With Max Aricochi, Myopia Expert
Isser Optik, Innsbruck, Austria
Maria, an eight-year-old Caucasian patient, was referred to our practice by an ophthalmologist, with a diagnosis of progressive myopia. She came to our office with her myopic mother.
The patient’s refraction in August 2020 was R +0.25 and L plano. By April 2021, her refraction changed to R -0.50 and L -0.75. Biometry with the Myopia Master confirmed elongation of the eyeball (OD 23.67 mm, OS 23.60 mm); we also obtained binocular vision status. At near, an exophoria of 10 cm/m was measured. The gradient AC/A was 2:1. The fusional reserves were 12/14/10 in convergent direction and 10/14/2 in divergent direction. MEM retinoscopy gave a lead of R/L -0.25 D. Accommodative facility was present in both directions. From these measurements and information provided by mother and child, we diagnosed nonsymptomatic convergence insufficiency.
Anamnesis brought to light maternal high myopia (-6.00 OU). The patient’s computer screen-time was unfortunately much too high due to home schooling (in excess of six hours a day), phone time was not excessive at less than an hour a day, and daylight dose was also sufficient, at over two hours daily. The eye length combined with the non-age-appropriate refraction was a major risk factor.
Treatment
Contact lens options were not the first choice of treatment because of the moderate exophoria at near and the increased exophoric shift to be expected with a switch from glasses to contact lenses. Atropine is prescribed in our area only at a dosage of 0.01%. Since its effectiveness remains controversial, we also decided against this treatment.
We found the most suitable treatment to be a prescription for glasses with DIMS technology, as this option would not change the vergence and accommodation relations, and would provide a practical and quick solution for Maria. In addition to the glasses, it was recommended that the screens be split during home schooling. The teacher
should be projected on a larger screen at a greater distance, and the laptop should remain at a normal working distance. Splitting the screens should bring more dynamism to the monotonous visual tasks triggered by a single screen.
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 without myopia software.
The Myopia Master from OCULUS now enables eye care practitioners 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.
Data Analysis and Take-home Report for Parents
The Myopia Master parameter interpretation is supported by ethnicity and gender-dependent growth curves, and the Myopia Report for parents includes all results and recommendations. It also helps with reading and understanding the scientific background. The report can be printed or sent by email directly from the Myopia Master software.
Conclusion
The long-term goal at our practice is to no longer provide single vision lenses to children. With the purchase of the Myopia Master, the integrated risk analysis software and our passion for finding the best solution for our youngest patients, we are getting closer to this goal every day.
