Dr. Lee Guo, O.D., How to Slow the Progression of Childhood Myopia

By Dr. Lee Guo, O.D.   “Myopia control” has been a hot topic among eye care practitioners for years.  Myopia, aka “near-sightedness,” is a refractive eye condition in which the images in the environment fall short in front of the retina, causing visual blur at distance that will require glasses, contact lenses, or refractive surgery like LASIK to correct.

Why Should I Be Concerned About My Child’s Myopia?
Myopia is especially troublesome for children, as it tends to progress in severity during
development and into early adulthood. That is, once they develop myopia during childhood, their distance vision is likely to worsen year by year.

In fact, prevalence of myopia is rising. In the 30 years between 1972 to 2004, there has been ~17% increase in prevalence of myopia in the U.S. (25% myopic 1971-1972 vs 41.6% myopic 1999-2004)1 and the numbers have only risen since then.

Myopia makes it difficult to see distance detail in the classroom and function visually in sports and numerous other activities that your child participates in. Furthermore, high myopia can lead to blinding medical complications into adulthood with elevated risk of retinal detachment, glaucoma, pre-mature cataracts, and myopic macular degeneration.2,3

What are Current Treatment Options for Myopia Control?

1. Corneal Reshaping Contact Lenses (Orthokeratology). These specialized hard contacts are worn before bed that reshape the cornea (front surface of the eye) overnight. When lenses are removed in the morning, vision is clear and stable throughout the day and effectively reduce myopic progression during visual development. Studies have shown 32-62% reduction in myopia.4

2. Soft Multifocal Contact Lenses. These soft contacts are designed to provide clear

distance vision and also control intermediate and near focusing demand. Studies have
shown 34-79% reduction in myopia.5

3. Pharmacological Eye Drops. Atropine and Pirenzepine eye drops have been recognized in medical studies6, atropine especially as highly effective with 76-96% reduction in myopia. However, side effects like light sensitivity from dilated pupils and near blur from accommodative paralysis can affect quality of life. Recent studies show low dose atropine can reduce these effects while still controlling myopia.

4. Bifocal or Progressive Glasses. These eyeglass options have been shown to not nearly be as effective in controlling myopia as contact lens versions7. However, they are still better than the following options below.

What DOES NOT Work for Controlling Myopia?

1. No Correction: Electing for No Glasses or Contact Lenses

2. Undercorrection: Prescribing Weaker Prescription than Necessary8

3. Regular Single Vision Glasses and Contact Lenses

Which Option is Right for My Child?

The doctors at Vision Care Specialists will provide a comprehensive eye health examination and fully evaluate your child’s visual demands, life style, and multiple other considerations in order to customize a treatment plan for your child’s myopia control. During the appointment, they will be happy to answer any questions or concerns you may have. To schedule an appointment with our eye care professionals, please call 303-991-9600 or contact us online.

References:

1. Vitale S., Sperduto R., Ferris F. (2009). Archives of Ophthalmology Volume 127 No 12.
2. Sowka J., Gurwood, A., Kabat, A. Pathological Myopia and Posterior Staphyloma, Handbook of Ocular Disease Management, Review of Optometry.
3. Ward, B (2011). Degenerative Myopia: a Review of its Nature and Curent Treatment. Macula Vision Research Foundation.
4. Orthokeratology studies in controlling myopia: Charm (2013), Cho and Cheung (2012),
Santodomingo-Rubide (2012), Kakita (2011), Walline (2009), Cho (2005).
5. Soft multifocal contact lens studies in controlling myopia: Walline Grenier (2011, 2013),
Anstice (2011), Sankaridurg (2011), Holden (2010), and Aller (2006).
6. Atropine and pirenzepine studies in controlling myopia: Chia (2012), Fang (2010), Chua
(2006), Ostrin (2004), Shinh (1999), Yen (1989), North and Kelly 1987.
7. Bifocal and multifocal spectacle studies in controlling myopia: Greiner (2013), Cho and
Cheung (2012), Gwiazda (2003).
8. Undercorrection and progressive myopia: Aller (2006), Chung (2002).