Children are accessing screens at school, around the home and for personal entertainment at younger and younger ages. At the same time, there has been an unprecedented increase in myopia in children, with higher numbers and earlier age of onset. Read about what we do and don’t know about this link; the impact of screen time on binocular vision and dry eye in kids, and guidelines for advice to parents.
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?
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.
Here we focus on clinical advice comparing efficacy between available options which have been researched for myopia control. We also discuss best corrected acuity outcomes, and how MFCLs may influence accommodation, with this potentially linking to myopia control efficacy.
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.
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.
Non-responders are those children who have shown minimal efficacy of their treatment in myopia control studies, and it turns out that there’s around 15-20% of children who are classified this way across the major myopia control intervention studies. We look at non-responders in atropine, multifocal and myopia controlling contact lens, orthokeratology and DIMS spectacle lens studies, and what factors non-responders share across these studies.
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.
This review covers how well axial length relates to refraction and predicting future myopia, how to measure axial length, its value in orthokeratology and atropine management, how axial length influences a treatment plan and can you practice myopia management without it.
You may be ready to cease treatment, or the patient has done so of their own accord. Then you observe that the rate of myopic progression accelerates again – a myopia rebound effect. When does this happen? Can you avoid it? What should you consider doing in practice?
