Management of the Patient with Myopia

A tip of the cap to Drs. Daniel Press and Barry Eiden for a wonderful article on Myopia Management just published in the Review of Optometry.

The article speaks for itself, but there is one section on clinical first steps that I’d like to highlight.  It reads:

“A child at six years of age with +0.75 or less of hyperopia has a significantly higher risk of developing myopia, and clinicians should recommend more frequent monitoring. Common recommendations for at-risk cases include increasing time outdoors and general visual hygiene such as monitoring working distance and taking breaks from accommodating at near for extended periods of time.

Once a child is diagnosed with myopia and both the patient and parents understand myopia as a medical concern, our clinicians schedule a comprehensive myopia baseline evaluation. This includes measurements and procedures, beyond a routine eye exam, that reveal visual findings potentially contributing to myopia development and amenable to interventions (Table 1). The specialty evaluation guides the informed decision on which therapy is most appropriate and provides important data for comparison over time.

Binocular vision and accommodation are important to monitor in school-age children, as deficits can lead to difficulties with academic behaviors.  The myopia management programs offered in our practice have the potential to impact binocular vision and accommodation, which necessitates a baseline that includes those measurements.”

Practice pearl. This diagnostic battery is considered advanced testing, and the doctor should be compensated appropriately. In our practice, patients are financially responsible for the myopia management evaluation as a non-covered service billed outside of any managed care insurance program.”