Kids, contact lenses, dry eye and binocular vision

Kids and dry eye Only a minimal percentage of children are likely to suffer dry eye symptoms (4%) compared to 56% in adult contact lens wearers.(1) Teens may be more likely to report contact lens related dry eye than younger children,(2) and consideration should be given to any systemic medications which could exacerbate dry eye symptoms, such as acne medications …

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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. Oliver’s story Oliver, age 10, was referred with a history of fast, recent myopia progression. His mother was R&L -7.00 and he was …

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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. Looking away from the optical centre of the lens (while keeping the vertex distance constant) also reduces …

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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 …

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Latest research: International Myopia Conference 2017, Part 1

The sixteenth, biennial International Myopia Conference (IMC) brought together over 350 myopia researchers from more than a dozen countries to drizzly, chilly Birmingham in September 2017, where the latest research was presented in 45 lectures and more than 150 scientific posters over four days. The session topics covered prevalence, progression and risk factors of myopia, mechanisms such as light exposure …

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Latest research: International Myopia Conference 2017, Part 2

More of the latest from the sixteenth biennial International Myopia Conference (IMC) is below – read here for Part 1. Three more fascinating areas and/or pieces of research presented at IMC, and some bonus material, are below. A more detailed write up, published in Australian industry journal Mivision, can be accessed from the link, which includes relevant references. IMC #4 – …

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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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