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.

Selecting an option: Clinical Decision Trees in myopia management

There is no one-size-fits-all when prescribing for childhood myopia control. Which option should you choose? In this important reference article, we ask you to consider three key questions which form clinical decision trees in myopia management.

Atropine – wonder or weak treatment?

Atropine has been the apparent hero of myopia management since the 2006 ATOM1 study, and since then, low concentration 0.01% atropine has become the new hero and then fallen out of favour. This article describes how lower concentrations work to balance efficacy and side effects, which should we select now, and what newer research on formulations and combinations can tell us.

Four reasons why binocular vision matters in myopia management

Binocular vision is a much neglected (and even maligned?) domain of eye care where I’ve had numerous colleagues say their professional excitement and learning opportunities have been reinvigorated through seeing the clinical imperative and application in practice. Not only does binocular vision assessment add so much more to your clinical picture, and make optometric life more interesting, it could be the secret sauce that helps us bridge the gap towards 100% efficacy.

Getting started – choosing a treatment for fast myopia progressors

Myopia control is vital for children with fast myopia progression. What are the key risk factors for faster myopia progression? What clinical findings indicate a more proactive myopia management strategy may be required? This case describes risk factors and evidence-based treatment options for fast myopia progressors.

Three clinical pillars for myopia management

Once the myopia management message has been communicated to the parent and patient – information on expectations, efficacy and safety – and the initial correction has been selected, there are three key areas of clinical focus.

How can we set myopia control expectations?

When setting myopia control expectations both at outset and follow up, it is important to compare the child’s observed myopia progression to ‘average’, and to then judge the expected outcomes of treatment. Bringing their lifestyle, motivations and abilities into consideration is also important. Here we explore how to use resources in practice to set expectations and gauge success along the way.