Initial assessment and follow-up of a myopic child: A clinical evaluation tool

Myopia comprises the leading cause of visual impairment in childhood, showing a global rapid rise in prevalence over the past years.  Myopia progression has been related with a number of ocular complications potentially resulting in blindness, including glaucoma, macular degeneration, cataract, and retinal detachment. Etiopathogenesis of this disorder is regarded multifactorial, involving both environmental and genetic components. Near work activities are believed to play a key role in myopic development, owing to the induced hyperopic defocus on the peripheral retina that may result in axial elongation. Other parameters including outdoor exposure, physical activity and digital screen time are also hypothesized to be connected with myopic development. Ocular examination of myopic subjects should include visual acuity assessment, refraction, biometry and choroidal thickness measurements, as well as evaluation of the accommodative functions. We propose a clinical assessment tool, as a useful guide for all eye care professionals examining and treating juvenile myopes.