Atropine

Myopia Management in the netherlands: advice and outcomes from a new protocol

The Erasmus Medical Group in the Netherlands set out four steps in their myopia management protocol: providing visual environment advice, identifying high-risk myopes by axial length and treating them with atropine 0.5%, managing other myopes with optical treatments or lower-concentration atropine, and ceasing treatment in the late teens once axial length is stable. The described use of axial length percentile growth charts for diagnosis, choice of treatment, monitoring and cessation is a world-first.

Why MiSight 1 day is not a multifocal contact lens

MiSight 1 day is a dual focus contact lens – it’s not a multifocal as it does not provide an ‘add’ at near. When considering a first correction for a young myope, how should we prioritize both myopia correction and control? Read more in this case.

Can we reconsider contact lenses?

Contact lenses offer numerous functional, psychological and myopia controlling benefits for children. What should you do if a parent or patient says no to contact lenses for their child, and you consider it an ideal option? How can you approach communication to convey the safety and benefits?

Influence of atropine on retinal signaling in a mouse model

This research showed that the concentration of atropine which reaches the retina is 400 times less than by topical administration; and that higher concentrations directly exposed to the mouse retina influence retinal signaling. Whether this is indicates a possible mechanism or unintended impact of atropine, and how this may translate to atropine use in humans, is unknown.

Determining the Optimal Concentration of Atropine

Despite being used for myopia management for many years, significant controversy exists in both literature and clinical optometric practice regarding the optimal concentration of atropine. The LAMP study sheds light on this mystery by investigating efficacy of 0.05%, 0.025% and 0.01% atropine for slowing myopia progression.

Do pseudophakic children need myopia control?

How does the normal emmetropization process in childhood influence refraction shifts in pseudophakes? Should a myopic shift in a pseudophakic child be viewed as myopia progression? How should they be managed and is myopia control needed? This blog covers important considerations in managing these atypical myopes.

Managing a 5-year-old pre-myope

Pre-myopes can be readily identified, and best practice dictates that we should offer some form of intervention to help delay the onset of myopia. In this case we discuss the features of a pre-myope and an example in a 5 year old patient who satisfies the refractive criteria for pre-myopia, and has a strong family history of myopia.

How to identify and manage pre-myopes

If our goal is to manage myopia, preventing its onset should be an even more valuable target. How can we consistently identify pre-myopes, explain the concern to parents, and how can we best manage them based on the evidence?

Switching from atropine to MiSight – one or both treatments?

When atropine isn’t working as a monotherapy, is it valuable to combine it with a myopia controlling contact lens? Could switching from atropine to a contact lens be the better option? In this post on the Facebook discussion group, a colleague sought opinions on combining atropine and MiSight contact lenses.

A two-year-old with low myopia – to correct or not?

Would you prescribe glasses for a young child with mild myopia? Is myopia control beneficial for a toddler? This case discussion covers whether to treat or monitor, with the research evidence for prescribing as well as clinical considerations for co-management between primary eye care and ophthalmology.