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Clinical Skills > DEVELOPMENT OF THE AMETROPIAS > Flashcards

DEVELOPMENT OF THE AMETROPIAS Flashcards

1
Q

Higher degrees of _____ in premature infants (especially with very low birth weights

A

myopia

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2
Q

5 or 6 year old children with +1.50 D or more ______ will still be that at age 13 or 14

A

hyperopia

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3
Q

Majority of 5 or 6 year olds with refractive error of +0.50 to +1.24 D will be _____(-0.49 to +0.99 D) at age 13 or 14

A

emmetropic

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4
Q

Most children entering school with refractive errors of 0 to +0.49 D will be _____ at age 13 or 14

A

myopic

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5
Q

Children who are myopic at age 5 or 6 will become _____ myopic

A

more

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6
Q

Changes in Hyperopes Compared with Myopes 

Among school-aged children, greatest changes in refractive error occurred in

A

myopes

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7
Q

Changes in Hyperopes Compared with Myopes 

Refractive change is _____ when a child crosses from hyperopia into myopia.

A

faster

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8
Q

Four types of myopia

A

Congenital 
Youth-onset
Early adult-onset 
Late adult-onset

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9
Q

Axial Elongation of _____ chamber is responsible for myopia progression

A

vitreous chamber

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10
Q

Emmetropic children between age 6 and 14 years old show: 

A

Increase in axial length 

Decrease in crystalline lens thickness 

Decrease in crystalline lens power

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11
Q

Myopic Young Adults:
Greater _____ depth 
_____ corneal power 
Greater posterior crystalline lens _____

A

Greater vitreous depth 
Greater corneal power 
Greater posterior crystalline lens radius

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12
Q

School-aged and Young Adult Females

A

Shorter eyes 
Steeper corneas 
More powerful crystalline lenses

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13
Q

The earlier in life the onset of myopia occurs, the ____ the amount of myopia developed by late teens to young adulthood

A

greater

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14
Q

Higher rate of childhood myopia _______ is associated with earlier onset of myopia

A

PROGRESSION

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15
Q

How does astigmatism effect the rate of myopia progression?

A

Children with ATR at 5 or 6 years of age developed myopia by 13 or 14 years of age vs. those without astigmatism or WTR (not found in other studies) 

Once myopic, ATR astigmats do not have greater rates of childhood myopia progression

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16
Q

What are factors associated with higher rates of childhood myopia progression?

A

Earlier onset age and/or higher initial amount of myopia

Near-point esophoria 

Temporal crescents and other myopic fundus changes 
Higher intraocular pressure 

Greater amount of time spent reading and doing near work 

Less time spent on outdoor activities

17
Q

What are drops for myopia to slow down its progression?

A

Atropine and Pirenzepine

18
Q

What type of contact lens can control myopia?

A

Rigid contact lenses

19
Q

Bifocal spectacle lenses can help control myopia. How?

A

These lenses provide different refractive correction for distance and near.

20
Q

What is most effective in lowering myopia progression rates for children with esophoria at near?

A

Bifocal spectacle lenses

Want a near addition power to shift near phoria to ortho / low exo range.

21
Q

What is another type of lens used for myopia control?

A

Progressive-addition Spectacle Lenses (PALs)

22
Q

5 to 6 year olds with _____ more likely to become myopic than those with ______.

A

5 to 6 year olds with ATR more likely to become myopic than those with WTR

23
Q

General Trends (Late teens or early 20s to ~40 years old) 

A

Refractive error stabilizes

Some have: 
Onset of myopia 
Progression of myopia 
Small shift in the hyperopic direction

24
Q

What is adult stabilization?

A

Adult Stabilization: childhood myopia progression is followed by stabilization of refractive error in young adulthood

25
Q

What is adult continuation?

A

Adult Continuation: childhood myopia progression followed by a general slower progression of myopia in young adulthood

26
Q

What is adult acceleration?

A

Adult Acceleration: refractive change in the myopic direction accelerates in young adulthood

27
Q

Adults with increases in myopia tend to have _____ in corneal power

A

Adults with increases in myopia tend to have increases in corneal power.

28
Q

What is it when Refractive Power Decreases (from decrease in crystalline lens power and decrease in corneal power)?  

A

Hyperopia

29
Q

It is unlikely for entering college student with ≥ +1.00 D (_________) in either principal meridian will be myopic after 4 years of school

A

noncycloplegic refraction

30
Q

After Age 45: 
Shift in ______ direction 
Some myopes increase in myopia 
Age-related Nuclear Cataracts shift towards myopia

A

hyperopic

Trend Toward Hyperopia

31
Q

After 40, there is a trend of what kind of astigmatism?

A

Trend Toward Against-the-Rule Astigmatism

32
Q

Axial Length greater in:

A

neonatal eyelid closure

juvenile corneal opacification

congenital cataracts

33
Q

What are some causes of high myopia?

A
  1. lid hemangiomas
  2. ptosis
  3. neonatal eyelid closure
  4. retrolental fibroplasia associated with retinopathy of prematurity, vitreous hemorrhage In infants and children
34
Q

Prevailing Theories of Myopia Development:

A
  1. Mechanical forces on the sclera
  2. Retinal Defocus
  3. Retinal Biochemistry
35
Q

What are mechanical forces on the sclera?

A

Tension from Extraocular Muscles and Intraocular Pressure –> axial elongation

Could possibly be a cause of myopia.

36
Q

What is retinal defocus?

A

Defocus itself alters axial length (not the mechanism of accommodation)

Could possibly be a cause of myopia.

37
Q

What is retinal biochemistry?

A

Biochemical agents affect the function of retinal synapses.

Some studies show that this stops myopia, others show that these molecules induce myopia

38
Q

What is a possible cause of astigmatism?

A

Eyelid tension steepens the vertical corneal meridian and causes WTR.

  1. Corneal WTR astigmatism decreases when eyelids lifted from eye 
  2. Corneal WTR astigmatism increases when palpebral aperture (conjunctiva) is narrowed 
  3. Shift towards ATR in over 40 years of age is due to decreased lid tension

Clinical Skills (7 decks)

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