Predicting future myopia from axial length

Predicting future myopia from axial length

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.

Adult-onset myopia: measurement and management

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.

Is it myopia progression or early keratoconus?

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.

Are you measuring the cornea in myopia management?

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.

How much axial length growth is normal?

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.

Myopia Management in the netherlands: advice and outcomes from a new protocol

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.

Is axial length regression possible?

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.

Is it really fast progressing myopia, or something else?

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.

how to use growth chart

How to Use Axial Length Growth Charts

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.

Learning more about ‘normal’ axial elongation in emmetropic children

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.