Spring Session Athens - 6 April

Myopia management is a hot topic in children’s vision – we have a huge variety of successful treatment options to choose from in the fight against myopia. But what about the children with binocular vision issues? Sometimes we forget how important good binocular vision is in our school children…it is not always the myopic children we need to look out for. Ocular issues such as eye dominance, muscle imbalances, tracking and visual stress can make learning and reading difficult. Specialist glasses can support these children and help alleviate symptoms throughout their academic journey.

Over the last 10 years, several new technologies and licenced myopia management treatments have been developed and introduced to the optical market which have shown reasonable slowing in myopia. This is timely, given that myopia prevalence continues to rise year upon year, including after the Covid pandemic. More evidence continues to come out for the different treatment options available, including optical interventions, pharmaceutical interventions, and potential new technologies such as light therapies. However despite the progress in the myopia field, there are many aspects still unknown, such as when we should cease myopia treatment, what the best way to evaluate treatment success is, or whether we should consider combing treatments as a first line therapy. In this talk, updates on different technologies will be discussed, alongside current thinking of how to select the best treatment for patients. Contemporary thinking on the uncertain debated topics in myopia management will also be presented.

The myopia boom that we have been experiencing for several years requires us to be able to offer and even if we do not do so, at least inform children and their parents in an objective and professional manner about the different possibilities that exist. We cannot ignore a subject that not only can improve the quality of life for children, but will also represent a real public health issue in the future. Should a child be fitted with contact lenses? What should be done in the event of a significant myopic progression? What are all the existing solutions? What method of wearing contact lenses should be chosen? What special precautions should be taken? What is the ideal age? And what type of communication should be had with children for whom we do not want to take any risks.

Over the last decade, Ortho-k lenses have significantly progressed in design based on better knowledge of the cornea shape. One of these new developments is the ability to better design empirical Ortho-k contact lenses, reducing the chair time and the number of refits. Previous studies showed that many remakes were often necessary. Nowadays we have sophisticated CNC lathing technology machines + reverse curves + topography and softwares . The construction of Ortho-K designs continues to morph as innovators with four to five curves (or zones) attempted to improve fitting characteristics. Ortho-K has increased in popularity for pediatric myopia. More practitioners prescribe overnight Ortho-K as treatment to reduce myopia progression and axial elongation in children instead of standard single- vision correction.

Empirical Ortho-k contact lens fitting based on corneal topography data seems to have several advantages. Reduced chair time and less fatigue of practitioner and patient are two of them. The patients are very satisfy with the speed and the efficiency of the fits and the results. The Orthokeratology lens market is expected to grow in the coming years.

On July 31st 2024, the Lancet Commission published a paper which added sight impairment to the list of risk factors for dementia. Dementia is recognised as a global public health issue. In 2021 it was estimated that 55M people worldwide had a dementia diagnosis with the number predicted to rise to 135M by 2051 (WHO, 2021). It does not only affect the people with the diagnosis but also their families who are often carers in the later stages of the disease. 2/3 of people who live with the condition are living in their communities and we all want to live in our homes as we age, so maintaining independence and daily activities is important. Emerging evidence suggests that having well-corrected vision (and hearing) can improve quality of life and independence for people with dementia. The 2022 World Azheimer’s Report identified that looking after the senses for people living with dementia enables them to be, and do, what matters to them in their daily lives.

This presentation will allow delegates to understand dementia better and develop initiatives to be able to serve patients well. As primary care actors it is important that we are aware of the best ways to manage the eyecare needs of people living with the condition. We should be interested professionally but one day, the information in this talk may be of value personally as well. The chances are that we know someone with dementia - maybe a relative, a friend, a colleague or more probably a patient. The loss in brain function associated with dementia usually happens in later life for a variety of reasons, although it is not classed as age-related. The numbers of people with dementia seeking help in ophthalmic practice, not only for simple refractive error but also for age related ocular pathologies, will increase. Optical professionals can help improve the quality of life of people living with dementia and this presentation will help with initiatives.

Falls are common and are a very serious health risk for older people, being a major cause of accidental death in the elderly. They are not random events and although multi-factorial and linked to a variety of intrinsic and extrinsic factors, poor vision is a significant risk factor. This would suggest a simple solution of providing cataract surgery and new glasses to reduce falls. Unfortunately, it is not that simple and the reasons why will be discussed. Guidance will be given regarding how clinicians can help prevent falls, particularly in relation to the type of spectacle lens and refractive correction prescribed to elderly patients.

The lecture summarises the extent of non-tolerances or “non-tols” (also called rechecks; patients who return to an optical practice because they are dissatisfied with their new spectacles) and their causes. Many non-tols lead to the need to remake the spectacles at no cost to the patient. Evidence will be presented that supports the prescribing of a refractive correction that differs from the subjection refraction result to reduce non-tols. This correction is typically modified based on the difference between the habitual or presenting spectacle correction and the subjective refraction. This evidence includes a review of the validity and variability of subjective refraction, the degree of tolerance to small changes from the subjective refraction and causes of spectacle adaptation difficulties in the elderly. A series of recheck cases from a recent study will be used to demonstrate the problems and illustrate the usefulness of recommended prescribing guidelines.

Sport and exercise should be a fundamental part of our everyday lives. Particularly today, following COVID-19 and with a huge increase in diabetes, vascular disease and myopia globally, Eye Care Professionals should be encouraging their patients to see sport as an essential part of our health and well-being. But, in reality, how many Optical Professionals are regularly factoring this into their patient examination and dispense? Arguably, not enough.

All sporting decisions are made from visual cues and could mean the difference between; a win or a lose, a precise tackle or a penalty, safety or injury. Sports Vision goes far beyond understanding what you can see on a letter chart. It takes an in-depth look into the aspects of your vision that matter most when playing sport, including the speed and accuracy of focus, eye dominance, the stability of your visual system, and peripheral awareness - offering a total view of the efficiency of your vision. The ‘Sports Vision Assessment’ involves a multi-faceted approach of binocular harmony, eye health, psychology and a great relationship between the Ophthalmologist, Optometrist, Dispensing Optician and athlete.

This presentation will address the key elements of a Sports Vision Assessment, including the multiple steps involved when screening a team and translating this into a written team report. This presentation will draw on and discuss an array of case studies involving elite athletes as well as an understanding of how to help the “normal patient” - bringing Sports Vision to your practice.