Contact lens options are ideal for higher myopes. What about when they have moderate astigmatism as well? This case discusses the evidence base for myopia control options which correct for astigmatism, along with patient-specific considerations and whether a combination treatment with atropine is needed.
When prescribing myopia controlling contact lenses for children, daily disposables are the safest modality. Only spherical corrections are available, though, which can impact lens selection for children with astigmatism. The NaturalVue Multifocal contact lens is suggested for up to 2D of astigmatism, much higher than is typical for spherical CL designs. Is is ‘masking’ astigmatism, or ‘partially correcting’ it instead?
Axial length (AXL) has been well established as the critical measurement in myopia control research. The measurement accuracy and link to disease risk make AXL increasingly important in a clinical setting. But what else should we measure in the myopic eye? Does the cornea change as well? Will we end up doing away with refraction? Read more on measuring the whole eye in myopia.
Children can be tricky to refract. Here is a challenging refraction case discussed by colleagues – while not a case of a myope, it describes useful clinical principles for prescribing for children, especially children under 6 who require particular consideration to ensure normal visual development.
Here we provide clinical advice on considering astigmatism and add power choices, over-refraction and final lens power, and safety outcomes in myopia controlling soft contact lenses.
Soft multifocal contact lenses for myopia control can provide a great option for children with high myopia and astigmatism. In this case study we review what options are available, including toric and sphere-plus-other options, materials and replacement schedules.
This research summary describes the major multifocal contact lens (MFCL) research studies for myopia control, and what we still need to learn. From the first studies only a decade ago, to wearing time, commercially available lenses, the influence of BV, novel designs and more, this comprehensive review will get you all the way up to date on MFCLs.
When fitting orthokeratology for astigmatism, it is important to distinguish between refractive astigmatism and corneal toricity. Factors influencing the speed of response are also discussed.
MCS was hesitating fitting OrthoK to a patient who showed inferior corneal steepening. Her main concern was that OrthoK may induce corneal ecstasia/keratoconus in the future and whether there is a link between OrthoK and keratoconus.
Children with more than 5-6D of myopia can require special consideration to ensure safe management of their ocular and systemic health. This clinical case details important aspects of care for the very high childhood myope: ophthalmology co-management, best optical corrections, parental education and eye health monitoring.
