Refraction can be challenging in children, and even more so in a complex presentation as for this case. Is this patient a myope or not? When dealing with a complex case of pseudomyopia, antimetropia and latent hyperopia, all in one patient – how should we manage the patient? The answer involves balancing goals to manage ametropia correction, binocular vision function and myopia control.
Orthokeratology is designed to achieve slight over-correction so the optical treatment will last all day. How much overcorrection is ideal to achieve good vision throughout the day while achieving good visual performance?
There’s a common clinical belief that orthokeratology doesn’t work as well in lower myopes for myopia control. This is even sometimes included in conference presentations as prescribing advice. Is orthokeratology useful for control of low myopia? Here’s what’s fact and what’s fiction, when considering its efficacy for low vs high myopia, and orthokeratology vs multifocal contact lens myopia control.
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.
Half of children with high myopia have an underlying systemic condition: ophthalmology co-management, best optical corrections, parental education and eye health monitoring are crucial. It’s also important to offer myopia control strategies while also being aware of the limitations of the evidence base. This blog provides guidance on appropriate ocular health and optical management of children with more than 5-6D of myopia.
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.
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.
Most myopia control intervention studies employing spectacles or atropine enrol from age 6, and most contact lens studies enrol from age 8. So how should we manage myopes younger than this? In this blog we’ll give you some guidance on managing myopes under age 6-7 with low and moderate myopia. Children in this age group with high myopia will require primary eye care as well as ophthalmology care. This important clinical reference includes information on first steps, when and how to prescribe for both myopia correction and control, when to refer or co-manage with ophthalmology, and communication with parents.
A two-year-old with high myopia and astigmatism – the discussion included co-management, the best optical correction, and the lifelong management ahead. Read more on managing the highly myopic toddler.
When myopia progression seems to be faster than expected for a myopia control treatment, various factors can be at play, such as non-compliance, user error, high myopia, binocular vision, visual environment. Or you may have a non-responder on your hands. What should you do? Read more here.
