Identifying and Monitoring Myopia Now
Several of the devices needed to do so are already at our disposal.
KEY TAKEAWAYS
- The phoropter can be used to track refractive changes over time to assess management efficacy.
- An optical biometer is beneficial in both identifying and monitoring myopia, as it allows us to track axial length elongation.
- Corneal topography provides a detailed map of the cornea, enabling us to identify any corneal irregularities and, thus, design an orthokeratology contact lens that will properly fit.
- An ultra-widefield retina camera helps us identify and track various retinal conditions, such as a retinal detachment, myopic maculopathy, and glaucoma.
Because cases of myopia continue to surge, it’s imperative all optometrists identify and treat this sight-threatening condition.1,2 This article discusses the technologies, most of which we have in our practices, available to facilitate both the diagnosis and monitoring of myopia. This way, more children can start treatment to slow disease progression. These technologies are a phoropter, an optical biometer, a corneal topographer, and an ultra-widefield retina camera.
PHOROPTER
Whether you have a digital or manual phoropter, we know this device is of great value in myopia, as it provides an accurate refraction to help tailor a long-term management plan. Additionally, the phoropter can be used to track refractive changes over time to assess management efficacy. Consider using autorefractor and autokeratometer readings as a starting point. A cycloplegic refraction is recommended, as it captures a precise prescription for young patients.
• Pro Tip. It is important to use the phoropter to obtain an overrefraction when working with orthokeratology and soft contact lenses for myopia control. Doing so will ensure you’re giving the patient the most accurate prescription in their contact lenses.
OPTICAL BIOMETER
This device provides a detailed map of the cornea, enabling us to identify any corneal irregularities and, thus, design an orthokeratology contact lens that will properly fit. Additionally, a corneal topographer allows us to track the treatment zone effectiveness over time. Essentially, without a corneal topographer, we can’t offer orthokeratology as a treatment.
• Pro Tip. Abnormal axial length elongation measurements indicate it’s time to change the myopia management plan or consider combination treatment.
CORNEAL TOPOGRAPHER
This device provides a detailed map of the cornea, enabling us to identify any corneal irregularities and, thus, design an orthokeratology contact lens that will properly fit. Additionally, a corneal topographer allows us to track the treatment zone effectiveness over time. Essentially, without a corneal topographer, we can’t offer orthokeratology as a treatment.
• Pro Tip. Obtaining a high-quality baseline corneal topography is essential in designing a proper-fitting orthokeratology lens. Apply a drop of preservative-free artificial tears in both eyes to ensure a smooth ocular surface for the scan.
ULTRA-WIDEFIELD RETINA CAMERA
While the gold standard for evaluating retinal health is a dilated eye exam, this device helps identify and track various retinal conditions, such as a retinal detachment, myopic maculopathy, and glaucoma. Myopia progression, when left untreated, increases the risk of these conditions. For the management of retina conditions, consider adding an OCT.
• Pro Tip. Photo documentation of the retina can help with overall management of these ocular conditions. Every diopter saved reduces the risk of myopic maculopathy by 40%.3
Forward-Thinking Outlook
A compact, portable, handheld, noncontact device is in the pipeline to provide direct axial length measurement. Called the Occuity AX1 Axiometer, its manufacturer says it expects the device to be available later this year.
GET INVOLVED
Myopia management is a popular topic in eye care right now—and for good reason. Don’t let equipment be the barrier to getting involved. There are devices you likely already own that can help you on your journey. You have the potential to create a positive difference in the lives of children in your community.
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