Thomas Aller, OD, FBCLA
As the prevalence of myopia grows throughout the world, the onset moves to younger ages, and higher levels are being seen in young adults, there is a developing consensus that treating myopia progression should have a goal of limiting the maximum level attained by an individual patient.1 That consensus, however, hasn’t yet led to broad adoption of myopia control in clinical practice.2 And while there is also no widespread agreement that myopia is a disease, there is general agreement that there are higher risks of certain ocular disorders and diseases with higher levels of myopia. These associations are well known for retinal tears and detachments, not well chronicled for the newly categorized myopia macular degeneration and not commonly appreciated for cataracts and glaucoma.3 For these conditions, we expect that the association with myopia is really an association with axial elongation, and that is why the goal of managing myopia progression should be to control axial elongation maximally.4
It may be many years (or perhaps never) before a study will conclude that 15 years of myopia suppression will reduce the consequences of pathologies linked with excess axial elongation.
For this clinical dilemma, practitioners are limited to drawing logical conclusions from the existing literature and perhaps freed in the same instance to provide care to their patients that likely will benefit them years down the road, without waiting for multiple studies to prove it.