Myopia: what is it?
Myopia or short-sightedness, is the eye condition where near objects are clear, but objects farther away are blurred. It is caused by the eye ball being slightly too long.
Myopia: an epidemic?
The percentage of people who develop myopia is increasing sharply, to the extent that it is now considered an epidemic. Myopia is getting worse around the world: in some parts of Asia, eighty percent of the girls in high school are myopic; in the United States, over forty percent of people aged 12-54 are myopic and, here in the UK, research has shown that over fifty percent of 1st year undergraduates are myopic.
Myopia: traditional thinking
Although there are significant negative issues associated with myopia (costs of lifetime treatment, inconvenience and increased risk of eye problems such as cataracts, glaucoma, retinal detachments and myopic maculopathy eye disease and blindness), they are not life-threatening and have been generally managed with glasses for over a century. However, current research indicates we may well be making the problem worse with glasses and standard contact lenses, plus myopia levels are accelerating for other reasons as well.
If you have a myopia child, you might wonder if there is a cure or something to slow its development. Recent research suggests it may now be possible to slow the rate of myopia progression.
Why Act Now?
We cannot cure myopia
Myopia occurs because the eyeball has grown too long: this cannot be reversed
We can aim to stop or slow it from getting worse
The younger you start the myopia control programme the better the chance of success
The average increase in myopia for those who are progressing is about 0.37 DS per year. That means a child with low myopia in year 7 most likely will not be able to read the top letters on the eye chart without glasses by year 10.
The best time for effective treatment is when myopia is low as the change is usually most rapid in the first year or two.
There are advantages to myopia control at any stage but there is no advantage in waiting.
The quality of life difference between a person with low myopia compared with one with high myopia is significant. A person with low myopia, such as -1.00 DS or better, is only slightly inconvenienced in many situations. They are part-time glasses wearers, perhaps using them only for seeing the whiteboard at school or driving. Hugely different to a person with high myopia who needs glasses to see even the alarm clock first thing in the morning.
Here are some myopia facts to get you thinking
Myopic parents are more likely to have myopic children than non-myopic parents. Ie genetics plays a part.
People in urban environments have more myopia than rural societies.
The amount of reading or near work a person does is not predictive of whether
they will become myopic.
The eye determines where correct focus is located while it is growing, by the clarity of peripheral (side) vision, not central vision.
People who spend more time outdoors, even if they have myopic parents and even if they read a lot, are less likely to become myopic.
As you can see, it’s not straightforward.
The Myopia Control Programme
1. Be Outdoors
Studies suggest that children should aim to be outdoors for up to 80 minutes a day. This is not a standardised time, as there is not enough research to be precise. But children who spend at least that time outside do not show as much myopia progression.
Research shows indoor sports such as basketball do not give the same protection.
Studies indicate that the activity might best be focused on distant objects, such as bike riding, as opposed to near activities like playing cards.
2. Join the Myopia Control Programme at Lynne Fernandes Optometrists
At your initial appointment, we will take a detailed family history with the aid of a questionnaire. Then, you can discuss the options available and get fitted with lenses. If you want time to think and research, we can use this appointment to point you in the right direction.
You will normally require a minimum of 3 appointments in the first year.
Treatment options
Overnight rigid reshaping contact lenses
Ortho-K (orthokeratology) involves a specially shaped rigid contact lens worn overnight to reshape the cornea and produce clear vision the next day. This is not permanent and is completely reversible. To ensure clear vision, the lenses need to be worn every night. Otherwise, normal myopic vision returns. Some studies have shown that this technique successfully reduces the rate of the eyes’ growth and, therefore, the rate of myopia progression.
Multifocal Contact Lenses
It has been shown that the use of this type of contact lens can reduce the growth in a child’s eye by around 30%. This is our preferred technique and means that any increase in myopia can be significantly reduced. The other great advantage of this method is that these lenses are available in soft, disposable types, which makes them both comfortable and affordable.
There are a number of multi-focal type lenses on the market, and precise power combinations must be used for myopia to be controlled.
Companies will probably soon be marketing specialised contact lenses for myopia control, but multifocal lenses appear to work for now. They require lens wear during the day. This is our favoured myopia control technique.
Executive Bifocals
Executive bifocals have a much stronger effect on slowing the rate of myopia progression than varifocals spectacle lenses. This is because they create more peripheral blur in front of the retina.
We, therefore, recommend that your child/teenager use these when not wearing their multifocal contact lenses (no spectacles required with Ortho-K lenses).
Lens makers are coming out with specially designed myopia control lenses for glasses, currently only available in Asia. Reports are not yet promising.
Atropine
Several studies have shown that a weak dose of atropine eye drops can reduce the rate of myopic change. However, atropine is not licenced for use in the UK to control myopia.
