Assessment of Myopia Risk Factors and Management Recommendations in a Tertiary Eye Care Centre

Abstract: Background: This study aimed to evaluate the clinical profile and factors associated with myopia risk among children and to describe the individualized myopia management strategies recommended at a tertiary eye care centre. Methodology: A prospective study was conducted at Rotary Eye Hospital, Navsari, from October 2024 to April 2025 and included 125 children aged 6–18 years with myopia. Comprehensive assessment included medical and ocular history, visual acuity, refractive status, indoor and outdoor activity time, ocular parameters including axial length, lens thickness and keratometry, and binocular vision assessment. Myopia risk was assessed based on spherical equivalent and further supported by the LVPEI Myopia Calculator. Patients and their parents were counselled regarding the risk of myopia progression and individualized management options, including spectacle correction, myopia-control spectacles, pharmacological interventions, environmental modifications, and vision therapy. Treatment compliance was assessed at the 3-month follow-up. Results: Among the 125 children, 69 (55%) were female and 56 (45%) were male, with 65% classified as high risk. The 3-month follow-up compliance rate was 42%, among whom 55% remained in the high-risk category. The recommended management strategies included regular spectacles (89%), myopia-control spectacles (59%), pharmacological interventions (24%), progressive addition lenses (1.5%), vision therapy (8%), and environmental interventions (100%). Multiple regression analysis demonstrated that spherical equivalent was the strongest predictor of axial length (β = −0.851, p < 0.001). Age (p = 0.029) and outdoor activity time (p = 0.012) were also significantly associated with axial length, whereas indoor activity time was not significantly associated (p = 0.905). No significant change in axial length was observed over the 3-month follow-up period. Conclusion: A substantial proportion of children were classified as being at high risk for myopia progression. Comprehensive assessment of refractive error, ocular parameters, and environmental factors may facilitate individualized myopia management. Myopia-control spectacles and environmental interventions were the most frequently recommended management approaches. The relatively low follow-up compliance emphasizes the need for structured follow-up and adherence strategies in childhood myopia management.