Despite being used for myopia management for many years, significant controversy exists in both literature and clinical optometric practice regarding the optimal concentration of atropine. The LAMP study sheds light on this mystery by investigating efficacy of 0.05%, 0.025% and 0.01% atropine for slowing myopia progression.
How does the normal emmetropization process in childhood influence refraction shifts in pseudophakes? Should a myopic shift in a pseudophakic child be viewed as myopia progression? How should they be managed and is myopia control needed? This blog covers important considerations in managing these atypical myopes.
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.
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?
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.
Would you prescribe glasses for a young child with mild myopia? Is myopia control beneficial for a toddler? This case discussion covers whether to treat or monitor, with the research evidence for prescribing as well as clinical considerations for co-management between primary eye care and ophthalmology.
What do you do when your patient doesn’t respond to your low-dose atropine treatment? This case explores the nuances in navigating management when atropine doesn’t work as well as you might expect.
Low dose atropine is often used for myopia control in children. How commonly will patients complain of side effects, such as photophobia, allergy or blurry vision at near? BL presents a patient who experienced blurry vision after using 0.01% atropine once, and subsequently refused to use it. This led to significant fear and misconception on the part of the parent. How should a case like this be managed?
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?
Professor Karla Zadnik, Dean of the Ohio State University College of Optometry in the USA,, discusses the Childhood Atropine for Myopia Progression (CHAMP) study, engaging with the literature, her favourite papers and an alternative take on myopia control as standard of care.
