Myopia Management

Myopia, also known as nearsightedness or shortsightedness, is a condition where close objects are seen clearly but distant objects appear blurry.

Both children and adults can experience myopia. However, children diagnosed with myopia at an early age are at a higher risk of developing myopia-related complications, which go beyond just needing thick corrective lenses.

The good news is that recent advancements have provided effective ways to manage myopia in young children. We now have the ability to slow the progression of nearsightedness and give children a better chance of controlling it.

Childhood-onset myopia is influenced by multiple factors. As children with myopia grow, their eyes elongate, causing images to focus incorrectly on the retina. Research shows that genetics, ethnicity, environmental factors, and individual behaviors all contribute to this excessive eye growth.

In contrast, adult-onset myopia typically develops as a result of increased near-vision demands, leading to a change in how the eye focuses.

Why Is It Important?

There is a growing trend of myopia developing in children at younger ages globally. In certain regions of Asia, up to 80% of high school girls are affected by myopia. In the United States, myopia rates have risen by 66% over the past 30 years.

Major health organizations such as the World Health Organization, the American Academy of Optometry, and the American Academy of Ophthalmology recognize the increase in myopia and emphasize the importance of controlling its progression as a public health priority. High levels of nearsightedness can increase the risk of conditions such as glaucoma, cataracts, retinal detachments, and retinal degenerations for some individuals. These organizations also acknowledge that certain treatments have proven effective in slowing myopia progression in children.

What Causes Myopia?

Research into the causes and risk factors of myopia indicates that spending extended periods focusing on close-up tasks is a major contributor to myopia development. Other factors that increase the risk include genetics and ethnicity.

Children as young as two years old are at an increased risk of developing myopia early, as more children are using devices like iPhones, tablets, and electronic games at younger ages.

Studies show a stronger correlation between Asian ethnicity and faster progression of myopia, with higher global prevalence in this group.

A child with one parent who is nearsighted has a threefold higher risk of developing myopia, and if both parents are myopic, the risk increases sixfold.

In addition, wearing glasses that are under- or over-corrected can trigger the onset of myopia and accelerate its progression.

How Can We Slow Myopia?

We have the tools to manage and slow the progression of myopia with evidence-based methods. Early detection of vision changes can help prevent or delay the condition's onset. While myopia has no cure once it starts, there are treatments to prevent its progression.

Routine eye exams should begin as early as age five to detect any early signs of myopia. Although no treatment guarantees success, delaying the start of treatment can eliminate potential benefits.

Children should limit close-up activities such as reading, homework, or screen time to under three hours a day, excluding school time. Excessive screen use can contribute to myopia, cause dry eyes, and heighten the risk of long-term eye damage.

Ensuring proper ergonomic posture when using electronic devices can help minimize eye strain. Taking breaks every 20 minutes to look at something across the room for 20 seconds can also alleviate strain.

Encouraging outdoor activities is beneficial, as children who spend at least 90 minutes outdoors daily show a 50% reduction in the onset of myopia. However, excessive outdoor screen use doesn’t have the same benefits. Always use UV protection, such as sunglasses and hats, when outdoors.

Research indicates that exposure to blue-white light from devices can harm long-term eye health and disrupt sleep patterns. To protect eye health, it’s recommended to avoid screen use at least 30 minutes before bedtime.

My Child Has Myopia. What Should I Do Next?

Specialty contact lenses and orthokeratology (Ortho-K) offer effective solutions for vision correction and slowing the progression of myopia. Research has shown that specially designed glasses can also help slow myopia progression, but not as effectively as contact lenses. These glasses are particularly helpful for those with binocular vision issues.

Low-dose atropine eye drops, such as 0.01% atropine, have been shown to reduce myopia progression by about 60% without significantly altering pupil size or near vision.

Myopia Control at Nexus Vision Eye Care

At Nexus Vision Eye Care Myopia Control Clinic, our mission is to provide the latest, evidence-based treatments to help control myopia and improve vision. By addressing eye growth and correcting myopia, we offer a range of treatment options that are proven effective in managing myopia progression in children.

Currently, four treatments have been shown to be effective for myopia control in some children: corneal reshaping (Ortho-K), multifocal contact lenses (MiSight), bifocal or progressive glasses, and low-dose atropine eye drops.

Corneal Reshaping Lenses (CR)

Also known as orthokeratology (Ortho-K), Corneal Reshaping lenses are FDA-approved custom rigid gas permeable (RGP) lenses designed to reshape the cornea. Worn overnight, these lenses temporarily alter the cornea’s shape, allowing for clear vision throughout the day without the need for glasses or contact lenses. The effects are temporary, so they must be worn every night to maintain vision clarity. Studies suggest that corneal reshaping lenses can reduce myopic progression by up to 41%.

Multifocal Contact Lenses

Multifocal contact lenses provide a solution for myopia by offering better vision at both distance and near, reducing eye strain. These lenses have a graded prescription to address both far and near vision needs. Research shows that these lenses can slow myopia progression by an average of 40%.

Bifocal or Progressive Glasses

Bifocal or progressive glasses help reduce the strain caused by focusing on near objects, potentially slowing myopia progression by 39-51%. These glasses are to be worn full-time and are especially effective in children with myopia-related focusing challenges.

Low-Dose Atropine

Atropine eye drops, typically used to dilate the pupils, reduce the eye’s ability to focus on near objects. Although the exact mechanism by which atropine slows myopia is not fully understood, research shows that low-dose atropine (0.01%) reduces progression by 60% without significant pupil dilation or loss of near vision.