Myopia - What's the future?
Philipp Hessler explains the status quo and the possibilities of myopia management with the OCULUS Myopia Master®. The world's first device combines all the important measurement parameters for myopia management: axial length, refraction values and central corneal radii.
Myopia: short-sightedness in children and adolescents on the rise
When it comes to the spread of myopia some studies already speak of an epidemic. The well-known Brien Holden Vision Institute has forecast that by the year 2050 one out of two individuals could be affected by myopia. That is alarming, and it makes it more than clear that early detection and management of myopia are becoming more and more important. For there is no other way to effectively reduce the risks of myopia in children and adolescents.
Numbers speak a clear language
A comparison illustrates the rapidity of this development: In the year 2000 22.9% of the global population were affected by myopia and 2.7% had high myopia beyond -5 diopters. According to Brien Holden's forecast, by 2050, 50% of the world's population could be myopic and at least 10% could be suffering from high myopia. The development is also dramatic within Europe. According to data recently presented by the European Eye Epidemiology Consortium, more than 47% Europeans between 25 and 29 years of age are myopic
Risk of severe eye disease on the rise
Those affected also have a greater risk of developing severe eye disease such as cataract or retinal detachment and eventual blindness. In general it can be said, that the earlier the myopia onset, the higher will be the myopia in the adulthood and the higher will be the risk for severe eye disease.
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Causes of myopia
The single greatest cause of myopia is the change in lifestyle.
Nowadays, tablets, smartphones and laptops impact heavily on media consumption behaviour. Screen devices of course also pose a new burden on the eyes. In the morning people are in the habit of checking their emails or reading the news on their smartphone while on the subway. This is often followed by long hours of work sitting at a computer. As a result, myopia prevalence is significantly elevated in all instances where the eyes have an especially large amount of short-distance work to cope with. This relates not only to screen time, though there is a clear correlation with the intensity of digital device use.
For example, people in Asia spend an average 14 hours of their day on the Internet, while in the USA it is 6 hours. By contrast, the time spent in outdoor activities in natural bright light in these countries is very short. Conversely, in Australia, only 30% of 17-year-olds are myopic, and the average Australian spends three hours a day out of doors. This is far more than the maximum one to two hours of the average American, Asian or European, who thus incur a heavy burden on their eye health.
Early and accurate measurement and reliable follow-up of myopia
With myopia prevalence increasing in children, adolescents and young adults and growing exponentially overall, it is becoming more and more important to monitor for myopia early on in life. Simply put: The earlier myopia is discovered, the better. Children should therefore be regularly tested for myopia from the age of 4.
The greatest changes in myopia occur from age 6 to 16 when the eye can start growing out of focus. This results into a bigger axial length of the eye and myopia. Once the eye is grown longer, there is no method shrinking the eye again. The treatment of myopia reduces the eye growth, or, in the best case, stops it. This demonstrates how important it is to regularly test children already at an early age.
The best combination:
Refraction, axial length and keratometry
The standard method for measuring myopia is by refraction. However, due to day-to-day changes in visual acuity as well as measurement variability, refraction tests are prone to fluctuation and unavoidable measurement inaccuracies.
Axial length measurement
The axial length of the eye can be measured accurately and independently of accommodation. Progression in axial length is a reliable indicator of progression in myopia.
The central corneal radii are what ultimately determines the refractive component of the myopic process . These can be automatically measured and succinctly displayed using a keratometer.
Myopia Management Redefined
Being able to detect myopia at an early stage before it develops is extremely important. In cooperation with the Brien Holden Vision Institute, the values measured are compared with age-related normative data derived from a database of about 25 000 eyes. The growth curve makes it possible to compare the individual measurement with normative data. The earlier an abnormality trend is recognized, the more efficiently it can counteracted with appropriate treatments.
The diagram shows both axial length and refraction (spherical equivalents) of an individual patient’s measurement in an easy-to-understand way. The growth curves support the data interpretation. A traffic light scale indicates the estimated risk of developing myopia.
Follow-Up Examinations and Trend Analysis
– Treatment strategy and success made easy to visualize
One or multiple treatment strategies can be selected with a simple click. The effects of axial length growth on refraction with or without the selected treatment strategy can be intuitively illustrated in a diagram.
Colour-coded representations explain the success of treatment to both parents and child. This provides the customer with an optimal overview of the individual development as well as a summary about the treatment strategy..
The solution for the future:
The Myopia Master® from OCULUS
Previously there was no all-in-one device available for performing refraction, axial length measurement and keratometry in combination. The only option was to purchase at least two devices, but this still left one with no myopia software.
The Myopia Master® from OCULUS now enables opticians, optometrists and ophthalmologists to position themselves optimally for the future. The Myopia Master® combines the most important parameters, making myopia detection and management much easier and more reliable than ever.
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