What is Myopia?
Myopia is blurry long-distance vision, often called ‘near-sightedness’. A person with myopia can typically see clearly up close – when reading a book or looking at a laptop screen – but words and objects look fuzzy on a whiteboard, on television, across the room, when looking outdoors or when driving. Most myopia is caused by the eye length growing too quickly in childhood. The eyes are meant to grow from birth until the early teens and then cease, but in myopia the eyes grow too much and/or continue growing into the teenage years. Once a child becomes myopic, their vision typically deteriorates every 6-12 months, requiring a stronger and stronger prescription. Most myopic children tend to stabilize by the late teens and early 20s.
Why is myopia a concern?
Myopia is more than just blurred distance vision but is also an ocular health condition that can lead to irreversible damage to the eye. The rate of myopia is growing across the world, increasing from 22% of the world’s population in 2000 to 33% in 2020 – half of the world’s population is expected to be myopic by 2050. Excessive eye growth raises concern because even small amounts of stretching can lead to an increased likelihood of vision-threatening eye diseases in later life, such as macular disease, retinal detachment, glaucoma, and cataracts. This risk increases with each increase in myopia.
What causes Myopia Progression?
Genetics plays a large role in a child both becoming myopic and the progression of myopia. Additional factors such as your child’s current visual clarity and eye-teaming ability can increase the risk of progression. Environmental factors such as decreased time spent outdoors and increased time performing near-vision tasks (such as reading, video games, screen time, and homework) have been shown to play a large role in increased myopia.
Why Myopia Control?
Myopia Control is the term describing the treatment methods used to slow down the progression of myopia and reduce the risk of related eye disease. Our eye care physicians are professionally trained in these treatment methods and are encouraged by the results as more and more studies show the benefits, efficacy and safety of myopia control treatments.
Myopia progresses fastest in younger children, especially those under age 10. This means that the most important opportunity to slow eye growth is when children are younger. Myopia management aims to apply specific treatments to slow excessive eye growth to a lesser rate.
The short-term benefit of slowing myopia progression is that a child’s prescription will change less quickly, giving them clearer vision for longer between eye examinations. The long-term benefit is reducing the lifetime risk of eye disease and vision impairment. For example, reducing the final level of myopia by only 1 diopter reduces the lifetime risk of myopic macular degeneration by 40% and the risk of vision impairment by 20%.
Why haven’t I heard of myopia control before?
Just like many areas in the medical field, our knowledge about myopia and its long-term effects is constantly expanding. Only in recent years have experts recognized the rapid rate of myopia progression worldwide which has triggered a large increase in clinical studies to find solutions to combat the worrisome trend. Long-term studies demonstrating the safety and efficacy of myopia control treatments have led to the first FDA approval for myopia control treatment in 2019 with many more treatments within the approval process.
Myopia Control Treatment Options
The best option for your child will depend on their current prescription and other vision and eye health factors determined during your myopia control consultation. Treatment options vary across the world due to availability, supply and regulatory reasons. It is important to note that no treatment can promise the ability to stop myopia progression in children, only to slow it down.
Glasses
Standard single-focus spectacles do not slow the worsening of childhood myopia but specific designs do. Myopia controlling spectacles can both correct the blurred vision of myopia and work to slow down myopia progression. They are safe to wear and adaptation is typically easy, with the only side effects being related to the limitations spectacles pose for sport and active lifestyles. Options currently available in the US include bifocal or progressive glasses and have a lower ability to slow down myopia progression then contact lenses or eye drops
Contact lenses
Standard single-focus contact lenses do not slow the worsening of childhood myopia but specific designs do. These specific designs can both correct the blurred vision of myopia and work to slow down myopia progression. The options include soft myopia controlling contact lenses and orthokeratology.
Orthokeratology contact lenses are worn overnight and removed upon waking, such that no spectacles or contact lenses are required for clear vision during the day. They can require more appointments for fitting than other types of myopia control treatment. Adaptation to the lens-on-eye feeling can take 1-2 weeks but shouldn’t affect sleep. There are significant benefits for water sports and active lifestyles, and since the contact lenses are only worn at home there is low risk of them being lost or broken during wear.
Soft myopia controlling contact lenses are worn during waking hours. They may be daily disposable, or reusable for up to a month. They typically require more appointments for fitting than spectacles but less than orthokeratology. Adaptation to the lens-on-eye feeling typically occurs in a few days. There are benefits in safety with daily disposables being the safest modality, and the number of lenses retained meaning loss or breakage is less of a practical issue.
Atropine eye drops
Atropine eye drops in strong concentrations (typically 0.5% to 1%) are used to temporarily dilate the pupil of the eye and stop the focussing muscles working in a variety of clinical applications. Atropine eye drops for myopia control, though, are a low-concentration (0.01% to 0.05%) with much fewer such side effects. Spectacles or contact lenses are still needed to correct the blurred vision from myopia, as atropine only acts to slow myopia progression.
Atropine eye drops are typically used at night-time, before sleep, so are only utilized in the home environment. They are also ideal if the effective spectacle or contact lens options for myopia control are not suitable or not available for your child or can be used in conjunction with contact lens options to enhance myopia progression treatments.
What is Myopia?
Myopia, or near sightedness, is a common condition that affects your distance vision
Symptoms of Myopia
Distant objects look blurry
Headaches
Squinting
Eyestrain
Additional symptoms to watch for in children
Poor performance in school
Shortened attention span
Holding objects close to face
Risk factors of Myopia?
Family history
Spending a lot of time looking at screens/smartphones etc
Spending a lot of time doing close up work like reading, needlework, etc
Myopia is diagnosed by your eye doctor during your routine eye exam, and is treated with glasses, contact lenses or surgery.
When diagnosed before the age of 20 there are additional options that can slow the progression of myopia.
Ask us which option is right for your child.
Treatment Options for Children
Ortho K lenses
worn at night to temporarily reshape the eye (think dental retainer)
Atropine drops
used at night to slow the progression of myopia
MiSight
daily disposable contact lenses designed to slow
the progression of myopia
