MYOPIA MANAGEMENT
Learn about myopia management with our expert Dr. Sydney Lin
Learn more about myopia and treatment options from the American Academy of Ophthalmology
What is Myopia?
Myopia, also known as nearsightedness, causes poor long-distance vision when uncorrected. In myopic eyes, the eyeball is either longer than normal, or the cornea is too curved. The result is that images at variable distances appear blurry. Both genetics and environmental factors play a role, however the significant increase in the number of myopic people in recent years is attributed to environmental risk factors. On average, 30% of the world is currently myopic and based on current trends, it is estimated that by 2050, almost 50% will be myopic. That’s a staggering 5 billion people! Studies from across the world have indicated that less time outdoors and longer time on near based activities (for example reading or screen time) could play a role in the development of myopia.
What is it like to have myopia?
Click the link to see through your child's eyes: Myopia Simulator
Why do we want to slow or halt the progression of myopia?
High myopia is associated with potentially blinding complications such as glaucoma, retinal detachment, cataracts, and myopic macular degeneration. An analysis of several papers allows us to explain the increased risk of the development of specific eye diseases based on the severity of increasing myopia. (see table below)
What can be done to treat myopia?
Although corrective lenses (spectacles and contact lenses) are the traditional way to treat myopia, they do not help stop the progression of myopia. Recent research indicates that traditional corrective lenses may, in fact, make myopia worse. The intent of myopia management is to stop lengthening of the eyeball to reduce the risk of ocular complications.
MYOPIA MANAGEMENT
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What can we do to slow the progression of myopia?
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Prescription Atropine Eye Drops
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Overnight Ortho-keratology Contact Lenses
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Peripheral Defocus Daytime Contact Lenses
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Increase time outdoors
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Limit screen time
Prescription Atropine Eye Drops
Atropine is an eye drop that typically makes light seem brighter because it makes the pupil (black hole in the middle of the eye) bigger, and blurs near vision because it reduces the ability of the eyes to focus while looking near. Low concentration (0.01% to 0.1%) atropine has been shown to significantly slow the progression of nearsightedness without increasing pupil size or decreasing near vision dramatically. In a recent large study, only a very small percentage of children complained of problems with low concentration atropine, and glasses can reduce symptoms if your child notices poor reading vision or lights seem too bright.
Overnight Ortho-keratology Contact Lenses
Corneal reshaping contact lenses are worn during sleep and removed in the morning. They temporarily change the shape of the cornea, so that the wearer can see clearly all day long without glasses or contact lenses. During the first two weeks of overnight lens wear, your child will experience changing vision. When the vision gets worse, s/he may put on glasses to provide clear vision. Although the chance of an eye infection is still very low (about one case per 500 years of wear), it is greater for corneal reshaping contact lenses than usual daytime contact lens wear because the contact lens is worn overnight.
Peripheral Defocus Daytime Contact Lenses
Soft multifocal contact lenses are worn in the daytime and provide clear distance vision with simultaneous peripheral defocus. Children may not see quite as clearly with these contact lenses as other types of contact lenses, but there are no additional risks compared to regular daily contact lenses.
Combined Management
Currently, many patients are electing to utilize combined treatment options. Studies are currently underway studying the efficacy of combined treatments of peripheral defocus daytime contact lenses and atropine. Studies on the combined treatment of orthokeratology and atropine eye drops showed that combination therapy may be effective for slowing axial length elongation.
