How common is microbial keratitis in children wearing orthokeratology?

The risk of microbial keratitis (MK) in orthokeratology-wearing children was shown in a 2013 analysis to be around 14 per 10,000 patient wearing years, but new data indicates that it may be lower. Data gathered from a large group of practices in Russia found MK risk of around 5 per 10,000 patient-wearing years, similar to the risk of daily wear soft lenses. This should increase confidence in fitting orthokeratology to children for myopia control.

When myopia management is not working after COVID-19 home confinement

During the COVID-19 pandemic, governments imposed home confinement and school-based learning was the normal. Has this caused more myopia? In this clinical case, the unique environment of lockdown is explored in view of myopia management outcomes.

Contact lens fitting for an anxious child

Does contact lens fitting for an anxious child with ADHD seem impossible? Here is an inspiring case that saw success at the end – we add guidelines on clinical approaches with children to reduce anxiety.

A monocular myope with coloboma

An 8-year-old child is essentially monocular, due to unilateral high myopia associated with coloboma. The normally sighted eye has low myopia. How should we best balance safety and proactive myopia control in such a case?

Is it myopia progression or early keratoconus?

How would you manage a progressing myope with early keratoconus? In this case, refractive progression of myopia was not just due to axial elongation, and astute repeated measurement of both the corneal curvature and axial length helped with accurate diagnosis.

How should we manage a presbyopic progressing myope?

The myopia history in childhood can influence how an adult myope copes with their correction and even how their vision changes over time. Read more about this case of a 50-year-old progressing myope.

Which is best? Myopia Management for an astigmatic myope

Contact lens options are ideal for higher myopes. What about when they have moderate astigmatism as well? This case discusses the evidence base for myopia control options which correct for astigmatism, along with patient-specific considerations and whether a combination treatment with atropine is needed.