Why My Daughter's Myopia Measurements Keep Changing: A Parent's Concern

The degree of myopia varies with each measurement?

Dear Dr.
Wang,
My daughter originally had myopia of about 200-300 degrees with astigmatism (wearing daily disposable soft contact lenses).
On July 27, due to insufficient prescription, she was fitted with a pair of extended wear soft contact lenses (prescription approximately -275 degrees in the left eye and -375 degrees in the right eye).
At that time, she felt clear and comfortable.
However, during her health check on September 6 for her enrollment at Yang Ming University, it was discovered that her vision in the right eye was only 0.3 while wearing contact lenses.

On September 10, we immediately took her to an ophthalmology clinic for an examination, which lasted nearly three hours.
The doctor stated that her left eye was approximately -450 degrees and her right eye was about -500 degrees, with no signs of ocular pathology.
The doctor mentioned that since she had been administered a dilating agent, it was not suitable for fitting glasses at that time.

On September 17, I took her to a nearby ophthalmology clinic, where it was found that her right eye was -800 degrees and her left eye was -600 degrees.
The physician recommended further detailed examinations at a larger hospital, which has caused me considerable concern.
I am anxious about why her prescription has increased so dramatically in such a short period.

Please provide us with your guidance.
Thank you for taking the time to respond!
Sincerely,
A Concerned Mother

Jiao lü de mu qin, 40~49 year old female. Ask Date: 2005/09/18

Dr. Wang Yuwei reply Ophthalmology

Typically, this situation occurs due to the contraction of the ciliary muscle, leading to an increase in refractive error and resulting in blurred vision.
The approach to manage this is to use a strong mydriatic agent to determine the true prescription, or to employ certain techniques to fit glasses while the ciliary muscle is relaxed, rather than simply increasing the lens power.

Reply Date: 2005/09/18

More Info

Dear Concerned Parent,
Thank you for reaching out with your concerns regarding your daughter's fluctuating myopia measurements. As a parent, it is completely understandable to feel anxious when faced with such rapid changes in your child's vision. Let's delve into the potential reasons behind these changes and what steps you can take to address them.

Firstly, myopia, or nearsightedness, is a common refractive error that can progress over time, particularly in children and adolescents whose eyes are still developing. It is not unusual for children to experience changes in their prescription as they grow. However, the significant increase in your daughter's measurements within a short period raises some important considerations.

1. Measurement Variability: One of the first things to consider is the variability in measurements that can occur due to different testing conditions or methods. For instance, the use of cycloplegic agents (like the drops used during your daughter's eye exam) can temporarily affect the eye's ability to focus, leading to different readings. If your daughter was tested without these drops and then with them, the results could vary significantly. It is crucial to ensure that the same testing conditions are maintained for accurate comparisons.

2. Eye Health and Conditions: While you mentioned that the eye doctor did not find any pathological changes in the eye, it is still essential to rule out any underlying conditions that could contribute to the rapid progression of myopia. Conditions such as keratoconus or other corneal irregularities can sometimes lead to changes in vision. A thorough examination by a specialist, particularly in a larger hospital setting, is advisable to ensure that no underlying issues are present.

3. Lifestyle Factors: Environmental factors can also play a role in the progression of myopia. Increased screen time, lack of outdoor activities, and poor lighting conditions can contribute to worsening vision. Encouraging your daughter to spend more time outdoors and to take regular breaks from screens can help mitigate some of these effects.

4. Genetic Factors: Myopia has a hereditary component, and if there is a family history of myopia, it could explain the progression in your daughter’s case. Understanding your family's eye health history can provide insights into her condition.

5. Regular Monitoring: Given the rapid changes in your daughter's vision, it is crucial to have regular follow-ups with an eye care professional. This will help monitor her condition closely and adjust her prescription as needed. It may also be beneficial to keep a log of her vision changes and any symptoms she experiences, which can provide valuable information to her eye care provider.

6. Consideration of Treatment Options: Depending on the findings from the comprehensive examination, your eye care provider may discuss various treatment options. These could include specialized contact lenses designed to slow the progression of myopia, such as orthokeratology lenses or multifocal lenses.

In conclusion, while it is concerning to see such rapid changes in your daughter's myopia, there are several factors at play that can contribute to this situation. It is essential to work closely with her eye care provider to ensure that she receives the appropriate care and monitoring. Your proactive approach in seeking answers is commendable, and I encourage you to continue advocating for your daughter's eye health.

Best wishes for your daughter's vision and health. Please do not hesitate to reach out if you have further questions or concerns.

Sincerely,
Doctor Q&A Teams

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