PROGRESSIVE MYOPIA - Identify the Risk


Myopic degeneration

Clinical Relevance

76 yo wf. -9.00 OU. History of retinal detachment (superiorly), advanced glaucoma and myopic retinal degeneration. BCVA is 20/50 OU. Pt has a cochlear implant and reads lips. She is scared about losing her vision, her ability to communicate, and her independence.

Myopia control, myopia control, myopia control…

This topic is gracing the headlines of many articles. With our busy practices and personal lives, it can be daunting to stay abreast of all of the new information on this topic.

As Eye Care Practitioners, it is critical for us to be able to identify which of our patients are most at risk for fast-progression of their myopia. Let’s walk through it together.

The more risk factors a patient has, the more likely they are to progress. The presence of 3 or more of the following risk factors puts the patient at ‘high risk for fast progression'.

Risk Factors

  • Age of Onset: Myopia developing at age 9 or younger is more like to be progressive because children at this age are growing so rapidly. And so are their eyes!

  • Family History: Ask parents if they or another close relative are nearsighted. Even if they don’t have high myopia, it still increases risk. The more family members that are myopic, the greater the influence it can have.

  • Rate of Progression: Look for a history of progression of -1.00 Diopter (or more) in a 12 month period. Obtain old records or read old spectacles with lensometry.

  • Ethnicity: Myopia affects up to 80% of Asian children, whereas around 40% of Western populations develop myopia. As many as 10-20% of Asian children will progress into high myopia.

  • Near Work: Phones, tablets, gaming, reading… Increased accommodative demand increases risk. Spending more than 2 hours per day (excluding school-time) may be too much.

  • Time Spent Outdoors: The correlation is clear that averaging less than 2 hours per day of time spent outdoors increases risk of progression.

Pro Tip

Download and laminate this quick reference guide. Keep it in your exam rooms and use it when talking to your patients about their risk for fast progression of their myopia.

Myopia Control Course:

If you would like to dive a little deeper into a fee setting exercise, pre-enroll for my Myopia Management courses below: