Myopia Management

Myopia control Bella rev

Myopia Management

What causes myopia?

Myopia, or short-sightedness, is a refractive error caused by the eyeball growing too long. This means when light enters the eye, the eye doesn’t bend light correctly. The light entering the eye then fails to form a clear focus on the light-sensitive retina in the back of the eye. The result is blurry distance vision. A child with myopia may squint or frown when trying to see distant objects clearly.

What causes myopia?

Myopia is a rapidly increasing epidemic. By 2050, it has been projected that over 50% of the world will be short-sighted and 10% of the world will be highly short-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.

FAQs about Myopia from Parents and Guardians

Short answer is No. We cannot stop the eye from growing, but we can definitely control the amount of growth (i.e. slow the increase in prescription) until they reach around 20 years of age where their prescription should stabilise. At Eyecare Kids we provide the full range of myopia managing treatments that enable this.

6 months is preferred to monitor for any myopia progression.

It is not recommended to allow your child to see blurred vision during the day as evidence shows that this can increase their risk of further myopia development. Wearing spectacles or contact lenses as recommended by your optometrist is important in myopia management.

To slow the progression of myopia, you can most commonly use specially designed eyeglasses or contact lenses. We recommend taking frequent breaks from screens and mobile devices and to spend more time outdoors (at least 2 hours per day).

Unfortunately once myopia is established, it needs to be treated using spectacles or contact lenses to help your child see clearly. Exercises may be useful to help a myopic patient with binocular concerns to help improve their overall vision. 

There are many risks that worsen the progression of Myopia, commonly genetics, ethnicity and environmental factors such as screen and phone time as well as the increased  time spent indoors.

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

An image showing retina and retinal detachment

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.

myopia levels

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 management 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.

Myopia guidebook

Download for FREE The Little Guide to Myopia Management

Download for FREE The Little Guide to Myopia Management

Current Myopia Management Treatments

Orthokeratology

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 management effect for each child. Studies show that Ortho-K can slow myopia progression by up to 55% compared to single-vision spectacles.

Advantages

Advantages

  • Considered the gold standard for myopia management.
  • 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

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

Myopia Control Treatments - 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

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

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

Myopia Control Treatments - HOYA Miyosmart (DIMS)

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 management. According to research, the HOYA Miyosmart lens has shown a 52% myopia management effect in children aged 8-13 years over a two year study.

Advantages

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

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

Myopia Control Treatments - 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 management. 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

Advantages

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

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

Myopia Control Treatments - 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

Advantages

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

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

Myopia Control Treatments - Progressive Lenses

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

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

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?

Danny