Binocular vision is a much neglected (and even maligned?) domain of eye care where I’ve had numerous colleagues say their professional excitement and learning opportunities have been reinvigorated through seeing the clinical imperative and application in practice. Not only does binocular vision assessment add so much more to your clinical picture, and make optometric life more interesting, it could be the secret sauce that helps us bridge the gap towards 100% efficacy.
The purpose of this 2 year study was to determine the effect of MiSight contact lenses used to control myopia on binocular vision and accommodation in children, as compared with children wearing SV spectacles, with the researches finding no significant differences in binocular and accommodative measures between the study groups.
Refraction can be challenging in children, and even more so in a complex presentation as for this case. Is this patient a myope or not? When dealing with a complex case of pseudomyopia, antimetropia and latent hyperopia, all in one patient – how should we manage the patient? The answer involves balancing goals to manage ametropia correction, binocular vision function and myopia control.
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.
Esophoria at near is a risk factor for myopia development and progression. Does it need to be managed in an emmetropic patient without symptoms? Is this patient a pre-myope, and how should this factor into management? Read this interesting clinical case, where colleagues discuss whether to intervene or not, and how to potentially manage both myopia risk and binocular vision.