Myopia control
Myopia Control
As a parent, your child’s well-being is most important. If your child is diagnosed with myopia, what can you do to prevent your child's sight from worsening?
With the correct treatment, you can reduce myopic progression in your child; it can be as easy as wearing glasses or contact lenses.
Recent studies, research and development have led to the development of specialized glasses lenses and specialized contact lenses aimed at slowing the progression of myopia.
What is Myopia?
Myopia affects nearly 30% of all Canadians, and it’s likely to worsen. Many estimate 50% of the world will have myopia by 2050. Myopia causes far-away objects to look blurry while nearby objects appear clear. Myopia (or nearsightedness) is very common. With myopia, the eyeball is longer than normal, or the cornea has a steep curvature. This in turn causes light entering to focus in front of the retina instead of on the retina causing blurry vision. Myopia causes objects that are far away to appear blurry.
Myopia Correction
Myopia is usually corrected with eyeglasses, contact lenses and laser eye surgery in come cases. More severe forms of myopia can increase your chances of having some eye diseases, such as: cataract, glaucoma and retinal detachment.
Causes of Myopia
There can be other factors contributing to your child's myopia as well, such as:
- Family history
- Increased time in front of screens
- Reduced time spent outdoors.
Studies show myopia is becoming more common among children. Research has shown that children who spend more time indoors doing near-focused activities (such as computer work, video games, and reading) have higher rates of myopia than those who spend more time outdoors.
What is Myopia Control?
Myopia control refers to the use of various techniques to slow down or prevent the progression of myopia, also known as nearsightedness. Myopia is a common eye condition that causes distant objects to appear blurry, while close-up objects remain clear. It occurs when the eye is elongated, causing light to focus in front of the retina instead of directly on it.
The prevalence of myopia has been increasing in recent years, particularly in urban areas and among young people. This has led to a growing interest in myopia control strategies to reduce the risk of complications associated with high myopia, such as retinal detachment, glaucoma, and myopic macular degeneration.
Some common myopia control techniques include:
- Orthokeratology (Ortho-K): This is a type of contact lens that is worn at night while you sleep. The lenses gently reshape the cornea so that you can see clearly during the day without wearing glasses or contact lenses.
- Multifocal contact lenses: These contact lenses have different prescription powers in different parts of the lens, which can help to slow down the progression of myopia.
- Atropine eye drops: Atropine is a medication that is typically used to dilate the pupils during eye exams. In lower doses, it has been found to be effective in slowing down the progression of myopia in children.
- Behavioral modifications: Spending more time outdoors, reducing near work activities (such as reading and using electronic devices), and taking frequent breaks from near work activities can also help to slow down the progression of myopia.
- Glasses: Specialized glasses lenses have also been developed to help control myopia progression in children, known as “Myopia Control Lenses”.
It's important to note that myopia control techniques may not be effective for everyone and that the best approach will depend on the individual case. It's important to consult with an eye care professional to determine the most appropriate myopia control strategy for you or your child.
The eye doctors at North York Eye Clinic will also talk to you about your child’s visual environment, how much time is spent on screens and reading, and how much time they spend outdoors. Myopia cannot be reversed. The goal of myopia control treatment is to use methods to prevent the myopia from getting worse. This can protect a child’s eye health in the future, despite still needing to wear glasses or contact lenses.
What is Myopic Progression?
Myopia typically develops in childhood and progresses until early adulthood. Children’s eyes grow as they do, and this growth can cause a mild case of myopia to develop into high myopia. High myopia is more severe, occurring when a person’s vision is above -6.00 diopters. When myopia is severe, you’re at an increased risk of several eye conditions, including:
Myopia progression can be slowed or reduced with specialized treatments, protecting your child’s vision. Single vision eyeglasses alone cannot slow down myopia progression. Myopia control focuses on preventing abnormal eyeball growth, causing vision to worsen. There are several ways to treat myopic progression.
MYOPIA CONTROL OPTIONS
There are four widely accepted myopia control options:
1) Orthokeratology
2) Atropine Eye Drops
3) Contact Lenses such as MiSight
4) Specialized glasses lenses such as: Hoya (MiyoSmart ), Essilor (Stellest ) and Zeiss (MyoVision)
The eye doctors at North York Eye Clinic will consider factors such as the patient's age, prescription, hobbies and need. Sometimes the methods may be combined for maximum impact.
Please be warned that false misleading information that suggest "undercorrection", may actually lead to the increase in myopia.
Myopia control
1.) Orthokeratology (Ortho-K)
Orthokeratology is a contact lens that a child wears overnight to correct blurry distance vision during the day. This is a type of contact lens that is worn at night while you sleep. The lenses gently reshape the cornea so that you can see clearly during the day without wearing glasses or contact lenses. Once you stop wearing the lenses, the cornea slowly goes back to its normal shape and myopia and blurry distance vision will return. Ortho-K may provide some permanent reduction in myopia progression. These lenses are custom made for each individual and are also more difficult to fit compared to regular contacts lenses, and more follow-up visits to the doctor are needed.
2.) Low Dose Atropine Eye Drops
Atropine is a medication that is typically used to dilate the pupils during eye exams. Low-dose atropine for myopia is used for children between 5 and 18 years old to slow down the progression of myopia. The drops are placed in each eye each night at bedtime. Side effects of atropine drops at low doses may include redness, stinging and light sensitivity of the eyes. Atropine is a very simple, yet effective method of myopia control.
3.) Peripheral Defocus Contact Lenses
Soft contact lenses can be used for myopia control using a technique called multifocal contact lenses. These lenses are designed with different powers in different zones of the lens, so that they correct for both distance and near vision. The idea behind multifocal contact lenses for myopia control is that the eye will be exposed to different levels of defocus, which may help to slow down the progression of myopia. The center of the lens, or “bull’s-eye,” corrects blurry distance vision, while the outer portions of the lens “defocus” or blur the child’s peripheral (side) vision. Blurring side vision is thought to slow eye growth and limit myopia.
Studies have shown that multifocal contact lenses can be effective in slowing down the progression of myopia in children and adolescents. One study found that children who wore multifocal contact lenses had a 50% reduction in myopia progression compared to those who wore single vision contact lenses.
However, it's important to note that not all types of soft contact lenses are suitable for myopia control. It's recommended to use a specific type of multifocal contact lenses called "center-distance design" lenses, which have a distance-dominant central zone and a near-dominant peripheral zone.
Additionally, it's important to consult with an eye care professional to determine if multifocal contact lenses are appropriate for you or your child, as there are various factors that can affect the success of myopia control with contact lenses, such as age, degree of myopia, and lifestyle factors. Regular eye exams and follow-up appointments are also crucial to monitor the progression of myopia and ensure that the treatment plan is effective.
MiSight Daily Disposable Contact Lenses
The MiSight lens is a type of soft contact lens specifically designed for myopia control in children. It is a daily disposable contact lens that has a unique optical design that provides clear vision for distance and reduces the progression of myopia. The MiSight lens was approved by the FDA in 2019 for use in children ages 8 to 12 years old.
The MiSight lens uses a process called peripheral defocus management, where the lens has a different prescription at the edges compared to the center. This creates a defocus or blur in the peripheral retina, which signals the eye to slow down its elongation and progression of myopia. In addition to the optical design, the MiSight lens has a center-distance multifocal design, which allows for clear vision for both distance and near.
Studies have shown that the MiSight lens can be effective in slowing down the progression of myopia in children. A three-year clinical trial found that children who wore the MiSight lens had a 59% reduction in myopia progression compared to those who wore regular single vision contact lenses.
However, it's important to note that the MiSight lens may not be appropriate for all children and that regular eye exams and follow-up appointments are crucial to monitor the progression of myopia and ensure that the treatment plan is effective. A thorough consultation with an eye care professional is recommended to determine the best treatment plan for your child's myopia.
4. ) Peripheral Defocus Spectacle Lenses
Special spectacle lens designs have been developed by the optical industry to attempt to control childhood myopia progression more effectively than the typical bifocal and progressive designs. These include the peripheral plus design, marketed by Zeiss as MyoVision, which showed a 20% myopia control effect in a one year study, for children aged 6-12 years with a family history of myopia. This lens is available in many countries.
GLASSES
- Pros:
- More comfortable to wear and remove than contact lenses (and require less maintenance)
- Can be used at a younger age than with contact lenses
- Myopia control eyeglass lenses have been shown to slow down the progression of myopia by about 15-30%
- Cons:
- Can be lost or damaged more easily than contact lenses
- May not provide the same level of myopia control as other myopia management options