A strategically oriented conception of optical prevention of myopia onset and progression
Е. П. Тарутта, О. В. Проскурина, G. A. Markossian, С. В. Милаш, Н. А. Тарасова, N. V. Khodzhabekyan
Abstract
The article presents a theoretical and clinical justification for optical techniques used for the prevention of myopia. Accommodation, wavefront aberrations, peripheral refraction, and retinal image quality are considered as interrelated factors affecting postnatal refractogenesis. A detailed analysis of myopia correction methods, conditions preceding its development and their impact on the dynamics of refraction and eye growth is given. A strategy of optical correction of myopia was proposed, which includes: 1) constant wearing of defocusing binocular positive spectacle lens or Perifocal-P spectacle lens (in case of exophoria) for children at risk aged 4–7 years; 2) constant alternating weak myopic defocusing in case of myopia from 0.5 to 2.75 D, ortho- or esophoria, positive relative accommodation (PRA), peripheral myopia or emmetropia; progressive addition spectacle lens in case of PRA less than 1.0 D; Perifocal-Msa spectacle lens in the case of a combination of reduced PRA and exophoria; 3) Perifocal-M spectacle lens in case of myopia of any degree with already existing hyperopic peripheral defocus; progressive addition spectacle lens in case of PRA less than 1.0 D in combination with esophoria or Perifocal-Msa spectacle lens in combination with exophoria; 4) contact correction with bifocal soft contact lenses or orthokeratological contact lenses (Ortho-K) in case of refusal from spectacle correction. Ortho-K is preferable with moderate and high myopia; 5) bioptic correction: a combination of monofocal soft contact lenses and Perifocal-M spectacle lens to correct peripheral defocus and residual astigmatism is preferable for myopia over 8.0 D and myopia with astigmatism.