Myopia Control

Myopia Control

Myopia, otherwise known as short-sightedness, occurs when distant vision is blurry or not clear.

As a child grows, their eyes do too. Sometimes the eye becomes elongated or the front surface becomes curved. On a healthy eye, light focuses on the retina, instead Myopia causes light to focus in front of the retina which makes distant objects appear blurry while close objects appear clear. As a result, Myopia can cause blurry distance vision and is often described as “short sighted” or “near sighted”. 

We have seen the prevalence of childhood Myopia almost DOUBLE in the past 5 years. Myopia in children generally progresses quickly and can become worse with age. There is also a high correlation between Myopia in children and increased risk of eye diseases in their later adult life. 

Myopia is a rapidly increasing epidemic. According to the ‘Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 to 2050’, published in the American Academy of Ophthalmology, 2016,

FAQs about Myopia from Parents and Guardians

What causes myopia?

Childhood myopia is often the result of axial elongation (growth of the eyeball), which causes the image to be defocused and blurry.

What are the risk factors for myopia?

There are several risk factors which affect the onset and appear to accelerate or contribute to the progression of myopia:

Genetic Risk Factors

  • Family history: children with 1 myopic parent are 2x more likely to develop myopia. Children with 2 myopic parents are 6x more likely to develop myopia.
  • Ethnicity: East Asian children are 4x more likely to have myopia compared to Caucasian children.
  • Age on onset: the earlier the myopia begins, the faster it will progress.

Lifestyle Risk Factors

  • Time outdoors: Repeatable research indicates that physically being outside appears to delay the onset of myopia and slow its progression.
  • Habits: children that spend more time looking at screens and books up close, without regular breaks, are more likely to progress faster.

Long-Term Risk Factors of Myopia

Whilst the most immediate effects of myopia are a reduction in vision, it can also significantly increase the risk of acquiring sight-threatening diseases such as retinal detachment, cataracts and glaucoma later on in life. The following table shows the risks associated with low, moderate and high levels of myopia.

Single-vision spectacles may give your child sharp vision, but this does nothing to slow down or stop their myopia from getting worse.

The most common corrective measure for myopia in children is to have them wear spectacles. However, research shows that single-vision lenses, whilst they may help your child see clearly, do nothing to stop myopia from getting worse.

The good news is…

Many studies have been performed which demonstrate statistically which methods have the best chance of stabilising changing vision due to progressive myopia. 

Our optometrists are very passionate about myopia control and collectively had extensive training, experience and access to the latest proven methods that aim to slow down myopia progression in children.

It is important to realise that there are many methods to proactively treat myopia.

We should not be contented with just changing spectacles every time prescription increaseswhen there is a better way!

Don’t settle for what’s always been done before when there is evidence-based research on treatment options. Read about promising treatment options for myopia which we’ll discuss in the next section.

Download for FREE The Little Guide to Myopia Control

Download for FREE The Little Guide to Myopia Control

Current Myopia Control Treatments

Orthokeratology

Orthokeratology (Ortho-K) is a type of specialised rigid lens that is worn overnight and taken off upon awakening. It is designed to temporarily reshape the cornea for improved vision during the day. With the newest Ortho-K fitting systems, each lens is customised to optimise the individual eye shape, curvature and myopia control effect for each child. Studies show that Ortho-K can slow myopia progression by up to 55% compared to single-vision spectacles.

Advantages

  • Considered the gold standard for myopia control.
  • Clear vision throughout the day without having to worry about spectacles or contact lenses.
  • Active children can freely run, swim and play.
  • Treatment is reversible and can be stopped at any time.

Limitations

  • Initially, it may take some time to adapt to the sensation of an Ortho-K lens. However, this usually improves after the first week.
  • May take up to 2 weeks to achieve clear, stable vision.  
  • Not all prescriptions are suitable for Ortho-K.

MiSight lenses

MiSight lenses are ready-made daily disposable soft contact lenses. As opposed to Ortho-K lenses, they are worn during the child’s waking hours. Studies show that MiSight can also slow the rate of myopia progression by up to 59%, compared to wearing single-vision contact lenses.

In order to achieve this, MiSight must be worn 10-12 hours per day for 5-6 days a week.

Advantages

  • No cleaning or disinfection products are required as these lenses are replaced daily. 
  • Immediate clear vision from the outset after insertion.
  • More comfortable than Ortho-K lenses from the outset. Better for children who have sensitive eyes and cannot handle Ortho-K.

Limitations

  • Limited prescription range, up to a maximum of -6.00 of myopia. No astigmatism correction is currently available. 
  • “One size fits all” design. If the lens does not fit correctly, vision and treatment effects may be sub-optimal.

HOYA Miyosmart

HOYA Miyosmart (DIMS) is a customised spectacle lens that follows a similar design to Orthokeratology and multifocal soft contact lenses. Children who are not ready to wear contact lenses may benefit from Miyosmart lenses. It is currently the most effective spectacle lens design for myopia control. According to research, the HOYA Miyosmart lens has shown a 52% myopia control effect in children aged 8-13 years over a two year study.

Advantages

  • Non-invasive on the cornea.
  • Immediate clear vision from the outset.
  • Great for children who are not as active and don’t mind wearing glasses.

Limitations

  • A well-fitting frame is crucial. Should the frames sit crooked or slide down, the treatment effect will be sub-optimal.
  • Spectacles can scratch or damage easily during sports.

Atropine eye drops

Atropine eye drops are used in combination with spectacles or contact lenses during the day. It is an eyedrop that in high doses (>1%) will relax the eye muscles to cause blurry near vision and dilated pupils. However, lower dosage of atropine – 0.01% to 0.05% – have been shown to have minimal effects on reading vision, making them more attractive options to prescribe for myopia control. LAMP atropine study showed low-dose atropine slowed eye growth by about 30%-50% depending on dosage. One eyedrop is placed in each eye before bedtime each night. That’s it!

Advantages

  • Non-invasive on the cornea.
  • Great for children who are not very active and don’t mind wearing glasses.

Limitations

  • Cannot be directly purchased from the pharmacy –  requires a compounding pharmacy.
  • They cannot be used alone. They are used in combination with glasses or contact lenses in order to see clearly.

Multifocal Soft Contact Lenses

Multifocal Soft Contact Lenses are contact lenses that provide a range of powers in the same lens. In doing so, the eye focuses through different powers, depending on how close or far they are looking. These are offered as daily or monthly disposable contact lenses. It is a great alternative to regular contact lenses as they have been shown to control myopia.

Advantages

  • Reduces dependency on spectacles whilst also offering myopia control.
  • They are made up of concentric rings of multiple prescriptions in one lens and provide improved vision at all distances.

Limitations

  • Some brands may be able to provide better near vision and some better distance vision but can be difficult to obtain perfectly clear vision at all distances due to optical limitations. 
  • Not suitable for some patients with certain eye conditions like severe dry eye or extremely high astigmatism with their myopia.

Progressive Lens

Progressive Lenses are spectacle lenses with a reading power. This is a similar principle to the multifocal soft contact lenses but in spectacle form. It provides a range of powers in the same lens. In doing so, the eye focuses through different powers depending on how close or far they are looking in a natural way. When you are doing distance tasks like watching television, you will look through the top part of the lens. When you are doing near tasks like reading, you will look through the bottom part of the lens.

Advantages

  • No visible lines on the lenses as seen on bifocals and trifocals. With progressives, you can do away with the old-fashioned lines.
  • The smooth transition between up-close, middle, and far-away viewing avoids the “image jump,” which is when objects abruptly change in clarity and apparent position as your eyes move across prescriptions in the lens.

Limitations

  • Because these lenses have no visible lines, it may take anywhere between a week to a couple of months to adapt and learn the correct way to look through the lens.
  • May also cause peripheral distortion when moving your eyes from side to side.

Whether you’re concerned or after some certainty, we highly recommend a comprehensive eye exam with a Behavioural Optometrist. Early detection can greatly reduce the progression of Myopia.

Could Myopia be impacting your child?

Could Myopia be impacting your child?

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