More on Myopia

Myopia occurs when the length of the eye is longer than a ‘normal’ eye. When that occurs, the person is no longer able to see distant targets clearly and will require aids (glasses, contact lenses or laser vision correction) to see things clearly again.

When myopic, the prescription tends to continue to change until our early twenties, depending on academic rigor. 

Myopia can develop due to genetic or environmental causes. If one or both parents are myopic, then there is a greater chance that their child will be as well. If a child spends more time indoors (especially completing near-focused activities) there is a greater chance that they will become nearsighted. When children develop myopia at a younger age, they often have prescriptions that will change more rapidly.

Myopia, or nearsightedness, is on the rise globally, particularly among children.

The Myopia Epidemic
Myopia is more than just a minor inconvenience; it’s a growing epidemic. Statistics from the World Health Organization (WHO) indicate that nearly 30% of the world’s population is myopic, and this number is expected to increase to 50% by 2050. This alarming trend is especially concerning among children and adolescents.

Understanding the Impact
Myopia is more than just blurred vision; it can lead to severe eye health issues.

High myopia is associated with a higher risk of conditions such as retinal detachment, glaucoma, cataracts, and macular degeneration. These conditions can have a profound impact on a person’s quality of life and can lead to vision loss if not properly managed.

The Role of Myopia Management
Myopia management strategies, such as specialty contact lenses, atropine eye drops, and orthokeratology, have been shown to effectively slow down the progression of myopia in children and young adults. By slowing progression, we can also:

• Maintain Academic Success: Effective myopia management ensures that children can see clearly in the classroom, enabling them to actively engage in lessons, participate in discussions, and excel academically.
• Enrich Extracurricular Experiences: By managing myopia, children can fully enjoy extracurricular activities, whether it’s playing sports, painting, or participating in music lessons. Clear vision enhances their participation, promoting social interaction and personal growth.
• Prevent Health Complications: Investing in myopia management for children can yield long-term benefits by reducing the risk of sight-threatening complications associated with high myopia in adulthood.
• Offer Long-Term Cost Savings: Investing in myopia management early on can result in substantial cost savings by reducing the need for stronger prescriptions, eye treatments, and vision correction procedures later in life.

The only way that we are able to reduce the onset of myopia is by spending time outdoors. The more time that a child spends outside will lessen their chances of becoming nearsighted. It was found that 76 minutes of outdoor time per day had a 50 percent protective effect from becoming myopic. Unfortunately, outdoor time will not decrease the progressive changes after myopia has started.²

Whether through orthokeratology, multifocal contact lenses, atropine drops, or lifestyle changes, there are effective ways to slow down myopia progression.

Orthokeratology (Ortho-K)
A rigid gas-permeable lens with a specific reverse curvature design is used at night, while a child is sleeping. The design of the lens will move the fluid within the cells of the cornea from the center of their vision to the midperiphery, creating a flatter central part of the cornea and a steeper midperiphery. The flatter central part allows the child to see during the day without the aid of glasses or contact lenses. The mid-peripheral steepening decreases the eye’s stimulus to grow by approximately 50 percent. The lenses are designed to not be felt when the eyes are closed, so it will not affect a person’s sleep quality. 

Multifocal Contact Lenses
Multifocal soft contact lenses are traditionally used with adults who are having difficulty reading near items. Similar to ortho-K, the mid peripheral blur (from the multifocal design) decreases the eye’s stimulus to grow. There are different modalities for the soft contact lenses, monthly or daily disposable. Most eye care providers recommend daily disposable options for young individuals as they have a lesser risk associated with eye infections. 

The appeal of soft contact lenses is the freedom from glasses, especially in sports and extracurricular activities. The lenses are often so soft that children are not aware of the lenses throughout the day. The mid peripheral blur is most often not visible by the wearer.

Atropine Eye Drops
Atropine is a dilation drop that is being used off-label to try to lessen the eye elongation process and subsequent myopic changes. The exact mechanism of action is still unknown at this time but it has been determined that 0.05% is the best concentration that slows the prescription and elongation changes while having the fewest side effects.³ The peak side effects of the drops are noted for eight hours after application of the drops. Many eye care providers will recommend using the drops at night, prior to bed, so that the child will be sleeping during the peak side effect hours. 

You are not able to pick-up these prescriptions at your standard pharmacy; eye care providers must use a compounding pharmacy to dose the exact concentration to ensure that there are no unwanted side effects from too small or high doses.