Refraction can be challenging in children, and even more so in a complex presentation as for this case. Is this patient a myope or not? When dealing with a complex case of pseudomyopia, antimetropia and latent hyperopia, all in one patient – how should we manage the patient? The answer involves balancing goals to manage ametropia correction, binocular vision function and myopia control.
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.
Esophoria at near is a risk factor for myopia development and progression. Does it need to be managed in an emmetropic patient without symptoms? Is this patient a pre-myope, and how should this factor into management? Read this interesting clinical case, where colleagues discuss whether to intervene or not, and how to potentially manage both myopia risk and binocular vision.
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.
Would you prescribe glasses for a young child with mild myopia? Is myopia control beneficial for a toddler? This case discussion covers whether to treat or monitor, with the research evidence for prescribing as well as clinical considerations for co-management between primary eye care and ophthalmology.