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Myopia Control

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What is Myopia (Nearsightedness)?

Myopia or nearsightedness is a growing epidemic. Approximately 70% of the population in Asia is nearsighted and approximately 30% of the population globally is nearsighted.

Myopia is when a person sees blur at distance but can see clearly at near. Scientifically speaking, myopia is when the central light rays are not being focused on the retina but rather in front.

The significance is that peripheral rays are focused behind the retina. This phenomenon will effectively cause the eye to elongate, thereby increasing the nearsighted prescription.

Myopia Progression and Prevention: Why It Matters

Risk of progression is influenced by:

Family History of Myopia

The likelihood of a child developing myopia when:

Both parents have myopia: 50%
One parent: 33%
Neither parent: 25%

Screen Time

Studies have shown a trend for increased myopia with increased screen time and a lack of outdoor activities especially during COVID-19 remote learning.

Undercorrection

Wearing the incorrect glasses prescription will cause more peripheral rays to focus behind the retina, thereby increasing the nearsighted prescription.

Why it Matters

The greater the nearsightedness, the higher the risk of ocular diseases such as glaucoma, retinal detachment, and cataracts. Thus, myopia control and prevention are extremely important in maintaining good eye health.

Job opportunities can be impacted based on vision. Myopic children with high prescriptions may not be able to qualify for certain jobs (think pilots, surgeons, and firefighters to name a few). Parents of myopic children can help their child by reducing myopic progression through myopia control so their child is not limited or barred from opportunities.

Myopia Control - Slow the Progression of Nearsightedness

Myopia Control

Myopia control is a method to prevent myopia from getting worse. It will not reduce or cure myopia. The best way to determine the amount of progression is by measuring the axial length of the eye. Axial length is the length of the cornea (front surface of eye) to the retina (back of eye). The greater the axial length, the greater the progression.

Myopia control options:

  1. Corneal refractive therapy or Orthokeratology
  2. Multifocal contact lenses
  3. Atropine

Corneal Refractive Therapy / CRT

CRT is a method of using a rigid contact lens to reshape the cornea to improve vision. It is temporary and reversible. You will need to wear these lenses overnight to correct for myopia. Upon awakening, you will be able to see without the need for glasses or additional contact lenses. As an added benefit, the reshaped cornea provides a stimulus to the eye to reduce progression.

As a first time contact lens wearer, patients may feel a foreign body sensation which will result in mild discomfort. Discomfort is usually not noticeable as these lenses are meant to be worn during sleep. Patients are advised to instill an eye drop solution prior to lens insertion for better comfort.

As with any type of contact lens wear, there is always a risk for infection. The risk of a contact lens infection from CRT is very low especially with proper cleaning techniques and hand hygiene. Our myopia control team is equipped to teach the parent and child on proper handling and care of lenses.

Depending on the candidate’s prescription and the shape of the cornea, results of clear vision can be seen as early as day one but may take a couple of weeks. Vision will progressively improve with continued wear, and will revert back to the original prescription if discontinued. Myopia will need to be reassessed in 6 months or sooner if the child is determined to be a fast progressor.

Multifocal Contact Lenses

Soft Multifocal contact lenses (Misight) are slightly different from spherical contact lenses in that the multifocal lenses are designed with concentric rings. When worn during the day, this design provides clear vision at distance/near as well as focuses the peripheral rays to be at or in front of the retina.

The MiSight multifocal contact lenses are the only FDA approved contact lens for myopia control. A three year study on axial length with patients wearing the MiSight lenses suggests about 52% reduction in axial elongation when compared to patients who are not undergoing any treatment.

Discomfort is minimal as it is a soft contact lens. Patients may take a few weeks to get used to wearing the lens daily.

As with any type of contact lens wear, there is always a risk for infection. Risk is significantly reduced with good contact lens hygiene. Our myopia management team is equipped to teach the parent and child on proper handling and care of lenses.

Results of clear vision will be instantaneous once the patient puts on the contact lenses. A few changes may be necessary prior to finalizing the prescription. Myopia will need to be reassessed in 6 months or sooner if the child is determined to be a fast progressor.

Atropine

Low dose atropine can be used as a method of controlling myopia. The idea behind atropine was that it helped relax the eyes’ focusing system.

Newer studies have since shown that atropine may influence some of the receptors in the eye, sending a signal to reduce the amount of progression.

Myopia will need to be reassessed in 6 months or sooner if the child is determined to be a fast progressor. It is important to note that spectacles or contact lenses will still need to be worn for clear vision as atropine does not correct for nearsightedness.

The most common side effects noted are mild blur at near, and mild glare or halo. These are often insignificant once the patient adapts.

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