Four reasons why binocular vision matters in myopia management

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.

Is it really fast progressing myopia, or something else?

In this case, a 14-year-old was found to be far less myopic than their refraction and terrifyingly fast progression suggested, thanks to careful diagnosis. Learn what didn’t add up and how utilizing technology o measure the ocular components helped to solve the puzzling clinical case.

MiSight’s Impact on Binocular and Accommodative Function

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.

Measuring near lag of accommodation

Assessing accommodative function, such as measuring near lag of accommodation, is a vital component of understanding the myopia profile of your patient. In this post Dr Kate Gifford describes how to measure accommodation lag in practice.

A myope or not? Pseudomyopia, antimetropia and more

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. 

Managing a 5-year-old pre-myope

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.

Do you need to treat esophoria in an emmetropic patient?

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.

Accommodation training in multifocal contact lens wear

This study showed that multifocal contact lens wear in young adult myopes increases accomodative lag, and utilized auditory biofeedback training to improve it. The results and implications are discussed here.

When to prescribe spectacles for myopia control

Here we explore an overview of spectacle prescribing for myopia management – from when to use single vision, to progressive and bifocal designs, new myopia control specific designs, and whether to fully or under-correct.