The major symptom of myopia (blurred distance vision) and the major sign
(reduced unaided distance visual acuity) can generally be improved with
appropriate minus power lenses.
The examination of patients who have any of the forms of myopia should
include a comprehensive patient history, measurement of refraction,
investigation of accommodation and vergence function, and evaluation of ocular
health. The patient should be advised about available treatment options and
counseled regarding the need for follow-up care.
The frequency and composition of evaluation and management visits for myopia
are summarized in the table, below.
|
| Type of Patient |
Number of Evaluation Visits |
Treatment Options |
Frequency of Follow-Up Visits |
Composition of Follow-Up Evaluations |
Management Plan |
| VA |
REF |
A/V |
OH |
|
| Simple myopia |
1 |
Myopia correction: optical correction vision therapy |
Children: annually
Adults: every 2 yr or p.r.n. |
Each visit |
Each visit |
Each visit |
Each visit |
Prescribe refractive correction; provide or refer patient for
vision therapy; patient education. |
|
|
Possible myopia control: optical correction, vision therapy |
Every 6 mos |
Each visit |
Each visit |
Each visit |
Contact lenses: anterior segment each visit posterior segment
annually
Bifocals: annually |
Prescribe refractive correction; provide or refer patient for
vision therapy; recommend vision hygiene improvement; patient education |
|
|
Myopia reduction: orthokeratology, refractive surgery |
Variable, depending on method of myopia reduction |
Each visit |
Each visit |
Annually |
Anterior segment: each visit, Posterior segment: annually |
Provide or refer patient for orthokeratology; refer patient
for refractive surgery; patient education. |
| Nocturnal myopia |
1 to 2 |
Optical correction |
3 to 4 wk after dispensing of prescription, then annually |
Each visit |
Annually or p.r.n. |
Annually |
Annually |
Prescribe refractive correction for nighttime seeing; patient
education. |
| Pseudo-myopia |
1 to 2 |
Optical correction, pharmaceutical, vision therapy |
Every 1 to 4 wk until accommodative excess is eliminated, then
annually |
Each visit |
Each visit |
Annually or p.r.n. |
Annually |
Prescribe refractive correction; reduce accommodative
response with vision therapy; prescribe cycloplegic agents to eliminate accommodative
spasm; prevent pseudomyopia with plus lenses; patient education |
| Degenerative Myopia |
1 to 2 |
Optical correction |
Annually or more frequently, depending on retinal an ocular
changes |
Each visit |
Annually or p.r.n. |
Annually or p.r.n. |
Each visit |
Prescribe refractive correction; provide or refer for
appropriate treatment for retinal complications; patient education |
| Induced myopia |
1 to 2 |
Variable, depending on inducing agent or condition |
Variable, depending on inducing agent or condition |
Each visit |
Each visit |
Variable, depending on inducing agent or condition |
Variable, depending on inducing agent or condition |
Identify inducing agent; prevent further exposure to
causative agent; refer to appropriate practitioner for additional testing and treatment;
patient education . |
|
