Clinicians addressed managing high myopia in children during a recent roundtable discussion. The case of an 11-month-old male who appeared to need to get very close to objects to see them was presented. Both parents are myopic, and the father was diagnosed with it early in life. Cycloplegic retinoscopy reveals −7.00 diopters of myopia in the right eye and −7.50 D in the left eye of the infant.
Frederick M. Wang, MD, from Albert Einstein College of Medicine in New York, said he would prescribe spectacles--specifically single vision lenses and plastic frames with a strap around the back. His cutoff for prescribing lenses in an 11-month-old is <2.50 D.
Donna D. Brown, MD, of the Virginia Eye Institute in Richmond, said that if the eye is otherwise normal, she would tell the parents that the condition is likely inherited. She would give the full cycloplegic refractive error correction and single vision lenses.
Dr. Brown uses these guidelines for prescribing spectacle correction: Greater than 2.00 D of myopia or 4.00 D of hyperopia, greater than 2.00 D of astigmatism at a vertical or horizontal axis, and greater than 1.50 D of astigmatism at an oblique axis. She checks the refraction in 6 months if the refractive error is borderline high.
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Brown D, Guo S, Want F, Wagner R. Management of high myopia in children. J Pediatr Ophthalmol Strabismus July 23, 2018.