correcting myopes

[sunsign]

today i had an discussion with one of the ophthalmologist in our practise who is of the opinion that by undercorrecting the young myopes even by _0.50 D, we are pushing the pt to early presbyopia. he is of the opinion that if the pt is back to us for followup he / she has to be given full correction irrespective retino (correction based on AR) and also even if the pt is having 20/20 vn in both eyes and asymptomatic.
let me know how our community feels about his views

Sunsign

[chip anderson]

I have heard from OMD's who feel that over correcting young myopes by
-0.50 dio. Pushes them into early presbyopia. I don't ascribe to either theory but I have encountered those that seem to believe in both strongly.

Chip

[Chris Ryser]

I don't ascribe to either theory but I have encountered those that seem to believe in both strongly.
Chip

There are different religions in every profession.

[drk]

To my knowledge, there is insufficient evidence that refractive error can be controlled by environmental factors.

As such, your ophthalmologist is practicing based on a belief that is not widely accepted (but not necessarily wrong).

I would say your job is to do what he believes, and do likewise with other staff physicians, even if it is making you crazy.

[chip anderson]

I do however ascribe (based on my 50 years of experience) that myopia is greatly suppressed by wearing hard (PMMA) lenses, properly fitted and managed of course.
Slightly suppressed by HGP's properly fitted and managed.
Slightly increased by wearing soft contacts.
All of the above as compared to spectacle wear.


Chip

[optical maven]

There is no evidence that playing with the refractive error in any way leads to 1) differences in the refractive error over time, or 2) any difference in presbyopia. What study has ever been done that looks at under or over correction prior to age 20 and any difference in age of onset of presbyopia? Grovesnor in the 1980's did do epidemiological studies and correlated refractive data such as noting that in families where neither parent has a refractive error prior to age 20, one of three children develop a refractive error.
There is also evidence that western, high carb diets (Lorain Cordein PhD) influence the development of myopia.
Wearing PMMA lenses can stop myopia but when the lens wear is discontinued the refractive error returns and more importantly very low Dk lenses, hard or soft lead to corneal disease such as endothelial polymegathism. That's why we don't use PMMA anymore.

[Borysko]

There is no evidence that playing with the refractive error in any way leads to 1) differences in the refractive error over time, or 2) any difference in presbyopia.

/thread

[DragonLensmanWV]

today i had an discussion with one of the ophthalmologist in our practise who is of the opinion that by undercorrecting the young myopes even by _0.50 D, we are pushing the pt to early presbyopia. he is of the opinion that if the pt is back to us for followup he / she has to be given full correction irrespective retino (correction based on AR) and also even if the pt is having 20/20 vn in both eyes and asymptomatic.
let me know how our community feels about his views

Sunsign

I say why shortchange your patients by giving them an incorrect Rx? I realize in that area there are many people who think that by giving them their correct Rx, their eyes will get worse. Hey, their eyes are going to get worse anyway, why give them even more adaptation problems?

[chip anderson]

Of course by undercorrecting them you can count on seeing them sooner for new exam and new glasses. You might ask if this enters into the theory.
Most ophthalmologists I know feel they should be slightly overcorrected to allow for the increases with night vision and slight increases between exams.

Chip

[Barry Santini]

Hi index lenses and progressives "HATE" undercorrection for satisfying DV acuity.

Keep this in mind when someonme is unhappy with the DV of either.

Barry