Myopia Management

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Why Is Myopia Management Important?

Dr. Russel Lazarus, April 23, 2020

While myopia is common vision problem that makes eyewear a new necessity, it can also cause serious eye diseases later in life.

Myopia occurs when the light entering the eye is focused in front of the retina, rather than directly on the retina. Myopia develops when the eye grows too long from front to back (axial length), and generally worsens over time until the eye is fully developed— usually around the age of 20.

While distance-only glasses and contact lenses are the traditional method of vision correction for myopia, these lenses focus light in a way that can actually increase the axial length of the eye— ultimately causing myopia to worsen.

A child with myopia has an increased risk for developing vision threatening eye diseases in the future, such as:

Is there a way to prevent my child’s myopia from worsening?

A number of recent studies suggest that it may be possible to control myopia by totally stopping, or at least slowing down, its progression during childhood and teenage years.

Myopia management is a treatment program aimed at controlling myopia, keeping the level of myopia as low as possible, in order to reduce your child’s risk of developing vision threatening eye diseases later in life.

Myopia management has shown to decrease myopia progression by up to 78 percent.

Myopia management can involve the use of eyeglasses, contact lens and eye drops — all scientifically proven to aid in the control of myopia progression. Schedule your appointment today to manage your child’s myopia.

A closer look at myopia management

Eyeglasses

Eyeglasses are a popular choice for children with myopia, as they enable vision acuity for distant images. Many times, reduced focusing skills can contribute to the development of myopia— these children may need a bifocal or multifocal lens to support the child’s focusing skills.  Bifocal and multifocal lenses contain different lens powers throughout the lens, and enable clear vision at all distances. The specific power for the child’s near vision reduces the stress on the eyes, and possibly the progression of myopia.

Contact lenses

Contact lenses provide clear vision at all distances, with a wider field of view as compared to eyeglasses. A multifocal contact lens works similar to eyeglasses to improve distance vision acuity while simultaneously reducing the stress on the eyes for reading and other near vision tasks. This can consequently reduce myopia progression.

Atropine eye drops

These medicated eye drops can be used to dilate the eye’s pupils during an eye exam, but have also been proven to reduce myopia progression. A very low dose of this eye drop is placed in the child’s lower eyelid every day.

This method is effective for children between the ages of 8 and 15, it only requires a single drop into the child’s eye once per day. Side effects may include blurry near vision or light sensitivity. Children will still need to wear their regular glasses or contacts during the day, but the eye drops can assist in slowing down the worsening myopia.

Orthokeratology (Ortho-k)/ Corneal refractive therapy (CRT)

Ortho-k reduces myopia progression through the use of specialized rigid contact lenses that reshape the cornea, the front outer surface of the eye. The contacts work to flatten the cornea, thereby changing the way light is focused on the retina at the back of the eye.

The contact lenses are inserted before bedtime, and are generally only worn while your child sleeps. Ortho-k provides clear vision for the whole day, thereby eliminating the need for wearing glasses or contacts during the day.

Ortho-k has been proven to reduce the rate of myopia progression in children by up to 50 percent.

Can vision therapy control myopia progression?

Vision therapy is an appropriate and effective treatment for children who have acquired myopia as a result of reduced eye focusing skills. Vision therapy involves a personalized program that trains the child’s visual system, including the eye-brain connection, to work more efficiently— thereby improving focusing abilities. Children who have reduced focusing skills, have a greater risk of developing progressive myopia.

When should my child start myopia management?

It is best to begin Myopia management as soon as possible to increase optimal results. Myopia generally worsens through the teenage years, and stabilizes as the child reaches adulthood, so these years are the optimal time to seek Myopia management options for your child.

There are now excellent myopia management options to help your child. Schedule your appointment today to explore which myopia management treatment option is most effective for your child.

Q1: What is myopia?

A: Myopia is a refractive error, or a vision condition that affects the ability to see distant images or objects clearly. Your eye doctor may refer to myopia as nearsightedness or shortsightedness.

According to the American Optometric Association, nearly 30 percent of the U.S. population, including both children and adults, suffer from myopia.

Q2: What are the signs and symptoms of myopia?

A: If your child is experiencing any of the following signs of myopia, schedule an eye exam with your eye doctor to determine if your child has a refractive error.

  • Squinting when reading the board or watching TV
  • Sitting at close proximity to the TV or computer screen
  • Sitting at the front of the classroom to clearly see the teacher and board
  • Holding books close to the eyes
  • Disinterest in playing sports that require clear distance vision
  • Reduced clarity of vision, as compared to friends and family

Q3: What causes myopia?

A: Myopia occurs when light enters the eye and focuses in front of the retina, rather than directly, on the retina. When the length of the eye is longer than normal, this particular shape causes the light to refract differently.

Myopia typically develops in childhood and worsens as the eyes continue to grow— as the eyes grow, so does their axial length. You may find that your child’s optical prescription worsens through their teenage years, and eventually reaches a plateau when the eye stops growing, typical around the age of 20.

Q4: Is myopia dangerous?

A: While myopia is not a dangerous vision condition, it does increase your child’s risk for developing serious, vision threatening eye diseases later in life.

In about 10 percent of people with myopia, the condition worsens in severity— and as myopia gets worse, your child’s risk of eye disease increases.

Eye diseases associated with high myopia include:

If your child has worsening myopia, schedule your appointment today to discuss the eye health benefits of myopia management.

Q5: How can I prevent my child’s myopia from worsening?

A: Recent studies suggest that it may be possible to control myopia progression, before it gets worse— to protect children from high risks of eye diseases associated with high myopia.

Myopia management is a treatment program prescribed by eye doctors, to completely stop, or at least slow down myopia progression.

Many eye doctors believe that commonly prescribed single-vision glasses and contact lenses may actually contribute to myopia progression.

Studies show that although distance-only glasses and contact lenses improve distance vision clarity, they focus light onto the retina in a way that can actually increase the axial length of the eye. Therefore, myopia management techniques move away from single-vision lenses, and include different methods of myopia correction.

Q6: What is involved in myopia management?

A: Depending on the age and severity of your child’s myopia, your eye doctor may prescribe any of the following management techniques:

Eyeglasses

Eyeglasses are one of the most popular choices for younger children. For many children with myopia, a further diagnosis of reduced focusing skills, which make it difficult for their eyes to work together as a team, can cause myopia to progress and worsen.

For these children, corrective lenses that contain more than one optical prescription, such as a bifocal or multifocal will be prescribed to support their focusing skills.

The optical power for near vision tasks reduces the stress on the eyes and the progression of myopia.

Bifocal lenses contain two optical powers. The top segment of the lens is used for distance vision, while the bottom segment is used for near-point tasks.

Multifocal lenses contain different lens powers throughout the lens, for distance, intermediate, and near vision tasks.

Contact lenses

Contact lenses are preferred by older children and adults with myopia, as they are more comfortable for sports and contribute to improved self-confidence in social gatherings. Contact lenses also provide a wider field of view as compared to eyeglasses.

Multifocal contact lenses are similar to multifocal eyeglasses, improving distance vision acuity while simultaneously reducing the stress on the eyes for reading and other near vision tasks.

Atropine eye drops

Studies show that a daily, low dose of these medicated eye drops can reduce myopia progression and prevent your child’s prescription from climbing higher and higher. This method is most effective for children between the ages of 8 and 15. While these drops can assist in slowing down myopia progression, they are not used to correct myopia— so your child will still need to wear their eyeglasses or contact lenses regularly.

Caution: Side effects of atropine eye drops may include blurry near vision or light sensitivity. Speak to your eye doctor if side effects are affecting your child’s daily routine.

Orthokeratology (Ortho-k)

Ortho-k has been proven to reduce the rate of myopia progression in children by up to 50 percent.

This method involves the use of specialized rigid contact lenses worn at night, while your child sleeps. These contact lenses flatten the cornea, the front outer surface of the eye, to improve the way light is focused onto the retina.

Ortho-k provides clear vision for the whole day, without the need for glasses or contacts.

Q7: How effective is myopia management?

A: Myopia management has shown to reduce myopia progression by up to 78 percent.

Q8: Can vision therapy control myopia progression?

A: Vision therapy is effective in treating reduced focusing skills that may be contributing to worsening myopia.

Vision therapy involves a personalized program aimed at training the visual system, including the eye-brain connection, to work more efficiently. By improving your child’s focusing skills, you are decreasing their risk of myopia progression.

Q9: When should my child start myopia management?

A: Myopia generally worsens through the teenage years, until it stabilizes as the child reaches adulthood. Therefore, for optimal results, it is best to begin myopia management in the teenage years or as soon as possible.

If your child has been diagnosed with myopia, or their myopia is getting worse each year, speak to your eye doctor about a myopia management plan.

Based on your child’s age and optical prescription, your eye doctor will determine which myopia management method will be most effective for your child.

Over 2.6 billion people worldwide have myopia. 

Can spending time outdoors reduce myopia progression?

With the prevalence of myopia (nearsightedness) on the rise, it’s critical for parents to understand how myopia can affect their child’s future and what steps they can take to safeguard their child’s eye health in the long run, with Myopia Management. 

Childhood myopia or nearsightedness, raises the risk of major eye sight-threatening diseases such as glaucoma, macular degeneration, and retinal detachment later in life.

What causes myopia?

Myopia results when the eye is longer than it should be, so the light entering the eye focuses in front of the retina rather than directly on it, creating blurry vision.

Myopia is caused by a mix of hereditary and environmental factors.

According to several research studies, the amount of time a child spends outside in the daylight plays a significant role in the development of myopia. 

How does outdoor play affect myopia?

Although researchers have yet to identify precisely why ‘outdoor time’ prevents or delays myopia, several studies have shown that outdoor time can prevent or lower the chance of developing myopia.

1. Sunlight

One likely reason is the exposure to rays of sunlight.

According to research published in Progress in Retinal and Eye Research (2017), the sun’s rays cause a release of dopamine which impacts the retina and may slow the elongation of the eye.

2. Relaxed eyes

Another theory is that spending time outside allows a child’s sight to move from nearby items to distant ones.

This constant changing of focus allows the eyes to relax.

Excessive near focus, such as staring at a digital screen, is thought to be a major contributor to the current rise in myopia.

Sending a child outside to play allows them to take a break from their smartphones, tablets, gaming, homework and other near focus activities.

3. Vitamin D

Furthermore, more time spent in the sun allows for greater Vitamin-D production. According to research published by Investigative Ophthalmology & Visual Science (2014), nearsighted people have lower levels of Vitamin-D than those with normal eyesight. However, more research is still needed to provide more information.

If you suspect your child has myopia, schedule your appointment today to find out whether your child is a candidate for myopia management.

What can you do as a parent?

Children with myopia are more likely to acquire sight-threatening eye problems later in life.

Parents should take an active role in their child’s eye health and do everything they can to avoid or limit the progression of myopia.

Allowing your child to play outside for a couple of hours a day, even if they don’t have myopia, has been shown to delay the onset of myopia, according to several research studies.

Genetics also plays a role: nearsightedness is more likely to develop in a child if one or both parents are nearsighted.

So, grab a water bottle, some sunscreen, and a pair of sunglasses for your child and send them outside to play!

Children ages 6 and up should spend approximately 2 hours every day outside in the sunshine.

However, simply spending time in the sun is insufficient to secure the best potential outcome for their eye health. A myopia management program can help your child have the best chance of having healthy vision for the rest of their life.

What is myopia management?

Myopia management is a science-based approach to decreasing or stopping the myopia from worsening.

A study published by Diseases (2018), myopia management has been shown to decrease myopia progression by up to 78 percent.

There are various treatment options, and your optometrist will sit down with you and your child to discuss which one is best.

Myopia management has been approved for children as young as 8 years old to adults. Myopia treatment is beneficial for children with low myopia, but it can also help to delay the progression of myopia in children and teenagers with moderate to severe myopia.

Myopia management can involve the use of eyeglasses, contact lenses, and eye drops— all scientifically proven to help control myopia progression.

Schedule your appointment today to find out whether your child is a candidate for myopia management.

Dr. Russel Lazarus, July 13, 2020 optometrist.org