MYOPIA CONTROL

Myopia, or shortsightedness, is a condition where only close objects can be seen clearly. People who have myopia need glasses or contact lenses in order to see distant objects well. In New Zealand, 30% of adults have myopia and it is becoming more common in children, particularly those whose parents have myopia.

WHY IS MYOPIA A PROBLEM?

Glasses, contact lenses*, laser refractive surgery, and regular eye examinations can be costly. Myopic children and adults are bound to need glasses to engage in sports and every day activities. High myopia is associated with a greater risk of eye complications such as retinal detachment and glaucoma.

*Contact lenses suitablefor children as young as 8 years old.

WHAT CAUSES MYOPIA?

No one knows for sure, but research has highlighted certain risk factors:

• At least one parent with myopia – 3x higher risk with one parent or 6x higher if both are myopic
• Ethnicity – research suggests a link between Asian ethnicity and faster progression of myopia, with higher worldwide prevalance in this group of people
• Close work, e.g. reading, computer games, drawing, or using smart phones and tablets. These devices are easy for toddlers to use, resulting in increased exposure to close work at a younger age and possibly causing myopia development to begin earlier in childhood

VISUAL HYGIENE

Children should not spend excessive amounts of time – in addition to school time – on close work such as reading, homework, or screen-time, and the younger the child, the less time should be spent on these activities. Parents need to ensure their children are not holding the book or screen too close – it needs to be at least an elbow’s distance away. Also, children should take regular breaks, following the 20-20-20 rule – every 20 minutes they should look at least 20 feet (6 metres) away for at least 20 seconds, preferably having some time to move their bodies also. Another good habit is for the child to look up in the distance every time they turn the page (or finish a round of the game). Too much screen time is linked to myopia, can cause dry eyes, and increase the risk of eye damage and diseases in adulthood similar to UV damage.

CAN MYOPIA BE PREVENTED?

For many years optometrists and ophthalmologists have been trying to prevent myopia. There have been many forms of corrections studies such as standard glasses, bifocals or progressive glasses, exercises, diet, and the use of eye drops. Many of these have had either no effect or a very mild effect. There are some treatments, however, that have proven effective at significantly limiting the development of myopia.

Orthokeratology (Ortho K)

With Ortho K, specially designed rigid contact lenses are worn overnight to mould the shape of the cornea. The moulding changes the way light is focused onto the retina to provide visual correction. In the morning, when the lenses are removed, children have good vision throughout the day. The altered focus of peripheral light seems to stop myopia progressing. The bonus is that no glasses or contact lenses are required during the day so there are no interruptions to school and daily activities.

Atropine

Atropine eye drops, which are used to treat other eye problems, slow the progression of myopia. However, how they work is unknown and most children find the side effects of standard doses unacceptable. Recent research has shown that much lower concentrations can reduce the rate of myopia progression without side effects. Low-dose atropine is now widely used to prevent myopia. It is not commercially available but can be compounded at special pharmacies. Optical correction with glasses is still required while using atropine drops.

MiSight DailyTM disposable contact lenses

MiSightTM contact lenses are a soft, daily, disposable lens which not only optically correct existing myopia, giving clear distance and near vision, but have also been proven to slow the progression of myopia in most children. The optics of these lenses provide peripheral defocus which is what slows myopia progressing. Daily disposable lenses mean there’s no cleaning, disinfection, or worrying about lost lenses. The lenses are designed to provide high oxygen transmission for healthy, comfortable wear all day long.

Outdoor play

Time outdoors is associated with reduced myopia progression. It’s not clear how this works, but it may be that ultraviolet light causes changes in the wall of the eye. The recommended time is two hours per day of outdoor play. This is relatively easy for children who walk, bike, or scooter to and from school, and who are outside during playtimes.

MYOPIA PREVENTION AND YOUR CHILD

Myopia prevention is best discussed with your optometrist. Our optometrists can discuss options with you and determine which will be best for your child. All the treatments discussed here are available at Canon Street Optometrists.

HOW LONG WILL TREATMENT TAKE?

Treatment will need to continue until the chance of myopia progression has ceased. Most children will need treatment until they stop growing.

RISKS

Contact lens wear and atropine treatment can have potential side effects. These are rare but need to be considered. It’s not yet known what will happen when preventative treatment stops, and myopia may still develop later in life. Nevertheless, due to the problems associated with myopia, most optometrists and ophthalmologists recommend treatment.