How to identify and manage pre-myopes

If our goal is to manage myopia, preventing its onset should be an even more valuable target. How can we consistently identify pre-myopes, explain the concern to parents, and how can we best manage them based on the evidence?

High Myopia in Childhood

High myopia in childhood – the underlying syndromes

Half of children with high myopia have an underlying systemic condition: ophthalmology co-management, best optical corrections, parental education and eye health monitoring are crucial. It’s also important to offer myopia control strategies while also being aware of the limitations of the evidence base. This blog provides guidance on appropriate ocular health and optical management of children with more than 5-6D of myopia.

Switching from atropine to MiSight – one or both treatments?

When atropine isn’t working as a monotherapy, is it valuable to combine it with a myopia controlling contact lens? Could switching from atropine to a contact lens be the better option? In this post on the Facebook discussion group, a colleague sought opinions on combining atropine and MiSight contact lenses.

How to manage the very young myope

Most myopia control intervention studies employing spectacles or atropine enrol from age 6, and most contact lens studies enrol from age 8. So how should we manage myopes younger than this? In this blog we’ll give you some guidance on managing myopes under age 6-7 with low and moderate myopia. Children in this age group with high myopia will require primary eye care as well as ophthalmology care. This important clinical reference includes information on first steps, when and how to prescribe for both myopia correction and control, when to refer or co-manage with ophthalmology, and communication with parents.

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.

Non-responders to myopia control treatments

Non-responders are those children who have shown minimal efficacy of their treatment in myopia control studies, and it turns out that there’s around 15-20% of children who are classified this way across the major myopia control intervention studies. We look at non-responders in atropine, multifocal and myopia controlling contact lens, orthokeratology and DIMS spectacle lens studies, and what factors non-responders share across these studies.

Child frowning because myopia treatment is not working

Why isn’t the myopia control strategy working?

When myopia progression seems to be faster than expected for a myopia control treatment, various factors can be at play, such as non-compliance, user error, high myopia, binocular vision, visual environment. Or you may have a non-responder on your hands. What should you do? Read more here.