Novelty Optimisation Techniques For Myopia Assessment & Management

Abstract

This thesis hoped to inform the practice of future individual myopia management. All myopia risk factors across global ethnic regions must be considered, instead of relying on the most widely used averaged parameters, towards the development of growth model tools. There could be possible crucial cut points of near phoria development at specified age ranges, earlier and later in life, suggesting this myopia risk factor should be measured alongside other primary outcome parameters important for treatment efficacy. Other notable human lifespan findings included: emmetropic and female patients attended eye examinations more frequently; females exhibited higher levels of near phoria and myopia; myopes were more esophoric than emmetropes, progressive myopes were more esophoric than both myopes and emmetropes, and were less likely to increase in exophoria with age. The presumed design optimisation, regarding daily CE-marked optical myopia control strategies, was based on the possible mechanism behind myopic retinal defocus (blur) and accommodative lag in myopia development and progression. Contact lens designs could have an inherent characteristic for their treatment effect in the temporal retina at 30° and J0 astigmatic component. Multifocal contact lenses for myopia control significantly impacted glare, but did not affect contrast sensivitiy differently than standard lenses, and would offer equally acceptable treatment compliance and qualifty of life expectations. Specialty instrumentation for measuring primary outcomes (refraction and axial length) should be used interchangeably for myopia control studies. This was confirmed between the gold standard biometers, IOLMaster 700 and IOLMaster 500, for the key parameters of axial length, anterior chamber depth and corneal topography, where discrepancies in white-to-white corneal diameter values, following MiSight and NaturalVue contact lens wear, were minimal and clinically irrelevant. Further novel discoveries proved myopia control contact lenses were viable non-invasive sampling vehicles for human dopamine detection. Thus, the thesis probed the viability of novelty applications of such “labelled” and/or gold standard medical devices and instrumentations towards treating individual myopic patients and highlighted that appropriate global myopia management and standardisation remain poor.

Date of Award	Mar 2021
Original language	English
Supervisor	James Wolffsohn (Supervisor), Nicola Logan (Supervisor) & Raquel Gil-Cazorla (Supervisor)