Prescribing adds for near esophoria

From a myopia control point of view, esophoria and accommodative lag are the key clinical red flags in assessing your patient’s visual efficiency, and thankfully both will usually respond positively to a near addition.

Assessing near phoria

Kate describes near heterophoria to her patients as where their eyes aim in space – the posture of their vergence system – and esophoria is our key enemy in the myopia control battle.

Assessing fusional reserves at near

Assessing horizontal fusional reserves at near gives you the measure of your patient’s stamina, or ‘petrol in the tank’ to be able to manage their phoria, or ‘posture’.

My journey into myopia control

This blog retraces my personal journey into myopia control and explains why I believe that this is the most important development for optometry that has taken place during my career.

Prescribing adds for accommodation lag

Given that a normal lag result is +0.50, I would generally prescribe an add which is the accommodative lag result subtracting 0.50, so the resulting final lag is within the normal range. For example, a lag of +2.00 results in a +1.50 Add; a lag of +1.50 results in a +1.00 Add. However, this formula may not work if:

Measuring accommodative facility

Assessing accommodative function at near is a vital component of understanding the myopia profile of your patient. Myopic progression in children and adults can be influenced by binocular vision function.