environment advice, identifying high-risk myopes by axial length and treating them with atropine 0.5%, managing other myopes with optical treatments or lower-concentration atropine, and ceasing treatment in the late teens once axial length is stable. The described use of axial length percentile growth charts for diagnosis, choice of treatment, monitoring and cessation is a world-first.
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.
In this case, a 14-year-old was found to be far less myopic than their refraction and terrifyingly fast progression suggested, thanks to careful diagnosis. Learn what didn’t add up and how utilizing technology o measure the ocular components helped to solve the puzzling clinical case.
