Patient informed consent for surgery or for high-risk methods of treatment or diagnosis means that unlawful breach of the patient’s personal interests is avoided and the patient accepts the risk of surgery and takes the brunt of it. Patient awareness – their knowledge of the condition and circumstances of continued therapeutic procedure, including offered and available methods of treatment and their possible complications – constitutes a particular aspect of the informed-consent process.

Myopia is a global problem affecting all aspects of patients’ lives. Objectives: The aim of the study was to evaluate the influence of low dose atropine (LDA) myopia control on the quality of life in patients with myopia. Material and Methods: A self-constructed questionnaire, including eight questions, was distributed among 40 patients. The questionnaire was divided into two subsections: (1) influence of LDA on visual functions and (2) influence of LDA on self-esteem. Answers were collected separately for boys (18 patients) and girls (22 patients) and compared considering spherical equivalent (SE) and myopia progression rate. Results: Girls reported more issues with near activities and pupil size. Boys and girls complained similarly, regarding the sun glare. We found a high level of certainty about the efficacy of LDA therapy among both examined groups and a little improvement in self-esteem. Girls recommended LDA therapy more often than boys, especially when the progression rate was low. There was no statistically significant difference in answer scores between groups with different myopia progression rates for boys. Girls with lower progression rates reported more issues with near work and sun glare and less trust in LDA therapy’s effectiveness than girls with a higher progression rate. There was no statistically significant correlation between SE and the total answer score for both genders. Conclusions: Findings concerning childrens’ and adolescents’ psyche are a new aspect of myopia control. We prove that patients during pharmacological myopia control did not report significant problems caused by LDA therapy and they were convinced about its efficacy, had greater self-esteem, and recommended it to peers.

Objectives: This study aimed to investigate the influence of soft multifocal contact lenses with high additions designed for myopia control on binocular vision in young adults. Methods: A prospective randomized, double-blind study including 24 subjects aged between 18 and 36 years. Subjects were divided into two groups. The first group wore multifocal soft contact lenses (MFSCLs) with a 3.0 mm central zone diameter, while the second group wore contact lenses with 4.5 mm central zones. Each subject was fitted with two MFSCLs: one with +2.00 D and the other with +4.00 D peripheral addition power and, additionally, with plano single vision contact lenses (SVCLs). Phoria at a distance and near, distance and near vergence ranges, vergence facility at near, stereopsis at near, and fixation disparity at near were measured in each study lens type.Results: No significant influence of addition on distance phoria was found in either group (p = 0.446 and p = 0.317, for 3 mm and 4.5 mm central zone diameter, respectively). Additionally, no significant difference was observed for any MFSCLs and SVCLs in near phoria (p = 0.320), near vergence facility (p = 0.197), or near fixation disparity (p = 0.203). A decline in fusional vergence ranges at a distance in the base-out direction was noted in subjects wearing +4.00 D addition compared to +2.00 D addition (p = 0.002) and plano lenses (p = 0.014). Both additions reduced fusional vergence ranges at near the base out (p = 0.020) and shifted vergence ranges more in the exophoria base in directions (p = 0.014). Conclusions: The study showed that MFSCLs with high additional power in the periphery have only a marginal impact on the binocular functions.

BACKGROUND: The aim of this case report is to present the successful management of both diplopia and amblyopia in a specific clinical situation, demonstrating neuroplasticity of the visual system in an adult patient. Causes of diplopia include eye pathologies in monocular diplopia and ischemic ocular motor nerve palsies, sudden life-threatening and chronic conditions in central nervous system in binocular diplopia. Strabismic amblyopia and nonarteritic anterior ischemic optic neuropathy are quite often ophthalmic conditions, first one is caused by suppression during developmental period and the latter one by ischemia of the optic nerve in adults. Coexistence of aforementioned conditions may cause unusual clinical situation in which ability of nervous system to functional reorganization could be demonstrated. CASE PRESENTATION: In our adult patient, diplopia was incited by the loss of suppression of the strabismic amblyopic eye, which was the consequence of a sudden decrease of the visual acuity in the previously better eye in the course of nonarteritic anterior ischemic optic neuropathy. This led to impairment in daily activities. RESULTS: Visual training rehabilitation improved distance and near visual acuity in the amblyopic eye over three months, and prescribing two pairs of glasses with prisms enabled the patient to return to daily activities. CONCLUSION: The discussed patient lost the suppression of the strabismic amblyopic eye. Management of amblyopia is usually undertaken in children, however considering neuroplasticity we successfully attempted to improve visual functioning of our patient, despite lower intensity of neuroplasticity functions in an adult brain.