Myopia is an eye health condition parents hear about but may not know what it means when their eye doctor says DUN-DUN-DUUUN …. “Your child needs glasses!”. Very often this is because they are myopic.
Myopia is sometimes referred to as nearsightedness/short-sightedness. It is when objects close-up are clear, while objects far away are blurry.
Both children and adults suffer from myopia (near/short-sighted). However, kids diagnosed with myopia at a young age are at a higher risk for myopia-related diseases beyond just only wearing very thick corrective glasses.
Fortunately, there are new ways we can control myopia in young children. We are learning that we have some control over the development of nearsightedness and may be able to give our children a chance to slow their myopia progression.
Child onset myopia is multifactorial. The eye becomes elongated in kids with myopia as they age, causing objects not to focus clearly on the retina. Research in this area indicates genetics, ethnicity, environment and individual behaviour all play a role in this excess growth.
Meanwhile, studies show that adult-onset myopia usually occurs as an adaptation from eye focusing due to the increasing demands near.
Why Do We Care? Myopia on the rise in Children
It is becoming apparent that more children are developing myopia at an earlier age around the world – in some parts of Asia, 80% of the girls in high school are myopic. The global prevalence of myopia is expected to increase from 27%in 2010 to 52% of the world’s population by 2050.
The World Health Organization, the Canadian Association of Optometry and the American Academy of Ophthalmology all acknowledge that myopia is increasing and that controlling myopia is a significant public health concern. Higher amounts of nearsightedness carry a risk of glaucoma, cataracts, retinal detachments and retinal degenerations for some patients. These same organizations recognize that some treatment options have been shown to slow the progression of myopia in some children.
DID YOU KNOW! The cost of glasses or contact lenses total, over the lifetime of a myopic person, is likely to be in excess of $50,000. Higher myopia reduces the quality of life and is more costly to correct with glasses and contact lenses.
What Is the Cause of Myopia?
Research studying risk factors and causes of myopia show strong evidence that spending more time doing things up close is a risk factor for myopia development. Other risk factors include one’s hereditary, and a person’s ethnicity can increase the risk.
Children as young as two years old have a higher risk of earlier onset myopia since more kids are using devices at a younger age (i.e., iPhones, tablets, and electronic games).
Research suggests a connection between Asian ethnicity and faster progression of myopia, with higher worldwide prevalence in this group of people.
A person with one short-sighted parent has three times the risk of developing myopia – or 6 times the risk if both parents are myopic.
Under or over-corrected vision (incorrect glasses, or having no spectacles when they are needed) has been shown to promote the onset and accelerate the progression of myopia.
How Can We Slow Down Myopia?
We have the POWER. There are evidence-based studies showing methods to prevent the progression of myopia. Catching early signs of vision changes before it fully develops can help slow onset and progression. There is no cure for myopia once it starts. Treatments are designed to prevent progression.
Early detection is key. Routine annual eye examinations should start as early as 5 years old. There is no promise that any specific treatment will work but the lack of early care prevents any potential benefit from starting early.
Children should spend less than 3 hours a day on close work (not including school time), such as reading, homework or screen time. Children and teens spend more time texting, on social media, reading, and gaming. Excessive screen time is linked to myopia, can cause dry eyes, and increase the risk of eye damage.
A proper ergonomic position should be used to reduce eye strain when using a computer and tablets. A good habit to develop is to take breaks every 20 minutes by looking across the room for 20 seconds.
Children with risk factors for myopia can benefit from spending more time outdoors. Outdoor play for at least 90 minutes a day can be beneficial to reduce the onset of myopia (50%), but it does not slow progression. And staring at your tablet or phone when outside doesn’t count! UV protection is still essential so wear sunglasses and a hat.
Some studies have shown that blue-white spectrum light (on tablets, phones, and LEDs) can affect sleep – while no guidelines on how much to limit a child’s overall time spent on screens, devices should be avoided prior to bedtime (suggestions vary but at least 30 minutes before bed).
My Child is Myopic. What Should I Do Next?
Specialty spectacle lenses and contact lenses for myopia control currently offer the best vision correction options to slow myopia progression. Research has shown that specially designed glasses are effective at slowing the progression of myopia as well as contact lenses specifically designed for this purpose. Additionally, low-concentration prescription eye drops have been shown to slow the progression of myopia and their use is gaining popularity.
Myopia Control Clinic at Twenty20 Eyecare
Our mission here at Twenty20 Myopia Control Clinic is to provide the best treatments based on the latest evidence-based research that will help improve vision and control myopia by affecting eye growth and the correction of myopia.
Currently, four treatments have been shown to be effective for myopia control in some children: corneal reshaping (orthokeratology, ortho-K or OK) contact lenses, multifocal contact lenses (MiSight lenses), bifocal eyeglasses or progressive spectacles, corneal reshaping (ortho-K) contact lenses, and low dose Atropine eye drops.
Multifocal Contact Lenses
Multifocal contact lenses can be used to treat myopia. It allows kids to see better at a distance without eye strain. The benefit of these lenses is in the gradient of the prescription level. Multifocal contact lenses are an effective way to control myopia in youngsters. These lenses can reduce myopia progression on average by about 40 percent.
Specialty Myopia Control Spectacle Lenses
Revolutionary spectacle lenses only available in the last few years are the easiest solution to help with myopia control. These lenses are based on ‘Peripheral Defocus’, and with the right fit can provide clear vision and manage myopia simultaneously. Evidence-based studies show a slowing of myopia progression by as much as 60%.
Low Dose Atropine
Atropine is an eye drop that is typically used to enlarge the pupil (black hole in the middle of the eye); it reduces near focus because it alters the eye’s ability to focus while looking at nearby objects. How this medication slows myopia development is still a mystery. At varying concentrations, Atropine has been shown to reduce progression without increasing pupil size or decreasing near vision dramatically at 60%.
Corneal Reshaping Lenses (CR)
CR lenses are synonymous with orthokeratology (ortho-K), Corneal Refractive therapy (CRT) and Vision Shaping Treatment (VST). These lenses are FDA-approved, specifically designed custom rigid gas permeable (RGP) lenses created to alter the shape of the cornea. CR contact lenses are worn while sleeping and not worn during the day. They temporarily change the shape of the cornea so that a person can see clearly all day long without glasses or contact lenses. The effect of treatment is temporary, hence the lenses must be worn nightly to maintain the clarity of vision from treatment.
Corneal reshaping contact lenses have the potential to reduce myopic progression on average by about 41 percent.
