Should we fit orthokeratology to a child with trichiasis?

Orthokeratology is effective for myopia control but is it suitable for a child with trichiasis and corneal staining? This case compiles the treatment suggestions for managing a young myopic patient with trichiasis from the Facebook community, with a focus on safety.

Pupil myopia management

Pupils and myopia management: what we know and need to learn

What is the relationship between pupil size and myopia management? As the pupil controls the light input to the retina, does pupil size influence myopia risk or the response to myopia treatments? This review covers atropine’s influence on pupil size, the relationship with treatment zone size in orthokeratology, combination treatments and advice on normal outcomes.

Axial length growth at an extraordinary speed

In this case study, a child with myopia appears to have progressed 2.50D in a year. Axial length measurement provided invaluable data to validate this refractive shift – read more about the case and how the patient was managed.

What is the effect of low-dose atropine on binocular vision?

Low-dose atropine (0.05% or less) has a maximum effect on pupil size for both bright and dim light conditions within an hour of instillation, but has little to no effect on binocular vision in myopic children when used for myopia management.

Atropine 0.01% combined with orthokeratology over two years

Atropine 0.01% combined with orthokeratology slows axial elongation to less than 0.1mm/year over two years in Chinese children aged 6-11 years. This is the equal-longest study on this topic and first to measure potential mechanisms of pupil size and choroidal thickness. The largest effect of the combination occurred in the first 6 months.

IMI Report on Prevention of myopia and its progression

In myopic children, interventions to slow progression are warranted to prevent the development of high myopia and subsequent pathology and also to reduce the economic burden caused by uncorrected and pathologic myopia. This IMI Report describes the latest advice on preventing the development and progression of myopia – read the summary here.

What happens to binocular vision during cycloplegia?

Do you check your patient’s binocular vision function after cycloplegic refraction? Is this useful? An unexpected finding in this case leads to discussion of binocular vision changes in cycloplegic conditions, ideal management for exophores, and even the impact of low-dose atropine.

Compounding Complications Questions

Compounded atropine for myopia control: safe and effective prescribing

Most atropine currently prescribed for myopia control is compounded rather than being commercially mass manufactured. How could this influence research results and clinical outcomes? Learn more about compounded topical atropine including questions to ask your compounding pharmacist.

Compounded topical atropine: is every bottle the same?

How consistent is compounded topical atropine from bottle-to-bottle? What clinical results could indicate variability? Read more in this clinical case where a miniscule change in concentration gave notably better clinical outcomes.