RESUMEN
Myopia is a major public health problem worldwide, including India, with the global prevalence of myopia increasing rapidly over decades. The clinical and socioeconomic impact of myopia is also expected to rise with rising prevalence. Therefore, the focus has now been shifted to prevent the incidence and progression of myopia. However, there is lack of any standardized guidelines for myopia management. This document aims to generate a national-level expert consensus statement on the management of childhood myopia in the Indian scenario. The expert panel of pediatric ophthalmologists consisted of 63 members who met in a hybrid meeting. A list of topics deliberating discussion in the meeting was provided to the experts in advance and they were instructed to provide their opinions on the matter during the meet. The panel of experts then gave their views on each of the items presented, deliberated on different aspects of childhood myopia, and reached a consensus regarding the practice patterns in the Indian scenario. In case of opposing views or lack of a clear consensus, we undertook further discussion and evaluated literature to help arrive at a consensus. A written document is prepared based on recommendations explaining definition of myopia, refraction techniques, components and methods of workup, initiation of anti-myopia treatment, type and timing of interventions, follow-up schedule, and indications for revised or combination treatment. This article formulates evidence-based guidelines for progressing myopes and pre-myopes and also establishes uniformity in the management of childhood myopia in the country.
RESUMEN
Purpose: The aim of this study was to determine the correlation of parental and childhood myopia among school children aged 5–16 years in North India. Methods: This study included a total of 1400 children aged 5–16 years in a district in North India. Visual acuity was measured using a Snellen’s chart. Children with myopia after retinoscopy were worked up in detail in our institute and a history of parental myopia was taken. Results: A total of 1400 students studying in class 5–10, aged between 5 and 16 years, were screened. A total of 487 students had myopia. Of the 487 myopes, 220 (45.2%) had parental myopia, of which 115 (30.1%) had myopia in both parents, 64 (19.3%) had mothers with myopia, and 41 (13.3%) had fathers with myopia. The prevalence of paternal (P = 0.001) and maternal (P = 0.002) myopia in myopes compared to parental myopia in emmetropes was found to be highly significant. There was a highly significant statistical correlation between maternal myopia and myopia in the child, when compared to the presence of myopia in both the parents (P = 0.007). Conclusion: There was a statistically significant correlation between myopia in the parents and children, which was more significant in the mothers of the children
RESUMEN
PURPOSE: To investigate the cause of failure in the correction of childhood myopia using orthokeratologic (Ortho-K) lenses. METHODS: The failure group was 29 patients who stopped wearing the lenses for various reasons, while the success group was 29 patients who bought lenses more than twiceand wore them for two years and more. Statistical analyses were performed to identify significant differences between the groups. RESULTS: Among the failure group, failure to continuously wear the Ortho-K lenses was attributed to undercorrection (19 patients), corneal erosion (2 patients), and sleep disorders (1 patient). Initial spherical diopter and initial spherical equivalent diopter showed statistical diffence between the success group and failure group. Of these two factors, as the initial spherical equivalent diopter increased, the chance of failure to use Ortho-K lens increased. According to a logistic multiple regression analysis, the odds of failure of using Ortho-K lens increased by 1.59 when the initial spherical diopter increased by 1. If the absolute value of the initial spherical diopter was over 6.24, the chance of failure increased by 80%. CONCLUSIONS: The failure of continuously wearing Ortho-K lenses due to undercorrection was found to be the major cause of failure in the correction of childhood myopia. The initial spherical diopter and initial spherical equivalent diopter were significant factors influencing the undercorrection. From these results, we predict that the odds of failure of continuously wearing Ortho-K lenses increases along with increases in the initial spherical diopter. In conclusion, clinicians should be warned concerning the odds of failure due to low initial spherical diopter.