Refraction alone can mislead when monitoring myopia control, because accommodation and measurement variability blur small changes. Axial length, measured by optical biometry, tracks eye growth directly and is what drives the long-term risk of myopic maculopathy and retinal detachment. Record cycloplegic refraction and axial length at baseline and every six to twelve months, and compare growth with age-normal curves where available. Encourage at least two hours a day outdoors, which helps delay onset in children who are not yet myopic.
- Measure axial length by optical biometry at baseline and every 6 to 12 months.
- Use cycloplegic refraction, not dry refraction, to monitor progression.
- Compare axial growth with age-normal curves where available.
- Advise at least two hours a day outdoors, especially before myopia starts.
Why it matters
Without axial data you cannot tell whether a myopia intervention is working.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for ophthalmology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free