Adult-onset myopia: measurement and management

Myopia which onsets in childhood usually stabilizes in the early twenties. How should we manage adult-onset myopia and progression? This case investigates factors, diagnostic measurements and management of adult-onset myopia.

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.

How can we promote safety in orthokeratology?

Many orthokeratology-related adverse events are due to poor compliance and hygiene processes. This case demonstrates the importance of patient discussion and provides guidance on key steps to promote safety in orthokeratology wear.

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.

Monocular Myopia Management

Monocular Myopia Management: unilateral and anisometropic myopia

How should you best manage children with unilateral or anisometropic myopia? Learn about what drives aniso-myopic development, associations with amblyopia and ocular pathology, and the evidence base for orthokeratology to slow aniso-myopic eye growth.

Managing unilateral myopia

Unilateral myopia can present a challenge to both myopia correction and control choices. In this case study, learn about which interventions have evidence for myopia control and reducing anisometropia, as well as the considerations for monocular versus binocular correction and treatment.

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.

Are you measuring the cornea in myopia management?

Measuring the cornea in myopes is crucial to understanding their clinical picture and even their profile of myopia risk. Flat corneas can mask an axial length which is longer than expected for the patient’s refraction. Learn more in this clinical case study.

Getting parents onboard with orthokeratology

How do you get parents onboard with orthokeratology when they are unsure of childhood contact lens wear capability, benefits or safety? In this case, one parent was receptive to this recommendation but the other parent was not. Read more on the steps to take to support your clinical communication, including further reading and resources to help.