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 and those taken for anxiety and depression.
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.
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.
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.
We’re excited to release our new clear, concise and clinically relevant infographic Which option to slow myopia?to help you with what we have learnt is the main practitioner need in myopia management, and the most popular discussion topic in the Myopia Profile Facebook group – guidance in selecting the right treatment for your patient. A world first, evidence based decision making tool.
Most eye care practitioners don’t routinely measure axial length in clinical practice, mainly due to lack of access to the instrumentation and its expense. This is not the only reason, though, that axial length (AXL) measurement is a bit of a problematic measure for gauging myopia management success in a clinical setting.
This article groups common clinical treatments in an effort to explore what we do and don’t know regarding myopia control efficacy. It highlights the need to balance the available evidence with emerging knowledge when discussing options for myopia control with patients and their carers.
When selecting an optical treatment for myopia management, contact lens options appear to be the most consistent, with OrthoK and multifocal soft contact lenses offering around a 50% efficacy for controlling refractive and axial change in myopia.1 And it’s not just the important benefit of modifying lifelong risk of vision impairment through successful myopia control which should be top of mind – contact lens wear for myopic children can offer significant immediate benefits to their self-perception and satisfaction with vision correction.
A key barrier to contact lens wear in children is parental and practitioner concern about safety. The research indicates, though, that children may be the safest contact lens wearers – here we describe the statistics and how to approach clinical communication.
Let’s cut to the chase – until further notice, you can consider low dose (0.05%) 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 axial length outcomes were put on a level playing field.
