The Clinical Course and Visual Management of Congenital Myopia

Introduction: To investigate the clinical course of congenital myopia which received early full correction of glasses either with atropine treatment or without treatment. Methods: Forty-five children with congenital myopia (spherical equivalent over-5.OD before the age of 5) were included, and were divided into two groups. One group (n=25) did not receive any cycloplegic treatment, the other group received atropine therapy (n=20). The mean follow-up time was 5.02 years. All patients with congenital myopia received early full correction of glasses with the mean age of 3.66 year. The cycloplegic refraction and the best corrected visual acuity were collected. Results: No significant difference in progression of myopia was found between without treatment (-0.11D/year) and with atropine treatment (-0.15D/year) (p=0.45). We also noted that the tendency toward progression or regression appeared to be related to the degree of refractive error. Lower grades of high myopia (-5.0-7.75D) had a stronger tendency to progress (47.9%) than highest initial refraction (≥-11.0D) (12.5%); whereas at the highest initial refraction showed higher regression rate (58.4%) than the lower initial refraction (21.7%). About 80% of congenital high myopes, their best corrected vision over 20/40. Only 5% of patients had their corrected vision less than 20/60. Conclusion: Early and full correction of refractive error to the congenital myopic children can get good visual prognosis. At the highest levels (≥-11.0D) the majority of eyes were stable and possible regression, whereas lower grades of high myopia (-5.0~7.75D) had a strong tendency to progress.