Explaining progressive myopia and myopia control to a family — OSCE

Candidate instructions (8-minute station)

You are the paediatric registrar in clinic. An 8-year-old girl has six months of squinting at the board and worsening distance vision. Both her parents wear glasses for short-sightedness, and she spends most of the day on screens with little outdoor time. Her distance vision improves to normal with a pinhole. The family has read about "atropine drops to stop myopia" and asks whether she should start them today. ^[1]

Your tasks are: ^[10]

1. Explain the likely diagnosis — myopia — in plain language, and why both parents being short-sighted and the screen time fit the picture. ^[1]
2. Explain why a cycloplegic refraction comes before the final prescription, and what that test involves. ^[10]
3. Outline the treatment — spectacles for clear distance vision, plus myopia control built on outdoor time and reduced near work, with low-dose atropine, orthokeratology or defocus lenses as options — and explain why deliberately under-correcting the glasses is not advised. ^[12]
4. Address the atropine question honestly — what the LAMP trial showed about 0.05 percent being the most effective of the low doses — and name the red flags that would bring her back sooner. ^[4]

You are not expected to start atropine in this station — the cycloplegic refraction and the shared decision with the family and ophthalmology come first. ^[5]