Myopia Management

Question 1

BY 2050, how much of the population is expected to be myopic?

Answer 1

50%

Question 2

how many children are myopic in the uk?

Answer 2

4million

Question 3

what did a study conducted in Ireland find?

Answer 3

children are becoming myopic at a younger age- myopia in 10-16 y/o has more than DOUBLED over past 50 yrs

Question 4

can myopia be classed as a disease?

Answer 4

yes, as:
Harmful deviation from normal state
Associated with signs and symptoms
Environmental and/or genetic
Evident at birth or later life

Question 5

what two major pathologies can we reduce the future risk of with myopia management in children?

Answer 5

retinal detachment and myopic maculopathy

Question 6

aside from correcting myopia, what other things can we do to manage pre-myopia?

Answer 6

-public education,
-awareness ,
-early and frequent discussions with parent s and public education (according to world council of optometry),
-lifestyle factors,
-risks to health and available management strategies

Question 7

what can be classed as ‘high myopia’

Answer 7

rx greater than -5.00ds

Question 8

what are 3 reasons why myopia management is becoming more necessary?

Answer 8

• Early intervention is important to slow progression
• Lowers ocular disease risk
• Offers additional benefits= Less unaided visual disability, Greater options for future corrections, Thinner, lighter glasses (cheaper as less thinning)

Question 9

reducing myopia by 1 dioptre has how much of a lifetime overall reduction?

Answer 9

40%

Question 10

what is myopia actually a disease of?

Answer 10

axial length- basically stretched

Question 11

what axial length can be defined as high myopia?

Answer 11

26mm and above (25% risk of problems)
-30mm you will have 90% risk of problems so try keep below 26mm

Question 12

0.4m in axial length equates to how many dioptres?

Answer 12

1 dioptre

Question 13

what are the 3 M’s of the world council of Optometry?

Answer 13

-Mitigation
-Measurement
-Management

Question 14

what is mitigation?

Answer 14

history-birth, fh,
lifestyle- reading?digitial devices
-outdoor time?
-recall frequency- shorter recall for pre or current myopic px

Question 15

what is the average time children should spend outdoors for preventing myopia?

Answer 15

2 hours a day

Question 16

what is the risk of myopia when both parents are myopic?

Answer 16

1 in 2

Question 17

what is the riskof myopia when 1 parent is myopic?

Answer 17

1 in 3

Question 18

what is the risk of myopia when neither parent is myopic?

Answer 18

1 in 4

Question 19

is outdoor time proven to help children already myopic?

Answer 19

no sadly

Question 20

what is the measurement aspect?

Answer 20

-refraction
-cycloplegic refraction
-keratometry
-axial length estimation
-biometry

Question 21

what rx in achild has a very low risk of myopia>

Answer 21

anywhere between +0.75 to +1.00ds (at 6 yo)

Question 22

what rx is a child with high risk of myopia

Answer 22

a child who is LESS than +0.75ds (so closer to minus) AND both parents are myopic (6 yo) - has 75% risk of becoming myopic- refer to able in lecture

Question 23

what does the college of optoms suggest optoms do within the scope of their practice?

Answer 23

Keep up to date with evidence
* Discuss options
* Explain short- and long-term benefits
* Manage expectations
* Monitor outcomes
* And should ensure accurate record
keeping
-Ensure you can hold a discussion
* Be aware of local myopia
management services
* Agree in advance a referral
arrangement

Question 24

what is management aspect of controlling myopia ?

Answer 24

Spectacles & Contact Lenses
Spectacles for MM
On-label Contact lenses for
MM (CE)
- Daily Disposable
- Monthly
Off-label Contact lenses for
MM
- Monthly
- Orthokeratology
- Monthly Toric
-Future Management
Pharmaceuticals

Question 25

what drugs can be potentially available in the future for myopia control?

Answer 25

atropine

Question 26

does undercorrection promote progression of myopia?

Answer 26

yyes

Question 27

what do optical management products do?

Answer 27

peripheral myopic defocus

Question 28

list some myopia control cls

Answer 28

mylo by mark ennovy
misight by cooperv
bloom day/night b menicon
stelles essilor

Question 29

how does misght 1 day work? and wear time?

Answer 29

rings that create peropheral defocus to slow down myopia- centre has clear area
WT 6 days pw, 10 hrs per day

Question 30

what is clinically signifcant myopia?

Answer 30

-0.75 or above

Question 31

how effectivee is mi-sight 1 day

Answer 31

MiSight 1 day cuts the worsening of myopiaby half-even young adults wear them peripheral

Question 32

how do hoya miyosmart gls work?

Answer 32

look like bubble wrap- segments have +3.50ds myopic defocus, centre clear

Question 33

what is the CHAMPS study?

Answer 33

The Childhood Atropine for Myopia Progression
in the UK
study will be the first randomised trial reporting outcomes of low-dose atropine eyedrops for children with myopia in a UK population

Question 34

when does myopia stop progressing?

Answer 34

48% STABILISED BY 15 YEARS
77% STABILISED BY 18 YEARS
90% STABILISED BY 21 YEARS

Question 35

how do you communicate myopia management to parents?

Answer 35

1.) try to avoid risks- say ‘manage ocular health’
2.) if you mention Evidence based research- keep it simple
3.) 3 way conversation
4.) Px specific treatment
5.) Risks as well as benefits
6.)No treatment is an option
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