Myopia Control

What is myopia?

Myopia is a condition in which light does not focus images correctly in the eye. This is usually due to the eyeball growing too long, resulting in light focusing in front of where it should. This causes what is commonly known as nearsightedness, in which objects further away are blurry.

As the eyeball continues to grow, the structures inside may stretch and can be damaged. When the power of myopia is over – 4.00ds, myopia can put you at risk of sight-threatening conditions, such as cataracts, glaucoma, retinal holes, tears, and detachments and myopic macular degeneration.

Risk factors for developing myopia include:

• Age: between 5-9 years old
• Prescription: higher (more minus) than expected for age
• Family history: at least one parent with myopia
• Ethnicity: East Asian
• Time spent outdoors: less than 1.5 hours per day
• Time spent on near work: more than 2.5 hours per day

The more risk factors the child has, the higher the risk of developing myopia.

What can prevent myopia?

Multiple studies have shown that at least 90 minutes spent outdoors on a daily basis or ~ 13 hours a week can prevent the onset of myopia in children. First, the outdoor environment is much brighter, being up to 500 times brighter than indoor light, even if you have sunglasses and hat on. Second, when you’re outdoors and everything is beyond 3m distance, your retina enjoys a full field of optical infinity.

Is there a cure for myopia? Are there eye exercises you can do?

There is no cure for myopia and typically cannot be reversed. With the exception that the cause of myopia is secondary to an eye muscle problem. In which case, then eye exercises (vision therapy) can help.

What is myopia control?

“Myopia control” is the term used to describe specific treatments to slow the progression of myopia in children. As mentioned above, myopia control is important because it may help reduce the risk of vision-threatening complications associated with high myopia later in life.

What are the methods of myopia control?

There are four primary categories of myopia control treatments: atropine eye drops, multifocal contact lenses, multifocal eyeglasses and orthokeratology (ortho-k). Every child is different, some will respond well to one form of myopia control treatment and for others perhaps a different strategy has more effect.

The ideal treatment is patient-dependent such as one’s ocular characteristics, age, maturity and lifestyle.

1. Atropine

Atropine eye drop for myopia control has been well-documented since the 1960s. Research has shown that a low concentration of atropine can reduce the rate of myopia progression by strengthening the scleral to prevent elongation of the eyeball. Due to the low concentration and preservative-free nature, its risk profile is very low. Small side effects include on larger pupil size which may result in light sensitivity and near vision might be slightly blurry. If a patient experiences side effects that cannot be tolerated, the doctor can adjust the dosage of the medication.

2. Spectacle lenses

MiyoSmart (by HOYA) is a safe and non-invasive option for myopia control. It works by reducing blur in the peripheral retina caused by a conventional lens, which can be a stimulus for the eyeball to elongate, resulting in myopic progression. A new wearer may experience some slight blurry vision during the initial 2-week adaptation. This impact resistance lens includes UV protection, anti-reflection and easy-clean coating. It also includes a 1 year – 1-time Dr Change replacement if the patient’s spherical equivalent power changes from 0.50D or more.

3. MiSight soft contact lenses

MiSight (Coopervision) is a daily disposable contact lens that gives clear vision while slowing down myopic progression. This is a great complementary treatment option for those who are in MiyoSmart lenses, but may require contact lenses for certain sports and outdoor activities where glasses get in the way. They are worn like any regular daily disposable contact lenses, and are disposed of at the end of the day. As with regular soft contact lenses, there is a very low chance of bacterial infection, which is mitigated with proper hygiene and lens wear schedule.

4. Orthokeratology

Also known as Ortho-K, these are hard lenses that are worn overnight to reshape the surface of your eye. It can provide clear vision without glasses or prescription the following day, and the effect usually lasts around a day. This is a great option for those who don’t want to wear glasses or contact lenses throughout the day. Risk of infection is very low with proper lens care and hygiene. The estimated incidence of a serious eye infection called Microbial Keratitis (MK) is 7.7 per 10,000 years of wear. This is a slightly higher risk of developing MK than your daily wear soft contact lens wearers do.

Frequently Asked Questions – FAQs

Do myopia control methods get rid of the need for glasses or contact lenses?

Myopia control does not reverse myopia nor arrest its progression. It cannot get rid of the need for glasses or contact lenses. It can only slow down how quickly the prescription changes with time.

What is the length of treatment?

We expect treatment to be ongoing during the years of your child’s life where there is a significant risk of further progression without treatment. This is typically between the ages of 6-17 when eye growth is occurring. Ortho-K and contact lenses can safely be worn for many years. Low-dose atropine clinical trials have been conducted over 5-year periods with good outcomes and minimal side effects.

What is the average increase in myopia per year?

With basic single-vision glasses, the rate of increase in myopia is on average twice as much as with myopia control methods.

Should I not wear my full prescription?

Under-correcting involves determining the appropriate prescription for a person to see at distance 20/20 or better and “backing off” the prescription so that distance vision is slightly blurrier than 20/20. However, the blur from under-correcting may actually be a stimulus to more nearsightedness.

Can I start Atropine eye drops as a preventative measure even if I don’t have myopia?

There are no published studies showing the benefits of starting atropine before the development of myopia.

Do myopia control methods really work?

There is much evidence in published scientific literature to support the effectiveness of myopia control treatments. Published research can be found here https://pubmed.ncbi.nlm.nih.gov/?term=myopia+control

Our practice serves patients from Bridgeland, Panorama Hills, S. Trail Crossing, and , Alberta and surrounding communities.