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.
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.
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.
