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.
Total spherical-like higher-order aberrations (HOA) increased by more than double in the distance-centred +2.50 Add compared to +1.50 Add, with total coma-like HOA increasing further. Since orthokeratology studies have reported an association between more change in HOAs and better myopia control efficacy, this could indicate a mechanism of action in multifocal contact lens myopia control.
Young adults fit with CooperVision Proclear multifocal contact lenses showed no loss of peripheral vision detection ability compared to single vision contact lenses. The near add was chosen to generate +0.50 or +1.00 of peripheral blur, confirmed by peripheral refraction measurement. This is a positive indication that fitting MFCLs in young wearers doesn’t impact peripheral visual performance.
The BLINK study found that +2.50 Add centre-distance multifocal contact lenses (MFCLs) slowed myopia progression but the +1.50 Add didn’t. Further analysis indicates that increased peripheral defocus created by the +2.50 Add only accounted for around 15% of the myopia control effect, indicating other mechanisms are involved.
When prescribing myopia controlling contact lenses for children, daily disposables are the safest modality. Only spherical corrections are available, though, which can impact lens selection for children with astigmatism. The NaturalVue Multifocal contact lens is suggested for up to 2D of astigmatism, much higher than is typical for spherical CL designs. Is is ‘masking’ astigmatism, or ‘partially correcting’ it instead?
The NaturalVue Multifocal contact lens is a daily disposable which may slow myopia. It is recommended for low astigmatism, as is typical for spherical contact lenses, but its unique optical profile has led practitioners to ask if it can be fit to patients with higher levels of astigmatism. Read this case which highlights the dynamics of a young visual system, using the fitting guide and finding the best solution for a very high myope.
The purpose of this 2 year study was to determine the effect of MiSight contact lenses used to control myopia on binocular vision and accommodation in children, as compared with children wearing SV spectacles, with the researches finding no significant differences in binocular and accommodative measures between the study groups.
In this review we explore the 6-year results for MiSight 1 day recently presented at the 2020 American Academy of Optometry meeting. Based on the abstract, children who were older at initial fitting (11-15 years) progressed similarly over 3 years to matched children who were treated for 6 years, indicating that older children could still gain a treatment effect from MiSight 1 day.
There’s a common clinical belief that orthokeratology doesn’t work as well in lower myopes for myopia control. This is even sometimes included in conference presentations as prescribing advice. Is orthokeratology useful for control of low myopia? Here’s what’s fact and what’s fiction, when considering its efficacy for low vs high myopia, and orthokeratology vs multifocal contact lens myopia control.