32 HOW TO TREAT: MYOPIA
32 HOW TO TREAT: MYOPIA
13 FEBRUARY 2026 ausdoc. com. au
Figure 12. Posterior subcapsular cataract.
Figure 13. Posterior subcapsular cataract( indirect light view).
How to Treat Quiz.
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1. Which THREE statements regarding myopia are correct? a The condition can be corrected with spectacles or contact lenses. b Myopia typically develops during childhood. c Myopia results in blurred vision when viewing objects close by. d Myopia has been shown to lead to a reduced quality of life.
2. What is the prevalence of high myopia in infants and children under the age of five? a 20 %. b 80 %. c Less than 1 %. d Nearly 30 %.
3. Which ONE is the most notable environmental risk factor for high myopia in children aged under five? a Exposure to sunlight. b Retinopathy of prematurity. c Excessive screen time. d Education.
4. Which THREE statements regarding myopia in school-aged children are correct? a Its development appears to be influenced by a complex interplay between multiple genetic and environmental risk factors. b Children of parents with myopia are more likely to develop the condition. c Children who stay up late are more likely to develop myopia. d Boys are at three times the risk of girls of developing myopia.
5. Which THREE may be complications of myopia? a Retinal detachment. b Entropion. c Cataracts. d Glaucoma.
6. Which THREE tests may be appropriate in the assessment of myopia? a Visual acuity. b Colour vision. c Refraction. d Ocular health assessment.
7. Which TWO statements regarding the management of myopia are correct? a Small degrees of myopia require correction before the age of four to prevent progression. b High levels of myopia before the age of four need to be addressed to prevent amblyopia. c In school-aged children, even small degrees of myopia require correction. d Traditional single-vision optical correction with minus powered lenses significantly limits the progression of myopia.
8. Which THREE statements regarding the management of myopia are correct? a The benefits for active myopia treatment in young adults needs to be weighed against patient motivation, cost and tolerance to side effects. b Orthokeratology is the use of rigid contact lenses worn only during sleep. c Keratorefractive surgery guarantees a permanent halt to the elongation of the eye. d The safety of light therapy is yet to be established.
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Corrected visual acuity is 6 / 30 on the right and 6 / 15 on the left.
Examination shows bilateral asymmetrical dense posterior subcapsular cataracts( see figures 12 and 13) in addition to the typical myopic fundal changes seen in early myopic maculopathy( thinning of the retinal epithelium and / or traction). Because the cataracts are causing significant symptoms, Ron undergoes bilateral cataract extraction and intraocular lens implants.
GPs have a unique opportunity to promote awareness around myopia and to encourage lifestyle changes to improve long-term eye health.
Case study two
Adele, a 5-year-old girl, failed the government-led visual screening program because of reduced vision bilaterally. She is referred to her GP for further investigation. Both her parents have moderate myopia. Adele has no other significant medical history.
MYOPIA
9. Which TWO statements regarding the management of myopia are correct? a Surgery may be considered for highly myopic eyes where there is a high risk of retinal and choroidal complications. b Orthokeratology has not been shown to be effective in reducing the progression of myopia. c Side effects of atropine include photophobia and reduced near vision. d Those undergoing orthokeratology will usually need visual correction in the daytime.
10. Which THREE statements regarding the prognosis of myopia are correct? a Low levels are easy to manage and correct with spectacles or contact lenses. b The earlier in life that myopia develops, the faster it tends to progress. c With the rising prevalence of myopia, increased global rates of blindness and vision impairment from myopic macular degeneration are being reported. d Current therapies can permanently stop or reverse progression.
The GP refers Adele to an optometrist. Examination reveals vision on the right of 6 / 12 and on the left of 6 / 9. Cycloplegic retinoscopy estimates her refractive error as-2.00 dioptres spherical equivalent bilaterally. Fundus examination is unremarkable. Given the significant family history of myopia and her relatively young age, the optometrist recommends that Adele wears spectacles full-time. Baseline axial lengths are obtained and these are within the normal range of 22-24mm.
At six-month follow-up, Adele’ s visual acuity has normalised at 6 / 6 bilaterally with spectacles. However, the axial lengths have shown a significant increase of 0.28mm on the right and 0.29mm on the left, indicating a significant risk of myopic progression.
Adele is started on atropine 0.03 % nocte in both eyes. At her subsequent visit six months later, the increase in axial length in each eye is only 0.15mm, a significant reduction compared with the previous examination. There is a mild increase of + 0.50 spherical equivalent in her myopia compared with her original prescription. Adele will be monitored six monthly while she is on the low-dose atropine treatment.
CONCLUSION
MYOPIA is a prevalent, and growing, worldwide problem. Increasing interest from scientists and researchers over recent decades has resulted in additional and more advanced management options. GPs have a unique opportunity to promote awareness around myopia and to encourage lifestyle changes to improve long-term eye health. Early detection, keeping patients informed about new treatment options and encouraging regular eye examinations has the potential to reduce the risk of later sight-threatening complications and to enhance overall quality of life.
RESOURCES
• International Myopia Institute myopiainstitute. org
• Myopia Australia myopiaaustralia. com. au
• Healthdirect healthdirect. gov. au / shortsightedness-myopia
• NSW Health— Statewide eyesight preschooler screening bit. ly / 3uMbkbz
• Children’ s Health Queensland— Prep vision screening service bit. ly / 49Qs6F9
• Victorian Government bit. ly / 49LngK1
• SA Government cafhs. sa. gov. au / services / health-checks
• WA Government bit. ly / 42ZtoM6
• ACT Government bit. ly / 3IgnRah
• American Academy of Ophthalmology— Pediatric eye evaluations bit. ly / 4bQkEMb
References Available on request from howtotreat @ adg. com. au