The measurement, correction, and clinical management of ametropia is the foundation of optometric practice. The optometrist is well aware of the concerns expressed by patients when correction is necessary: What causes it? Will it get worse? Does it run in families? Can it be treated? These are reasonable concerns given that ametropia is often a lifelong condition, carries the long-term economic burden of correction and in some instances can increase the risk of ocular pathology. Particular attention will be directed to myopia as this condition is now evident in around 25% of UK adolescents and is estimated to affect ~1Bn of the world’s ~6Bn population.
The module provides a contemporary account of relevant studies in epidemiology, physiology, biology and opto-electronic measurement that have provided new insight into the psychophysiological and neurobiological nature of myopia. Modern methods of genotyping have informed substantially the nature vs nurture debate concerning the onset and development of myopia. The module will demonstrate that there is scope to treat myopia by manipulation of the visual environment and will present the rational for current non-surgical options for treatment based on optical, pharmaceutical and behavioural studies.
The aim of the module is to enable participants to appreciate fully the nature of contemporary clinical research in myopia and understand its relevance to clinical practice in terms of the genesis, development and putative methods of treatment of myopia. OP4MY1 provides a solid academic foundation for Ophthalmic Doctorate students who may be considering undertaking their research projects in this field. Assessment consists of short assignments (50% of module mark) related to each of the lecture presentations, and five case records (50% of module mark). In undertaking this module, you will cover the following topics relevant to myopia:
1. Overview and Current perspectives: A review of contemporary issues in myopia research; outline of Module content and structure.
2 Classification & Epidemiology: Optical, structural and chronological taxonomy. Syndromic myopia. Ametropia and ocular/systemic pathology.A global/European perspective of epidemiology; socio-economic and educational factors; current UK studies.
3 Heredity & Genetics: Genetics of myopia: twin studies; the nature vs nurture debate.
4 Prediction & Progression: Factors affecting prediction; refractive progression from infancy to early adulthood.
5 Emmetropization: The concept of emmetropization; human and non-human primate models.
6 Structure & Function: 3-D structural correlates of myopia usingMagnetic Resonance Imaging; retinal stretch and retinal function.
7 Aetiological Foundations: Retinal blur and ocular growth; oculomotor factors; the role of peripheral image quality.
8 Optical Management: Progressive add/bifocal/single vision lens and contact lenses; peripheral refraction correction; corneal reshaping.
9 Pharmaceutical Management: Treatment of myopia using topical muscarinic antagonists.
10 Behavioural Management: The role of outdoor activity, sustained nearwork and nutrition.Aspects of Vision Training.