Week 2.06 Children CLs

Question 1

Most important factors when considering CL fitting

Answer 1

• Child’s interest and motivation to wear lenses
• Maturity level
• Childs ability to take care of CL by him/herself
• Personal hygiene habits
• Impact on self esteem
• Rx requirement
• Sport
• Age
• Parental interest in child having CLs
• Parental experience with CLs
• Cost of CLs
• Frequent spectacle lens damage
• Frequent frame loss/damage
• Gender

Question 2

Reasons for not fitting children

Answer 2

Takes up more chair time during fitting
15 minutes longer chair time compared to adults/teens
Most likely drop out? Cost, too difficult
Risk of MK

Question 3

What diseases are associated with myopia

Answer 3

• retinal tears and detachments common
• maculopathy
• AMD
• glaucoma
• refractive correction
• could be considered to be costly

Question 4

What is the light dopamine theory

Answer 4

Light releases dopamine in the retina that stops it growing. Not enough light = retina doesn’t know when to stop growing

• Use of atropine changes the dopamine levels neurologically in retina
• Atropine targets receptors that cause cascade of biological mechanisms that end in axial elongation
• Acts as competitive inhibitor for receptors (not just to open up the pupil for more light)
• Work even on very low dosage: 0.00001%
• However isn’t perfect:
  o Side effects with atropine, even at low dosages
• Accomodation
• Pupil size
• Systemic toxicity
  o Rebound effect at work – when stop using it you get even worse
  o Low dosage doesn’t reduce AL
  o Not available to optometrists

Question 5

What is hyperopic defocus theory

Answer 5

Explains why myopia continues to increase despite correction

If light focuses behind the retina the eye intercepts this as a signal that it is too short and needs to elongate. This can be centrally or peripheral

Question 6

Soft MFs for myopia control

Answer 6

• Soft multifocal lenses have also been shown to reduce myopia due to their concentric ring profile
  o Creates a ring of myopic defocus at periphery
  o Used off license

Question 7

Misight

Answer 7

• Coopervision to target those developing myopia
• Profile not too different from other MF CL designs – has a distance correction in centre, ring of near +2 power, ring of distance and then ring of near (amount of plus u put in the periphery matters – higher add more effective)
• Results appear promising
  o 59% reduction in myopia progression in 2 years
  o Results appeared more promising in the initial year