Prescribing for the Progressing Myope with Astigmatism

Whilst each individual child has their own circumstances and situation to consider when prescribing myopia control, children with astigmatism present a unique set of challenges when selecting the best option for not only slowing down the progression of their axial growth, but also providing them with good vision. Simply ignoring the astigmatism when selecting a prescribing choice runs the risk …

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Why Each Dioptre Matters

We all know that high myopia is associated with higher incidences of retinal detachment, glaucoma and myopic maculopathy1. Instigating early, evidence based myopia control in rapidly progressing myopes gives the best outcomes both pathophysiologically and refractively. However when faced with a low, slower progressing myope, or a patient whom has already progressed is there any point in persisting with myopia …

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Spectacle lenses for myopia control – Part 2

Back up corrections, clinical considerations and new designs There’s a little more to think about in the important role spectacle lenses play in myopia management. Even if we prescribe contact lenses, our young myopes are most likely to need a back up spectacle lens option. Children prescribed atropine will need the best spectacle lens prescribed for them to minimise the …

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Spectacle lenses for myopia control – Part 1

Progressives, bifocals, binocular vision and more Are progressive addition lenses and bifocals created equal for myopia control? When do they work and when do spectacles have minimal efficacy? How should we pick which lens type to prescribe, and what’s on the horizon for our non-contact lens wearing young myopes? We know that single vision spectacle lenses provide no useful efficacy …

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Assessing risk of myopia onset and progression

Identifying the pre-myope There are four key principles for assessing risk of myopia onset: Family history – one myopic parent increases risk by three-fold, while two myopic parents doubles this risk again1 Visual environment – less than 90 minutes a day spent outdoors increases risk, especially if combined with more than 3 hours a day spent on near work activities …

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An Ode To My Retinoscope

In May 2019 the professional journal Contact Lens Spectrum published my bi-annual ‘Refractive Focus’ column, entitled ‘An Ode to my Retinoscope’. Click on this link to read about how your trusty ret can help with: Pediatric refractions Diagnosing keratoconus and other corneal irregularities Toric contact lens assessment Multifocal contact lens troubleshooting OrthoK assessment Complex contact lens fitting About Kate Dr …

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Kids, contact lenses, dry eye and binocular vision

Kids and dry eye Only a minimal percentage of children are likely to suffer dry eye symptoms (4%) compared to 56% in adult contact lens wearers.(1) Teens may be more likely to report contact lens related dry eye than younger children,(2) and consideration should be given to any systemic medications which could exacerbate dry eye symptoms, such as acne medications …

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The esophoric myope and contact lenses

When it comes to contact lens corrections for young myopes, the impact of orthokeratology (OK) and multifocal soft contact lenses (MFSCL) on binocular vision is pertinent to visual comfort and understanding mechanisms of myopia progression and control. Oliver’s story Oliver, age 10, was referred with a history of fast, recent myopia progression. His mother was R&L -7.00 and he was …

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Specs to contacts – what happens to BV?

Changing a myope from spectacle to contact lens wear can alter their binocular vision (BV) function. The myope reading through their spectacles experiences base-in prism at near, as demonstrated in the image above, which moves the image further away and decreases vergence demand. Looking away from the optical centre of the lens (while keeping the vertex distance constant) also reduces …

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