This paper has found there are numerous correlations but only weak evidence to demonstrate a causal link between accommodation and myopia development. Assessment of the young myope’s accommodation and binocular vision function is still important. More understanding of the underlying mechanisms for myopia is needed in order to develop evidence-based interventions.
This study showed that aspheric multifocal soft contact lenses (Biofinity +2.50D and NaturalVue) reduce accommodative response and increase exophoria, while MiSight concentric dual-focus minimally impacts binocular vision function compared to single vision contact lenses. All myopia control contact lenses increased divergence range slightly but did not impact convergence.
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.