Overminus lenses for intermittent exotropia may increase myopia progression
Overminus therapy, a method that has been used to control intermittent exotropia, was found to increase myopia progression, particularly in children who are already myopic, according to research presented at the American Academy of Optometry virtual meeting.
While retrospective studies have suggested that overminus spectacles cause no more myopia progression than the natural rate of myopic change with age, “There’s been concern that increased accommodative effort might increase myopia progression,” S. Ayse Erzurum, MD, stated during an academy-sponsored press conference.
In this study, which was conducted by the Pediatric Eye Disease Investigator Group, children between 3 and 10 years of age with intermittent exotropia were randomly assigned to one of two groups: full-time overminus spectacles with -2.50 D over cycloplegic refraction or non-overminus spectacles with refraction correction only, if needed, or plano spectacles.
Erzurum said in the presentation that the children were kept in the same prescription for 12 months, and researchers evaluated them for change in refractive error between two visits.
“The overminus group [189 children] had a mean shift of -0.42 D, while the other group [169 children] was -0.04 D,” she said. “Seventeen percent in the overminus group had an increase in myopia of over 1D compared to 1% in the other group.”
Erzurum continued: “The findings are generalizable to kids 3 to 10 years old with similar characteristics.”
She noted that the long-term effects of overminus therapy on myopia progression are unknown, and, “we are now collecting refractive error and axial length data at 24 and 36 months.”
The researchers concluded: “Before considering overminus therapy, the risk of myopic progression should be discussed with the parents.”
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Erzurum SA, et al. Change in refractive error with overminus spectacle treatment in children 3 to 10 years of age with intermittent exotropia. Presented at: American Academy of Optometry meeting; October 7-22, 2020; virtual meeting.
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