Myopia Management Flashcards
BY 2050, how much of the population is expected to be myopic?
50%
how many children are myopic in the uk?
4million
what did a study conducted in Ireland find?
children are becoming myopic at a younger age- myopia in 10-16 y/o has more than DOUBLED over past 50 yrs
can myopia be classed as a disease?
yes, as:
Harmful deviation from normal state
Associated with signs and symptoms
Environmental and/or genetic
Evident at birth or later life
what two major pathologies can we reduce the future risk of with myopia management in children?
retinal detachment and myopic maculopathy
aside from correcting myopia, what other things can we do to manage pre-myopia?
-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
what can be classed as ‘high myopia’
rx greater than -5.00ds
what are 3 reasons why myopia management is becoming more necessary?
- 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)
reducing myopia by 1 dioptre has how much of a lifetime overall reduction?
40%
what is myopia actually a disease of?
axial length- basically stretched
what axial length can be defined as high myopia?
26mm and above (25% risk of problems)
-30mm you will have 90% risk of problems so try keep below 26mm
0.4m in axial length equates to how many dioptres?
1 dioptre
what are the 3 M’s of the world council of Optometry?
-Mitigation
-Measurement
-Management
what is mitigation?
history-birth, fh,
lifestyle- reading?digitial devices
-outdoor time?
-recall frequency- shorter recall for pre or current myopic px
what is the average time children should spend outdoors for preventing myopia?
2 hours a day
what is the risk of myopia when both parents are myopic?
1 in 2
what is the riskof myopia when 1 parent is myopic?
1 in 3
what is the risk of myopia when neither parent is myopic?
1 in 4
is outdoor time proven to help children already myopic?
no sadly
what is the measurement aspect?
-refraction
-cycloplegic refraction
-keratometry
-axial length estimation
-biometry
what rx in achild has a very low risk of myopia>
anywhere between +0.75 to +1.00ds (at 6 yo)
what rx is a child with high risk of myopia
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
what does the college of optoms suggest optoms do within the scope of their practice?
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
what is management aspect of controlling myopia ?
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
what drugs can be potentially available in the future for myopia control?
atropine
does undercorrection promote progression of myopia?
yyes
what do optical management products do?
peripheral myopic defocus
list some myopia control cls
mylo by mark ennovy
misight by cooperv
bloom day/night b menicon
stelles essilor
how does misght 1 day work? and wear time?
rings that create peropheral defocus to slow down myopia- centre has clear area
WT 6 days pw, 10 hrs per day
what is clinically signifcant myopia?
-0.75 or above
how effectivee is mi-sight 1 day
MiSight 1 day cuts the worsening of myopiaby half-even young adults wear them peripheral
how do hoya miyosmart gls work?
look like bubble wrap- segments have +3.50ds myopic defocus, centre clear
what is the CHAMPS study?
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
when does myopia stop progressing?
48% STABILISED BY 15 YEARS
77% STABILISED BY 18 YEARS
90% STABILISED BY 21 YEARS
how do you communicate myopia management to parents?
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
DOCUMENT EVERYTHING DISCUSSED
