Are you concerned about large prescription changes in your child’s glasses? How much change in a child’s glasses prescription would initiate an optometrist to look into myopia control? What is myopia control and is it appropriate for me or my child? In this article, you’ll learn everything you need to know about myopia control.
Is myopia progression on the rise?
Yes. Increasing daily near point tasks and homework for children in today’s world of education has a correlation with the increase in myopic progression world wide.
According to a previous review in the United States, the prevalence of myopia in schoolchildren aged 12–17 years increased from 12.0% (between 1971 and 1972) to 31.2% (between 1999 and 2004). The eyeball growth is dependent on a feedback mechanism that, if over-stimulated, can cause myopic degeneration in eyeballs that have predisposing factors such as genetics.
What is myopia control?
Myopia control describes methods used to slow the progression of worsening or degenerative myopia in younger patients. Optometrists can implement treatment methods backed by scientific research and clinical experience to proactively slow down or halt the progression of worsening myopia, also termed axial myopia.
A primary eye care provider can proactively test for attributes of worsening myopia by means of yearly eye exams on patients as young as five years old. These eye exams not only measure your prescription, but also your corneal curvatures, axial length, and accommodative responses. The earlier the problem is identified and treatment initiated the better the long term results.
Here’s a quick video where experts review myopia control treatment options.
4 main types of myopia control
There are four main treatments currently being used to control myopia. Each has varying degrees of success, depending on patient criteria. Since the main patient base of these treatments is usually children, all methods are reversible and non-permanent as children are continuously growing! When considering myopia control, a specially trained optometrist will consider the following;
1) Atropine eye drops
Atropine eye drops are compounded and diluted prescription eye drops designed to regulate muscarinic receptors of the eye and to relax the focus center.
2) Center-distance multifocal contact lenses
Center distance multifocal contacts are specially designed soft contact lenses that have different powers in different zones of the lens. Optically, this provides peripheral blur on growing retinal cells in the back of the eye.
3) Orthokeratology (ortho-k)
Ortho-k lenses are specially designed, FDA approved rigid contact lenses that are worn at night to prevent symptoms of myopia during the day. They also optically correct vision while inducing precise hyperopic blur on parts of the growing retinal cells.
4) Bifocal or progressive eyeglasses
Recently, increasing outdoor activities and decreasing the duration of near work has been reported to be effective in delaying myopia onset but not as a stand-alone therapy.
How myopia control is managed
Ok, you may be thinking “what if the prescription changes? We can just update the glasses/lenses right?” While that approach is very appropriate for some cases, eye doctors look at the patients’ overall trend that myopic changes indicate.
For instance, if it is on track to be over -5 diopters in myopia by age 8 or 10 years old, that can put the patient at a higher risk for certain ocular diseases such as retinal detachments, glaucoma, and/or choroidal neovascularization later in life. Sometimes, higher amounts of astigmatism also prohibit the treatment of myopia control. Also, since optically hyperopia is the opposite of myopia, it is not typical for hyperopic/farsighted patients to need these treatments either!
With that being said, while it is not contraindicated for adults, the aim of this treatment is typically towards the developmental growth phase for younger patients. Adult patients can still progress, but usually at a much slower rate. Some adult patients actually prefer the treatment of overnight orthokeratology lenses versus the traditional contact lens due to the independence from glasses or contacts during the day! I have some patients that use this customized type of overnight lens wear as an alternative to LASIK.
In the end, myopia control is a hot topic in eye care that is only going to be more defined as research progresses. If you or your child is considering myopia control, schedule an eye exam with an optometrist who offers this service!
What are your thoughts on myopia control? Share them in the comments below!