Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Mar;40(2):230-240.
doi: 10.1111/opo.12676.

Myopia management in the Netherlands

Caroline Klaver  1   2   3 , Jan Roelof Polling  1   4 ; Erasmus Myopia Research Group
Affiliations
Review

Myopia management in the Netherlands

Caroline Klaver et al. Ophthalmic Physiol Opt. 2020 Mar.

Abstract

Purpose: A trend that myopia is becoming gradually more common is shown in studies worldwide. Highest frequencies have been found in East Asian urban populations (96.5%) but also a study in Europe shows that nearly half of the 25-29 year olds has myopia. With the increase in prevalence, high myopia, i.e. a spherical equivalent of -6 or more and an axial length of 26 mm or more is also on the rise. High myopia particularly carries a significant risk of ocular pathology related to the long axial length. This highlights the need for myopia management in children with progressive myopia, in particular progression to high myopia.

Recent findings: During the last decade, many intervention studies for myopia progression have emerged. Although lifestyle adjustments are effective, pharmacological and optical interventions have shown the highest efficacy on reduction of eye growth. High concentration atropine (0.5%-1.0%) shows the most reduction in axial length progression, but has drawbacks of light sensitivity and loss of accommodation. Nevertheless, when these side effects are mitigated by multifocal photochromatic glasses, the long-term adherence to high dose atropine is high. Lower concentrations of atropine are less effective, but have less side effects. Studies on optical interventions have reported reduction of progression for Ortho-K and multifocal contact lenses, but are in need for replication in larger studies with longer duration.

Summary: The field of myopia management is rapidly evolving, and a position on the best approach for daily clinics is desirable. Over the last 10 years, our team of clinical researchers has developed a strategy which involves decision-making based on age, axial length, position on the axial length growth chart, progression rate, risk of high myopia, risk profile based on lifestyle and familial risk, side effects, and individual preference. This personalised approach ensures the most optimal long-term myopia control, and helps fight against visual impairment and blindness in the next generations of elderly.

Keywords: axial length; atropine; high myopia risk; myopic growth curves.

PubMed Disclaimer

References

    1. Morgan IG, Ohno-Matsui K & Saw SM. Myopia. Lancet 2012; 379: 1739-1748.
    1. Tideman JW, Snabel MC, Tedja MS et al. Association of axial length with risk of uncorrectable visual impairment for Europeans with myopia. JAMA Ophthalmol 2016; 134: 1355-1363.
    1. Verhoeven VJ, Wong KT, Buitendijk GH, Hofman A, Vingerling JR & Klaver CC. Visual consequences of refractive errors in the general population. Ophthalmology 2015; 122: 101-109.
    1. Younan C, Mitchell P, Cumming RG, Rochtchina E & Wang JJ. Myopia and incident cataract and cataract surgery: the Blue Mountains eye study. Invest Ophthalmol Vis Sci 2002; 43: 3625-3632.
    1. Qiu M, Wang SY, Singh K & Lin SC. Association between myopia and glaucoma in the United States population. Invest Ophthalmol Vis Sci 2013; 54: 830-835.

LinkOut - more resources