Which multifocal soft lens? Efficacy and function

In an earlier post on refraction and safety with multifocal soft lenses, I discussed how colleagues often as this question – if you’re fortunate to have access to multiple multifocal, dual focus or myopia controlling contact lens designs, which is best? In Part 1 I discussed considering refraction and safety, and in this second part I’ll discuss how these lenses compare based …

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Which multifocal soft lens? Refraction and safety

I was lecturing recently at the Southern Regional Congress, Australia’s largest optometry conference, run annually in Melbourne. I’d finished my myopia management lecture with a little time to spare for questions, and a colleague asked “when you’re talking about using multifocal soft contact lenses, which designs do you mean? Are you referring to [Coopervision’s] Misight, or the distance centred Biofinity …

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Clinical Myopia Management (Lecture)

This one hour lecture, delivered to final year QUT optometry students in August 2017, covers the ‘why’ of myopia control; understanding the relative risks of doing something versus doing nothing; a brief literature review of mechanisms and options; putting it into practice and clinical resources available online. Since, then, my message on efficacy has been updated and simplified, but the …

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Binocular Vision – Easier Than You Think (Lecture)

This one hour lecture, delivered to final year QUT optometry students, describes a simplified two-system approach to BV diagnosis and management, with cases, then details easy use of prism correction for vergence disorders; changes to BV in contact lens wear; and why BV matters – for reading and learning in kids, clinical problem solving, and myopia management. By far the …

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Prescribing adds for near esophoria

From a myopia control point of view, esophoria and accommodative lag are the key clinical red flags in assessing your patient’s visual efficiency, and thankfully both will usually respond positively to a near addition. Studies of progressive spectacle lens prescription for myopia control show a link between faster progression and hence better treatment results in children with esophoria and accommodative …

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Assessing near phoria

I describe near heterophoria to my patients as where their eyes aim in space – the posture of their vergence system – and esophoria is our key enemy in the myopia control battle. There is a reported association between higher levels of esophoria and accommodative lag at near in myopic children and young adults as compared to emmetropes.1-5 Studies of progressive …

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Assessing fusional reserves at near

Fusional reserves are easy to assess using a prism bar, and with some keen observation can become an objective measure of your patient’s ability to maintain the correct balance of convergence and divergence at near. There is a reported association between higher levels of esophoria and accommodative lag at near in myopic children and young adults as compared to emmetropes.1-5 …

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Myopia control – science or luck?

Mounting evidence from clinical studies published in the last 10 years demonstrate the efficacy of orthokeratology (OrthoK) in slowing myopic progression and controlling axial length increases in children.1,2 OrthoK has also been shown to be a safe and efficacious means of correcting refractive error.3 But, even with our best intention to slow myopic progression with OrthoK, none of us is truly …

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