Managing myopia progression

Optometrist Kate Gifford presented an excellent review of myopia in one of the clinical spotlight sessions at this year’s BCLA Conference. This included some practical tips that are useful for all who deal with refractive error in practice.

Before looking at how correction of myopia with contact lenses may also be used for myopia progression reduction, Gifford explained how any risks from contact lens wear (such as microbial keratitis) were significantly less than those from the myopia itself.

Myopia has a strong genetic component (having both parents myopic increases the risk of the child being so by 5-6 times) and environmental influences. Hyperopic defocus appears to drive axial growth and myopes of Asian backgrounds have significant relative peripheral hyperopia which might be corrected by specially designed lenses. Central (on axis) defocus, unstable esophoria, higher AC/A ratios and a lag of accommodation have also been associated with myopia. The goal of any intervention would be to modify central defocus, ensure accurate and stable binocular vision, maintain a ‘beneficial’ aberration profile and address peripheral shell defocus.