Written by Dr. Abby Taffe
Myopia, more commonly known as nearsightedness, is one of the most popular eye conditions affecting approximately one-third of the United States population. The prevalence of myopia has continued to increase in children over the past decade. Higher amounts of myopia are associated with an increased risk of sight-threatening problems, such as a retinal detachment, choroidal degeneration, cataracts, and glaucoma. Slowing the progression of myopia could potentially decrease the risk of these sight-threatening conditions and could be beneficial for millions of children in the United States.
There are many factors that are being investigated for why the amount of myopia has been rapidly increasing. Parental genetics play a partial role in determining whether a child will become myopic, but there are also several environmental factors that play an important role. Some of the more common environment suspects include:
- An increase in the amount of time a child spends on close-focus activities
- An increase in the amount of time spent using mobile devices
- A decrease in the amount of outdoor activities under bright sunlight
Research has shown that the way light focuses on the retina in the back of one’s eye can signal the eye to grow. In an ideal world, the light would focus perfectly on the retina all the way into the periphery. In most cases with traditional spectacle or contact lens myopic correction, light in the periphery is focused behind the retina (hyperopic defocus). This hyperopic defocus signals the eye to grow and therefore increases myopia.
To date, there are several proven treatment options aimed to decrease peripheral hyperopic blur and therefore slow down the rate of myopia progression. Some of those treatment options include: multifocal contact lenses, orthokeratology contact lenses, and low dose topical atropine drops. None of these modalities are currently FDA-approved, but studies have shown they can slow the progression of myopia by approximately 50% with very few risks.
- Multifocal Contact lenses:
- Approximately 48% effective in slowing myopia progression
- Center distance lens design – allows for optimal distance vision while creating myopic defocus in the periphery which slows down eye growth
- A non-surgical technique that eliminates the need for glasses or contact lenses during the daytime and can also slow the progression of myopia by approximately 50%.
- These hard contact lenses are designed to gently change the curvature or shape of the cornea in order to change how light is focused on the retina in the back of a person’s eye
- Light that focuses in front of the retina (myopic blur) acts as a signal to slow the growth of the eye
- These lenses allow for clear central vision while creating myopic blur in the periphery.
- After wearing the contacts while sleeping, the patient will wake up with clear, sharp, and natural vision that lasts throughout the daytime
- Low dose atropine drops:
- Anti-muscarinic eye drops are used during a typical eye exam to dilate the pupil and reduce or eliminate the eye’s ability to accommodate (focus up close).
- The specific myopia control mechanism of the anti-muscarinic agents is unknown, but studies have shown the use of low does atropine is approximately 77% effective at reducing myopic eye growth in children.
- These drops are typically instilled into the patient’s eyes twice weekly.
- The most common side effects include: light sensitivity and blurred near vision. The lower concentration of atropine doesn’t seem to have as significant of side effects for the patient and also does not seem to have as high of a rebound rate as the higher concentrations of atropine do.
To find out more information on myopia control in children, please ask your optometrist.
American Academy of Orthokeratology an Myopia Control (AAOMC).What is Orthokeratology.
Myopia Progression & Emmetropizaion. 2013. University of Rochester. Advanced Physiological Optics. http://www.cvs.rochester.edu/yoonlab/research/mpc.html
Santini, B. 2015. Conrolling Myopia in Children. 2020 Magazine Online. https://www.2020mag.com/ce/controlling-myopia-in-children-41B0E
Smith, M.J. and Walline, J.J. 2015. Controlling Myopia Progression in Children and Adolescents. Adolescent Health, Medicine, and Therapeutics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542412/
Turpin, S. 2017. Myopia Control – Everything you Need to Know. New Grad Optometry. https://newgradoptometry.com/myopia-control/