MYOPIA - WHAT DO I DO NEXT?
Myopia - A Growing Epidemic
My child has been diagnosed with myopia. What’s next?
Nearsightedness (myopia) is a common vision condition diagnosed during a basic eye exam where objects that are farther away appear blurry. Myopia is caused by genetics, as well as other environmental factors. For instance, staring at any object for too long can cause the eye to elongate — it’s this elongation that leads to myopia. Myopia has become increasingly common in children over recent years with intense near work (usually screen time) thought to be a key factor along with reduced time spent outdoors. Childhood myopia tends to get worse over time, resulting in the need for stronger and stronger glasses.
Q: WHY DID MY CHILD DEVELOP MYOPIA? ITS NOT PRESENT IN OUR FAMILY HISTORY
The rate and severity at which myopia is growing worldwide is alarming and estimates suggest about 50% of the world’s population will be myopic by 2050. These numbers support the knowledge that environmental and behavioural factors are playing an increased role in myopic progression in addition to genetic risk.The fact remains, our modern lifestyles are changing rapidly and children are spending less time outdoors and more time using screen-based devices at school and home. With the demands of a busy life, most parents do what they can to limit screen time and often struggle to know if they have done enough to reduce risk for their child’s visual development.
Table 1. Odds ratios of increased risk of ocular pathology with increasing levels of myopia, summarised from Flitcroft, 2012.
Q: WHY IS IT SUCH A BIG CONCERN? CAN’T MY CHILD JUST GET REGULAR GLASSES?
A: There is an increased risk for lifelong eye disease with higher levels of myopia.
It is clinically proven that more severe myopia leads to a significant increase in the risk of more serious eye diseases later in life. Diseases which can all lead to blindness, such as:
CATARACTS tend to develop at a younger age in nearsighted eyes.
Nearsighted people are 2 to 3 times more likely to get GLAUCOMA (high eye pressure).
Myopia increases the risk of RETINAL DETACHMENT.
Q: CAN I JUST WAIT AND SEE WHAT HAPPENS AS MY CHILD GETS OLDER BEFORE WE START SPECIAL TREATMENT LIKE MYOPIA MANAGEMENT?
A: Every Diopter (change in power) Counts! Each -1.00D reduction in power reduces the lifetime risk of serious eye disease by 40%
Conversely, every -1.00D increase in power increases the lifetime risk of macular and retinal disease from 20-67%!
Q: DO WE REALLY NEED TO GET THE SPECIAL LENSES OR CONTACTS FOR THIS?
By slowing the progression of prescription changes, myopia management also helps reduce the frequency and severity of prescription changes between visits, providing better vision for your child in the classroom and for their active lives. We don’t want them to struggle at school or with activities they enjoy between visits.
Q: CAN’ T MY CHILD JUST GET LASIK LATER IN LIFE AND FIX THIS?
Patients that have undergone lasik eye surgery are under the false belief that they have been “cured”; the fact remains that the risk for severe eye disease like retinal detachment and glaucoma remain even if vision is clear and those genetic risk factors still remain for their children.
How Do We Slow Down Myopia Progression?
There are four accepted treatment methods for Myopia Control:
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A custom-designed rigid contact lens (approved by Health Canada) is worn overnight to gently reshape the cornea. This treatment reduces the prescription to zero, allowing the child to remove the lens in the morning and see clearly without glasses or contact lenses. Similar to retainer for teeth, the lens is worn again each night to maintain the effect.
This is one of the most effective methods of slowing myopic progression. You can read more details by clicking here
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Our clinic carries both the Coopervision Mi-Sight and Acuvue ABILITI 1-day Myopia control lenses that are approved for daytime wear.
Contact lenses are safe and have a low risk for infection with proper care and daily replacement.
The reduction in myopia progression was effective in studies when lenses are worn 10-12 hrs daily during the week.
ACUVUE ABILITI 1-day
Mi-Sight from CooperVision
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Specialty spectacle lenses have been designed to control how light focuses in the peripheral retina to reduce myopic progression.
We have used the HOYA MIYOSMART (D.I.M.S.) lens since introduced in Canada in 2021. We now carry the next generation of spectacle lenses from Essillor STELLEST (H.A.L.T.) and the Zeiss Myocare
These are fitted to regular ophthalmic frames for your child and worn full time during waking hours.
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These drops, instilled once nightly, are used to dilate (open) the pupils and fully relax the focusing power (accommodation) of the eye. Studies have shown its effectiveness in a concentration-dependent response. While varying strengths (1%, 0.5%, 0.1%, 0.05%, 0.025%, and 0.01%) of atropine eye drops all reduced myopic progression, patients/parents must be made aware of the off-label use of these drugs, as well as all possible side effects, such as light sensitivity and impaired near focus (accommodation) and a rebound effect of increased myopia after cessation of treatment, all of which are heightened with higher concentrations. The eyedrops must be made at specialized compounding pharmacies and the exact mechanism of myopia management through atropine is still yet to be determined (unlike the other methods of treatment)
Myopia Control Program at Specs & Spines Optometry
EXPERT ADVICE AND FOCUS ON YOUR CHILD’S ONGOING CARE, NOT JUST THE TREATMENT
We have been practising myopia management at our clinic since our doors opened in 2016 and carry the latest products in this field and attend educational lectures regularly to keep updated on the advancements in research.
We have also invested in technology for this program; We have a diagnostic tool called a biometer to measure axial length (the length of your child’s eye). Much like height and growth charts used in pediatric care, we can track the axial length to monitor your child’s progress as they grow at least every 6 months to monitor and optimize their treatment program. As myopia risk is present throughout childhood, and sometimes beyond the teenage years, our clinic can easily modify or combine therapy when indicated to make sure they have the best outcomes.
We can help you get started on a proper myopia control plan for your child and keep them on track for their future goals and eye health.