IMI Report on Prevention of myopia and its progression

In myopic children, interventions to slow progression are warranted to prevent the development of high myopia and subsequent pathology and also to reduce the economic burden caused by uncorrected and pathologic myopia. This IMI Report describes the latest advice on preventing the development and progression of myopia – read the summary here.

Understanding on and off label prescribing

Understanding on- and off-label prescribing

What does on-label and off-label prescribing mean in myopia management? Here we explore this topic from the point of view of medications and medical devices, what regulatory approvals mean and how this applies to decision making and clinical processes such as informed consent.

Two-year clinical trial results of aspherical lenslet spectacles for myopia control

This study reports two year results from a randomized clinical trial examining myopia control spectacle lenses with highly aspherical lenslets (HAL) or slightly aspherical lenslets (SAL). The findings showed the HAL lens controlled refractive and axial progression by 50-55% and SAL by around 30% over two years. Read more about the outcomes and comparisons to other myopia control spectacles here.

Six-year MiSight 1 day clinical trial data

The MiSight 1 day clinical trial is the longest in soft lens myopia control, showing efficacy in children and teens in up to 6 years of wear. The first three years showed a 50-60% axial length and refractive efficacy. In the second three years, all control group children were switched to MiSight and showed axial growth similar to children under continued treatment, indicating benefits for commencing wear in children and teens alike.

Can orthokeratology be used to slow the progression of anisomyopia?

This meta-analysis investigated the effectiveness of orthokeratology in controlling the progression of anisomyopia (unilateral myopia or bilateral anisomyopia) in Chinese children. Total anisomyopia decreased at 2-year follow up, indicating orthokeratology may be a safe clinical method to slow myopia progression coupled with reducing interocular axial length difference. 

Compounded topical atropine: is every bottle the same?

How consistent is compounded topical atropine from bottle-to-bottle? What clinical results could indicate variability? Read more in this clinical case where a miniscule change in concentration gave notably better clinical outcomes.

Can using atropine enhance myopia control with orthokeratology?

This meta-analysis of 5 studies of 1, 6 and 12 months duration found that slower axial growth is evident when using orthokeratology in conjunction with atropine as a combined therapy compared to orthokeratology alone. A slowing effect of 0.09mm was seen with the combined approach for up to a 12 month follow-up period. Longer data was not available for the meta-analysis.

What is the effect of uncorrecting, undercorrecting and overcorrecting myopia in children?

This systematic review of 9 studies confirms that under-correction of myopia does not slow progression; rather, at least half of the studies have shown the myopia progression is accelerated. There was no benefit found in overcorrection, and the evidence for un-correction was equivocal. Clinically, this advocates for the full correction of myopia.

When myopia management is not working after COVID-19 home confinement

During the COVID-19 pandemic, governments imposed home confinement and school-based learning was the normal. Has this caused more myopia? In this clinical case, the unique environment of lockdown is explored in view of myopia management outcomes.

A monocular myope with coloboma

An 8-year-old child is essentially monocular, due to unilateral high myopia associated with coloboma. The normally sighted eye has low myopia. How should we best balance safety and proactive myopia control in such a case?