Clinical cases

Communicating with parents who reject myopia correction

How do you approach communicating with parents about myopia when they reject even standard single vision correction for their child? This is especially concerning given that even a full strength single vision correction is a better choice than under- or un-correction of myopia – for both myopia progression as well as the child’s functional abilities. This clinical problem is more common than you might think, especially in some regions of the world. Read more in this clinical case and how you can approach explanation and overcome barriers to ensure full correction of young myopes, the first step along the way to myopia control.

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. 

How much orthokeratology over-correction is ideal?

Orthokeratology is designed to achieve slight over-correction so the optical treatment will last all day. How much overcorrection is ideal to achieve good vision throughout the day while achieving good visual performance?

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.

A two-year-old with low myopia – to correct or not?

Would you prescribe glasses for a young child with mild myopia? Is myopia control beneficial for a toddler? This case discussion covers whether to treat or monitor, with the research evidence for prescribing as well as clinical considerations for co-management between primary eye care and ophthalmology.

How to manage the highly myopic toddler

A two-year-old with high myopia and astigmatism – the discussion included co-management, the best optical correction, and the lifelong management ahead. Read more on managing the highly myopic toddler.

patient doesn't respond to orthok

When a patient doesn’t respond to Orthokeratology

What do you do when your patient doesn’t respond to your orthokeratology (orthoK) treatment and things don’t add up? Here’s a case for you where an optometrist had to become a bit more investigative to determine the cause.

Does low-dose atropine cause blurry vision?

Low dose atropine is often used for myopia control in children. How commonly will patients complain of side effects, such as photophobia, allergy or blurry vision at near? BL presents a patient who experienced blurry vision after using 0.01% atropine once, and subsequently refused to use it. This led to significant fear and misconception on the part of the parent. How should a case like this be managed?