Adult-onset myopia: measurement and management

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Myopia onset typically occurs in childhood, but adult-onset myopia also occurs in clinical practice. While increased near tasks and reduced outdoor time can be risk factors for myopia onset in children, there is a stronger link between near work and myopia onset in adults. In thiscase，DS对近视资料Facebook社区的一些建议感兴趣，涉及成人近视的近视控制选择。

Adult onset_OP

Adult-onset myopia

A person whose myopia manifests during adulthood (18 years old or older) is referred to as adult onset myope. Onal et al showed that 14.7% of myopic cases amongst Turkish medical student were adult-onset1, whilst Iribarren et al showed almost half of myopic office workers had shown onset after age of 21.2

成人发作的近视通常低至中度近视。3In a group of young adult clinical microscopists, 40% showed a myopic shift over two years, attributed to an increase in vitreous chamber depth with no change in corneal curvature, anterior chamber depth or lens thickness.4One study also found that there could be a genetic contribution in adult-onset myopia.5

The risk factors for adult myopia onset and progression appear to be prolonged near work with short working distances, high AC/A ratio and high accommodative lag.7,8Jiang等人发现，高AC/A比与成人近视之间存在联系。9在成年人中没有关于这一研究的研究，但是在儿童中，假设可容纳的滞后滞后可以产生触角液，从而影响轴向伸长。10

Measuring axial length is important to understand ocular disease risk.Whilst there may or may not be changes in axial length in adult myopia, understanding the individual patient's axial length measurement helps to guide their ocular health management. Axial lengths over 26mm indicate high myopia and increased lifelong risk of pathology and vision impairment,11requiring annual retinal health review.12

测量角膜曲率对于排除由于角膜变化而排除任何折射变化很重要。在此中阅读更多有关此的信息Are you measuring the cornea in myopia management?评论者提到他们对轴向长度和成人近视进展率的观察。评论员MB引用的数据来自以下研究摘要。

Adult onset_3

Myopia control options

与在儿童进行的研究相比，对成人发作性肌无力或成年后近视进展的近视控制功效的研究受到限制。评论者强烈建议您使用隐形眼镜近视控制选项。有两项小型研究表明正差异学有能力减慢成年近视的进展，但两者都没有对照组。13,14

Adult onset_4

Based on PC’s personal observation, young adults tended to struggle adapting to multifocal soft contact lenses due to optical disturbances (e.g. halos and glare) more so than children. Kang et al showed low and high add multifocal contact lenses affected low contrast visual acuity in young adults.15While a direct comparison between multifocal contact lens acuity and that achieved with orthokeratology (OK) has not been undertaken, one study has shown no impact of OK on visual acuity or visual performance in young adults.16

关于低浓度阿托品对成年人群中近视控制的作用的纵向研究没有纵向研究。Kaymak等人研究了低浓度阿托品对年轻人的短期影响。17在前一天晚上，阿托品滴注0.01％后，在早晨和下午都记录了至少1D的瞳孔扩张，并在住宿点附近降低了。因此，与儿童相比，成年人的低浓度阿托品的耐受性可能较低。

What about the visual environment?

The case mentions that the patient does not have an intensive screen-based job and is not studying. Since adult-onset myopia is linked to both binocular vision disorders and close viewing distances, measurement of the former and providing advice on the latter are also important for this patient. Perhaps her retail work time doesn't involve much screen work but her leisure time does - according to a2021 survey,我们一半以上的美国成年人报告说，每天至少花5个小时在其智能手机上，不包括任何与工作有关的智能手机的使用。定期休息并使用智能手机使用合理的观看距离对于所有年轻的成人近视都是重要的建议。

Take home messages

  1. 成人近视通常与短距离观看距离，高AC/A比率和高住宿滞后相关。视觉环境建议对所有成人近视都很重要。
  2. Research on adult myopia control options is limited. This is an important point to communicate to patients when considering options to correct myopia and potentially slow progression as well.
  3. Measurement of the corneal curvature to rule out pathology, and measurement of axial length to understand ocular disease risk, facilitate best-practice management of the adult-onset myope.

Further reading on adult myopia

Kimberley 120x120

关于金伯利

Kimberley Nguis a clinical optometrist from Perth, Australia, with experience in patient education programs, having practiced in both Australia and Singapore.

康妮头像120x120

关于Connie

康妮·甘是来自马来西亚Kedah的临床验光师，为儿童提供全面的视觉护理，并在其临床实践中运营近视管理服务。

This educational content is brought to you thanks to unrestricted educational grant from

References

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