What is Myopia Management and Myopia Control?

Hey Good optometry morning.   Dr. Michael Nelson, your YouTube eye doctor here and today I’m going to tell you the difference between myopia management, myopia control and myopia correction….and we are starting right now.

The term myopia management is often used synonymously with myopia control but they both refer to the prescribing of an intervention to slow down the progression of myopia.  Myopia Control is the original term used and it was first used in 1946 in a journal article in the Optical Journal and Review of Optometry.   The term Myopia Management was not used until 1981 when it was first used in the American Journal of Physiological Optics.   Now, I think most eye doctors currently prefer to use the term myopia management and is more accurately represents that fact that we can’t stop or reverse myopia but we can help slow down the progression of it and for that reason I will be using the term myopia management.

Myopia occurs when there is a mismatch between the length of the eye, or axial length, and refractive components of the eye, which then puts images in focus in front of the retina instead of on it.  And Myopia progression occurs because of continued increase in axial length.  Myopia management can be defined as the slowing down of axial elongation, which will also slow down the rate at which the dioptric value of the refractive error increases.

The onset of myopia typically occurs somewhere between the ages of 6 and 12 years but in the past few decades, onset has shifted towards the younger end of the age range. This is why it is important that children start having at least annual eye exams starting at least by the age of 3.

So Myopia management can begin before a child is actually is measured to be myopic.   If a child is identified as having risk factors for myopia your optometrist may suggest steps to intervene, even before a myopic prescription is measured.   Risk factors include things like a lower hyperopic or farsighted prescription than expected for a child’s age, a strong family history of myopia or an axial length measurement that is longer than expected for a child’s age.  Some studies have shown that the axial length of the eye will start to grow up to a few years before we can actually measure a myopic prescription.

Myopia management refers to the decision to implement a strategy to slow down the progression of myopia in a child.   The initial stage of myopia management needs to occur as soon as there is evidence of myopia and ideally in the pre-myopia stage.

So are 4 things you should expect from your myopia management eye doctor:

1. Help you identity risk factors for myopia and high myopia….and one of the key ones I find is knowing the axial length of your eye and how this is changing.
2. Providing information, advice and recommendations to children and parents about myopia management.
3. Prescribing interventions like specific spectacle lenses, contact lenses and or eye drops to slow the progression of myopia and reduce the risk for developing high myopia
4. Being proactive.

So lets talk about what myopia management is NOT.

Myopia correction is not Myopia management.   Myopia correction refers to prescribing glasses or contact lenses to put the image in focus on the retina so someone can see clearly.   Myopia correction is essential and will provide the important benefit of being able to see clearly in the distance but it will not slow down the progression of myopia.   Myopiia management will involve using special spectacle and contact lens designs that will correct myopia AND slow down the growth of the eye.

Myopia management will always include myopia correction, but myopia correction does not include myopia management.

Another common misconception is that prescribing myopia correction lower than what is measured will help slow down myopia.  This is not recommended as most studies indicate that undercorrecting myopia can actual be a stimulus for myopia to increase.

And lastly, a wait and see approach does not seem to be the best approaching.   Waiting until the myopia prescription increases is not the best approach as we believe that there are risk factors and signs that indicate myopia will develop, even before we can detect a myopic prescription.  It is best to try to be proactive.

If you would like to see if your child has myopia, risk for myopia or start myoipa management book an eye exam for your child at Waverley Eye Care Centre.