Development of the Ametropias

Question 1

Hirsch Longitudinal Studies in California:

______ in refractive error b/w ages 6-7 to 11-12 yrs old

Answer 1

Linear change

Question 2

Hirsch Longitudinal Studies in California:5 or 6 yr old children w/+1.50 D or more hyperopia will ________ at age 13-14

Answer 2

still be hyperopic

Question 3

Hirsch Longitudinal Studies in California:

Majority of 5-6 yr olds w/refractive error of +0.50 to +1.24 will be ________ (-0.49 - +0.99 D) at age 13-14

Answer 3

emmetropic

Question 4

Hirsch Longitudinal Studies in California:

Most children entering school with refractive errors of 0 to +0.49 D will be ____ at age 13 or 14

Answer 4

myopic

Question 5

Hirsch Longitudinal Studies in California:

Children who are myopic at age 5 or 6 will become ______

Answer 5

more myopic

Question 6

Changes in Hyperopes Compared w/Myopes

-Among school aged children, greatest changes in refractive error occurred in _____

Answer 6

myopes

Question 7

Refractive change is _____ when a child cross from hyperopia into myopia

Answer 7

faster

Question 8

Onset of Myopia in Youth:

What are the four types of myopia (Grosvenor’s Classification of Myopia)?

Answer 8

• Congenital
• Youth-onset
• Early adult-onset
• Late adult-onset

Question 9

Describe Youth-Onset Myopia.

What is the prevalence at 5-6 years of age? 15-16?

Answer 9

Most common type of myopia
Onset: school-age years
Onset for females for about 2 years earlier than males

5-6 yrs of age–> 2%
15-16 yrs of age –> 20-25%

Question 10

Once myopia appears in childhood, it ____ until the middle to late teens

Answer 10

increases

Question 11

Emmetropic children b/w age 6 and 14 yrs show:
1)
2)
3)

Answer 11

Increase in axial length
Decrease in crystalline lens thickness
Decrease in crystalline lens power

Question 12

Axial Elongation of vitreous chamber is responsible for ________

Answer 12

myopia progression

Question 13

During childhood, myopia occurs from axial length increase –> refractive power _____

Answer 13

decreases

Question 14

_____: Axial Length Increases

Answer 14

Myopia

Question 15

Myopic vs. Emmetropic Young Adults:
1)
2)
3)

Answer 15

1) Greater vitreous depth
2) Greater corneal power
3) Greater posterior crystalline lens radius

Question 16

School-Aged and Young Adult Females vs. Males:
1)
2)
3)

Answer 16

1) Shorter eyes
2) Steeper corneas
3) More powerful crystalline lenses

Question 17

The earlier in life the onset of myopia occurs, the ____ amount of myopia developed by late teens to young adulthood

Answer 17

increases the

Question 18

Higher rate of childhood myopia progression is associated with?

Answer 18

the earlier onset of myopia

Question 19

Myopes vs. Nonmyopes
1)
2)
3)
4)

Answer 19

1) Spend more time reading/lots of near work
2) Have occupations that require near work
3) Better reading ability
4) Have more years of education

Question 20

Shorter reading distance is also associated with __________

Answer 20

greater myopia progession

Question 21

Once myopic, _____ astigmats do NOT have greater rates of childhood myopia progression

Answer 21

ATR

Question 22

Children with ____ at 5-6 developed myopia by 13-14 vs those without (or WTR)

Answer 22

ATR

Question 23

These factors are associated with Higher Rates of Childhood Myopia Progression:
1)
2)
3)
4)
5)
6)

Answer 23

1) Earlier onset age/higher initial amount of myopia
2) Near-point esophoria
3) Temproal crescents and other myopic fundus changes
4) Higher intraocular pressure
5) Greater amount of time spent reading and doing other near work
6) Less time spent on outdoor activities

Question 24

What are some pharmaceutical agents that control progression of Myopia?

Answer 24

Atropine and Pirenzepine

Question 25

What is the purpose of Atropine?

Answer 25

Effects the development of retinal ganglion cells

Question 26

Why is Atropine are unpopular with patients?

Answer 26

1) Complete Cycloplegia
2) Photophobia from dilation
3) Possible allergic reaction

Question 27

What is the major downfall of Atropine treatments?

Answer 27

Upon stopping treatment, Myopia progression ACCELERATES

Question 28

What are non-pharm methods for controlling Myopia?

Answer 28

1) Rigid Contact Lenses
2) Bifocal Spectacle Lenses
3) Progressive-addition Spectacle Lenses (PALs)

Question 29

This form of myopia control is most effective in lower myopia progression rates for children with esophoria at near.

Answer 29

Bifocal Spectacle Lenses

Question 30

_____ can be used for certain accommodation and vergence disorders (accommodative insufficiency, convergence excess)

Answer 30

Bifocal Spectacle Lenses

Question 31

The rate of myopia progression in Bifocals is ____ than in Single Vision Lenses

Answer 31

lower

Question 32

What is purpose of giving children with esophoria at near Bifocal Spectacle Lenses?

Answer 32

Want a near addition power to shift near phoria to ortho/low exo range