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.

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.

Which soft multifocal contact lens to choose?

Soft multifocal contact lenses for myopia control can provide a great option for children with high myopia and astigmatism. In this case study we review what options are available, including toric and sphere-plus-other options, materials and replacement schedules.

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.

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.

Patient progressing after treatment withdraw therapy myopia worse

Myopia Rebound: Back with a Vengeance

You may be ready to cease treatment, or the patient has done so of their own accord. Then you observe that the rate of myopic progression accelerates again – a myopia rebound effect. When does this happen? Can you avoid it? What should you consider doing in practice?