Myopia management message part 2 – efficacy

Let’s cut to the chase – until further notice, you can consider low dose (0.01%) atropine, soft multifocal CL’s and OrthoK as all quite similar in terms of their myopia control efficacy, being around 50% on average. A network meta-analysis of sixteen different interventions studied for myopia control showed these options to all have similar efficacy when their refractive and …

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Myopia management message part 1 – expectations

We have a convincing evidence base for several optical, one pharmacological and visual environment solutions to reduce the progression of childhood myopia, but nothing guarantees 100% efficacy. Because of this, even in when under a successful myopia management strategy, a child’s myopia may still progress. It is important to manage parental and patient expectations about myopia management – that we …

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Which multifocal soft lens? Efficacy and function

In an earlier post on refraction and safety with multifocal soft lenses, I discussed how colleagues often as this question – if you’re fortunate to have access to multiple multifocal, dual focus or myopia controlling contact lens designs, which is best? In Part 1 I discussed considering refraction and safety, and in this second part I’ll discuss how these lenses compare based …

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Which multifocal soft lens? Refraction and safety

I was lecturing recently at the Southern Regional Congress, Australia’s largest optometry conference, run annually in Melbourne. I’d finished my myopia management lecture with a little time to spare for questions, and a colleague asked “when you’re talking about using multifocal soft contact lenses, which designs do you mean? Are you referring to [Coopervision’s] Misight, or the distance centred Biofinity …

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Clinical Myopia Management (Lecture)

This one hour lecture, delivered to final year QUT optometry students in August 2017, covers the ‘why’ of myopia control; understanding the relative risks of doing something versus doing nothing; a brief literature review of mechanisms and options; putting it into practice and clinical resources available online. Since, then, my message on efficacy has been updated and simplified, but the …

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Binocular Vision – Easier Than You Think (Lecture)

This one hour lecture, delivered to final year QUT optometry students, describes a simplified two-system approach to BV diagnosis and management, with cases, then details easy use of prism correction for vergence disorders; changes to BV in contact lens wear; and why BV matters – for reading and learning in kids, clinical problem solving, and myopia management. By far the …

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Prescribing adds for near esophoria

From a myopia control point of view, esophoria and accommodative lag are the key clinical red flags in assessing your patient’s visual efficiency, and thankfully both will usually respond positively to a near addition. Studies of progressive spectacle lens prescription for myopia control show a link between faster progression and hence better treatment results in children with esophoria and accommodative …

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Assessing near phoria

I describe near heterophoria to my patients as where their eyes aim in space – the posture of their vergence system – and esophoria is our key enemy in the myopia control battle. There is a reported association between higher levels of esophoria and accommodative lag at near in myopic children and young adults as compared to emmetropes.1-5 Studies of progressive …

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