ABSTRACT
The treatment is optimal if the myopia is within the myopic model. It is still possible, however, to treat myopia slightly outside of it. There are some participants, for example, who tried their best to keep the ciliary muscle pliable except for the few times when they did something out of the ordinary—such as wearing contact lenses to play sports. Although it may have occurred less than a dozen times a year, it was enough to create a partial resistance. The directly induced stress induced a partial spasm.
You can refer to the resistance tests as a flow chart to help you identify the type of resistance encountered by the myopic eye. You start by testing a patient with the First Resistance Test. If you suspect a partial resistance, you would continue with the other tests only if he has a primary refractive error—not a secondary refractive error. A primary refractive error refers to mild and moderate myopia with the same prescription in each eye or with a disparity less than −0.50 D. The other types of refractive errors are considered secondary refractive errors, such as: anisometropia, compound anisometropia and anisometropic amblyopia, and compound myopia and astigmatism where the astigmatism is high. The Third and Fourth Resistance Tests are not compatible with the actual drill assigned to a secondary refractive error since the Third and Fourth Resistance Tests together make up the Standard Drill. The Standard Drill is more applicable to refractive errors that allow for the multiplier effect in the first part of the drill. Secondary refractive errors generally prefer a less intense stimulation by wearing one lens at a time to induce an indirect effect.
However, there is an exception. If you are addressing secondary refractive errors within the myopic model, the First Resistance Test can 126determine whether to apply the Standard Drill or Modified Preliminary Drill when treating borderline myopia and high astigmatism. You are not checking for a partial resistance. You already know there is a partial resistance due to the presence of astigmatism as well as myopia. Instead, you are actually testing the astigmatism’s intensity level. If it is high, it would not respond to the First Resistance Test.
