Managing a myopic anisometropic amblyopic child

This case is not your typical astigmatic myope. There are several features to this patient that require careful consideration, including high myopia, amblyopia, myopia correction and control, and eye health management.

An Ode To My Retinoscope

In May 2019 the professional journal Contact Lens Spectrum published my bi-annual ‘Refractive Focus’ column, entitled ‘An Ode to my Retinoscope’.

Kids, contact lenses, dry eye and binocular vision

Only a minimal percentage of children are likely to suffer dry eye symptoms (4%) compared to 56% in adult contact lens wearers.(1) Teens may be more likely to report contact lens related dry eye than younger children,(2) and consideration should be given to any systemic medications which could exacerbate dry eye symptoms, such as acne medications and those taken for anxiety and depression.

What about the exophores?

While esophoria and myopia have a long-associated link,(1-3) exophoria must also be on our myopia management agenda. The punchline, up front – research has shown that of kids with intermittent exotropia, 50% are myopic by age 10 and 90% are myopic by age 20,(4) and we need to be extra wary if considering fitting a myopic child like this into contact lenses.

The esophoric myope and contact lenses

When it comes to contact lens corrections for young myopes, the impact of orthokeratology (OK) and multifocal soft contact lenses (MFSCL) on binocular vision is pertinent to visual comfort and understanding mechanisms of myopia progression and control.