Myopia control clinic information for practitioners

Who should be considered for myopia control?

Myopia generally starts around the age of 7 and progresses most rapidly during the school years into early adulthood. Therefore, myopia control intervention is most effective during this period of time. Eligible candidates should show:

• onset of myopia before 16 years
• progressing myope
  
• emmetropes at risk of developing myopia due to positive family history of high myopia (one or two myopic parents, siblings).
  

Managing patient expectations

Promising results from various clinical trials suggests that wearing special contact lenses slows down myopia progression. Although we may be able to slow down the progression of myopia we cannot stop it completely as the eye will continue to grow but just at a slower rate than it would without the myopia control treatment. There is also no proven treatment to reverse myopia. It is important that parents/patients are aware of this before they attend our clinic.

What to expect at the first appointment?

As efficacy of myopia control treatment varies significantly between patients it is essential that extensive baseline measurements are taken to identify any ocular changes that occur. As part of the initial visit the following will be assessed:

• evaluate rate of myopia progression if data is available
• cycloplegic and peripheral autorefraction
• axial length measurements
• corneal topography
• choriodal thickness and retinal curvature
• lifestyle and family history questionnaire.

If an emmetropic ‘high risk’ patient has presented with a positive family history of myopia these outcomes will be assessed at 6–12 month visits even if they are not undergoing myopia control.

Based on the findings at the first visit a discussion will be had with the patient/parents on the most appropriate choice of myopia control. At present the options available include MiSight daily lenses and orthokeratology. Depending on which option is chosen the patient will be fitted with the contact lenses at a second visit. Any patient undergoing myopia control will be monitored every 6–12 months to determine the efficacy of the treatment.