What to do when a patient doesn’t respond to atropine

What do you do when your patient doesn’t respond to your low-dose atropine treatment? This case explores the nuances in navigating management when atropine doesn’t work as well as you might expect.

When to prescribe spectacles for myopia control

Here we explore an overview of spectacle prescribing for myopia management – from when to use single vision, to progressive and bifocal designs, new myopia control specific designs, and whether to fully or under-correct.

Prescribing for the Progressing Myope with Astigmatism

Whilst each individual child has their own circumstances and situation to consider when prescribing myopia control, children with astigmatism present a unique set of challenges when selecting the best option for not only slowing down the progression of their axial growth, but also providing them with good vision.

Spectacle lenses for myopia control Part 2: Back ups and dispensing

There’s a little more to think about in the important role spectacle lenses play in myopia management. Even if we prescribe contact lenses, our young myopes are most likely to need a back up spectacle lens option. Children prescribed atropine will need the best spectacle lens prescribed for them to minimise the impact of any side effects.

What about the exophores?

While esophoria and myopia have a long-associated link,(1-3) exophoria must also be on our myopia management agenda. The punchline, up front – research has shown that of kids with intermittent exotropia, 50% are myopic by age 10 and 90% are myopic by age 20,(4) and we need to be extra wary if considering fitting a myopic child like this into contact lenses.

The esophoric myope and contact lenses

When it comes to contact lens corrections for young myopes, the impact of orthokeratology (OK) and multifocal soft contact lenses (MFSCL) on binocular vision is pertinent to visual comfort and understanding mechanisms of myopia progression and control.

Specs to contacts – what happens to BV?

Changing a myope from spectacle to contact lens wear can alter their binocular vision (BV) function. The myope reading through their spectacles experiences base-in prism at near, as demonstrated in the image above, which moves the image further away and decreases vergence demand.