Myopia, otherwise known as short-sightedness, is when vision is not clear in the distance.

Myopia is a rapidly increasing epidemic. Currently 1 in 6 people are myopic, and this is expected to affect 50% of the population by 2050. In the past 6 years, myopia prevalence in Australian 12 year olds has doubled!

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 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.
  • Education: children that spend more time looking at screens and books up close, without regular breaks, are more likely to progress faster

Myopia’s Effects on Ocular Health

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 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. It is important to realise that there are many methods to proactively treat myopia and we should not be contented with just changing spectacles every time prescription increases when there is a better way.

Don’t settle for a bare minimum when it comes to your children’s health. Read about promising treatment options for myopia which we’ll discuss in the next section.

Current Myopia Control Treatments

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 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 are ready-made daily disposable soft contact lenses. As opposed to ortho-k lenses, they are worn during the childs 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 orthoK.

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 effect may be sub-optimal.

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

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 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

We recommend speaking to your specialist myopia control Optometrist, who will offer the best option for your child once they have completed a comprehensive assessment of your child’s eyes.

Does your child have myopia, especially one that is steadily progressing?

Book in for a consultation so we can find you the most suitable treatment option.

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