Consensus on progressive myopia management

Abstract

Purpose: To reach a consensus on the management of progressive school age myopia.
Materials and methods: The Myopia Study Group of the Argentine Society of Pediatric Ophthalmology evaluated the available scientific evidence in August and September 2021 to develop a questionnaire on the diagnosis, follow-up, prevention and treatment of myopia in the ages of progression. In October 2021, the questions were sent electronically to 40 experts in Argentina and the responses were subsequently analyzed, in masked form, considering consensus for each question when 80% of respondents agreed.
Results: Consensus was obtained on the inclusion in the clinical records data of behavioral and environmental history related to near vision tasks and outdoor exposure, controlling the former and encouraging the latter. Consensus was also obtained on the importance of complementary examinations in cases of early onset, high myopia at diagnosis, accelerated progression, signs of fundus atrophy and high astigmatism. There was also consensus on a minimum follow-up of 2 visits per year and the use of pharmacological treatment with atropine 0.01% (or 0.05% for refractory cases or high myopia), which should be discontinued gradually and not before 18 years of age.
Conclusion: As a result of the scientific evidence analyzed by a committee of experts, a consensus was reached on the management of myopia at the age of progression in Argentina, emphasizing that there are multiple tools currently available to establish the diagnosis, optimize follow-up, carry out treatment and take preventive measures, in addition to prescribing glasses.