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HomeMyopia ResourcesReview of Myopia ManagementWhen to Initiate Myopia Management Intervention and When to Stop

When to Initiate Myopia Management Intervention and When to Stop

Daniel Tilia, BOptom (Hons), MOptom, GradCertOcTher, FBCLA, FAAO
Brien Holden Vision Institute

Implicit in deciding when to initiate myopia management is monitoring pre-myopic patients who are at risk of developing myopia. Some of these risk factors include:

  • Parental myopia.1-3
  • Excessive near work at close distances.4, 5
  • Reduced time outdoors.6
  • Ethnicity, with East Asian children at greater risk of developing myopia.1, 7, 8
  • Less than age-expected hyperopia.9
  • Female gender.7, 10

There is no published evidence that treating pre-myopes, irrespective of risk, is beneficial in terms of myopia progression. The decision to initiate myopia management is therefore very simple—initiate treatment when myopia is first diagnosed.

There is no published evidence that treating pre-myopes, irrespective of risk, is beneficial in terms of myopia progression. The decision to initiate myopia management is therefore very simple—initiate treatment when myopia is first diagnosed.

However, there is a lack of conformity in not only diagnosis of myopia, but also with the magnitude of refractive error considered to be myopic.

In 2015, the World Health Organization defined myopia as:

A condition in which the spherical equivalent objective refractive error is ≤ -0.50 diopter (-0.50 D) in either eye.11

More recently, Flitcroft et al.12 proposed an alternate definition for myopia:

A refractive error in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina when ocular accommodation is relaxed. This usually results from the eyeball being too long from front to back, but can be caused by an overly curved cornea and/or a lens with increased optical power.

It also is called nearsightedness.