Do you need to treat esophoria in an emmetropic patient?

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.

Which soft multifocal contact lens to choose for astigmatism?

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.

A two-year-old with low myopia – to correct or not?

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.

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.

patient doesn't respond to orthok

When a patient doesn’t respond to Orthokeratology

What do you do when your patient doesn’t respond to your orthokeratology (orthoK) treatment and things don’t add up? Here’s a case for you where an optometrist had to become a bit more investigative to determine the cause.

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 you have low myopia and high axial length

Usually myopia and axial length are correlated. What does it mean when your patient has low myopia and high axial length? This case discusses various correlations between ocular and individual parameters and axial length.

Axial length measurement in myopia management – how often and how much change is normal?

How frequently should we measure axial length in myopia management practice, and how should it best direct our treatment strategy? Here we discuss how axial length change is related to refraction and ethnicity, and how to determine whether an axial length change is normal due to emmetropization or indicating myopia progression.

Does low-dose atropine cause blurry vision?

Low dose atropine is often used for myopia control in children. How commonly will patients complain of side effects, such as photophobia, allergy or blurry vision at near? BL presents a patient who experienced blurry vision after using 0.01% atropine once, and subsequently refused to use it. This led to significant fear and misconception on the part of the parent. How should a case like this be managed?