The amount of myopia at stabilisation was influenced by ethnicity with African American children having 1. Gender was not a significant factor in stabilisation. A further analysis of the COMET data set found that in the 15 year-old cohort, half of which had stable myopia and half of which were still progressing, there was no difference in their self-reported time spent on outdoor activities, which were an average of nine hours per week. The average time spent on near-work activities was 21 hours per week.
Scientific research only provides a couple of insights into this important question. In wearers aged 20—25 years, almost half progressed by at least Table 1 provides data reproduced from this study, published by Bullimore et al.
Axial length was not measured, and in fact no data is available in the literature on axial length increases in adult myopia progression. Nevertheless, this is valuable data indicating that myopia cannot be presumed stable in adulthood. The longest available data on adult myopia progression comes from Finland and encompasses up to 23 years of follow up, from myopia onset at age eight to 12 years and into adulthood, for almost individuals.
All baseline examinations were performed by the same ophthalmologist, the lead author on the research , using cycloplegic subjective refraction techniques. The outcome reported was that mean myopia progression in the decade of the 20s was While visually significant in itself, this represented a mean annual progression of only In almost half of cases, progression was more than At the final follow up average age 31 years , there was no relationship found between final myopia and time spent on near-work in either childhood or adulthood, academic attainment last grade point average at school or years of education.
The sum total of these observational studies are that one-fifth of myopes in their 20s will likely experience significant progression of at least 1D. Three key considerations for management of adult myopia progression are monitoring eye health, providing myopia correction, and attempting myopia control. Monitoring eye health is important given the association between increasing myopia and the lifelong risk of myopia-associated pathology and vision impairment. While myopic maculopathy may be considered the purview of the elderly patient, the leading cause of monocular blindness in Japanese adults over 40 years is myopic macular degeneration MMD.
Given current data and projections on increasing myopia prevalence across the world, the authors predicted that by , more than 55 million people 0. The risk of vision impairment due to myopia-associated pathology increases with longer axial length, specifically more than 26mm.
Since most clinicians do not measure axial length in practice, consider this information as reason to follow up closely on all myopes, and educate the young adult myope of their lifelong need for ocular health monitoring. Providing myopia correction is likely the simplest part of the equation. Older teens and young adults may be more open and willing to wear contact lenses than children, despite evidence indicating children aged eight to 12 may be the safer wearers of soft contact lenses.
Attempting myopia control must be undertaken with the caveat that there are almost no studies on the success of myopia control interventions in older teens and young adults, and no randomised controlled trials. Undertake annual retinal examination for your young myopes, with dilated pupils exams for higher myopes and especially for eyes 26mm or longer.
Myopia progression CAN still occur in the late twenties, much to the disappointment of some patients. Hence its crucially important to explain that myopia control strategies MAY work for them but it can't be guaranteed. The logical first choice would be contact lens options as they both correct and control myopia, and this age group will likely be amenable to contact lens wear if they've not tried it already. Atropine 0. Niathi Kona considered this in an 8 Hour Survey of 0. Two small studies have indicated as such.
The first, published by Kate Gifford et al. Prior progression was not quantified for comparison and there was no other adult control group. Gonzalez-Meijorne and his team found similar results in 12 in a case series of three adults wearing OK over three years. Cassandra Haines is a clinical optometrist, researcher and writer with a background in policy and advocacy from Adelaide, Australia.
She has a keen interest in children's vision and myopia control. Clinical Science Case studies. How should you manage adult myopia progression? Monitor progression and eye health in adult myopes Keep in mind that myopia can still progress in young adults. Consider contact lenses, and communicate Myopia progression CAN still occur in the late twenties, much to the disappointment of some patients. Lens powers that correct myopia are preceded by a minus sign — , and are usually measured in 0.
Mild myopia typically does not increase a person's risk for eye health problems. But moderate and high myopia sometimes are associated with serious, vision-threatening side effects. When myopia-related eye problems and vision loss occur, high myopia also is called degenerative myopia or pathological myopia. Adults with high myopia usually started getting nearsighted when they were young children, and their myopia progressed year after year.
In a recent study of cataracts and cataract surgery outcomes among Koreans with high myopia, researchers found cataracts developed sooner in highly myopic eyes compared with normal eyes. Also, eyes with high myopia had a higher prevalence of coexisting disease and complications, such as retinal detachment.
And in an Australian study of more than 3, adults ages 49 to 97, the odds of having cataracts increased significantly with greater amounts of myopia. The odds of having a particular type of cataract was twice as high among subjects with high myopia compared with those with low myopia. Myopia — even mild and moderate myopia — has been associated with an increased risk of glaucoma. In the same Australian study mentioned above, glaucoma was found in 4.
The study authors concluded there is a strong relationship between myopia and glaucoma , and that nearsighted participants in the study had a two to three times greater risk of glaucoma than participants with no myopia. Also, in a Chinese study , glaucoma was significantly associated with the severity of myopia. Among adults age 40 or older, those with high myopia had more than twice the odds of having glaucoma as study participants with moderate myopia, and more than three times the odds of having the disease compared with individuals with mild myopia.
Compared with participants who either had no myopia or were farsighted , those with high myopia had a 4. Are you concerned that your child needs stronger eyeglasses? The increasing prevalence of myopia Over the past 20 years, the number of children with myopia has increased significantly. Find an Eye Doctor Search near me. Popular Articles on this Topic. About us Your plain English library for vision therapy, children's vision, neuro-optometry, and primary eye care.
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