Myopia: What Can We Do About It Clinically?

Methods that have been used by vision practitioners for the control of myopia include visual training, biofeedback training, undercorrection, overcorrection, the use of bifocal lenses, the use of contact lenses, the instillation of atropine, and refractive surgery. With some exceptions the use of these methods has achieved only limited success. The lack of success with the less-invasive methods--which are based on the supposition that myopia is caused by accommodation--may be due to the fact that they are used for eyes that are already myopic and therefore have already undergone axial elongation and scleral stretching. If it were possible to predict which children were at risk for the development of myopia, vision practitioners would be able to institute procedures for the control of myopia when only a minimum of scleral stretching has occurred. Risk factors that warrant investigation include the axial length/corneal radius ratio and the resting state of accommodation.