Myopia Management
What Is Myopia?
Myopia, commonly known as short-sightedness, is a common vision disorder that causes distant objects appear blurry while close objects can be seen clearly. This occurs when the eye grows too long from front to back or when the cornea is too curved. This causes light entering the eye to focus in front of the retina instead of directly on it.
What is Myopia Management?
Myopia management is a name for any process that tries to delay or limit how myopic a person becomes. Currently in the UK, the most common approaches to myopia management are to prescribe specially designed glasses or contact lenses and advise people to make simple changes to their lifestyle.
Myopia management uses myopic defocus to slow the progression of short-sightedness. Myopic defocus is achieved by using specially designed glasses or contact lenses that focus some light in front of the retina and some directly on it. This dual focus sends a signal to the eye to slow its growth. Essentially, it tricks the eye into thinking it is too long, which helps to prevent further elongation. By slowing the eye’s growth, these methods aim to limit the severity of myopia and reduce the risk of associated eye problems later in life.
Typically, the eye grows rapidly in childhood and continues to grow at a slower rate throughout the teenage years, and even into early adulthood, so myopia management might need to be continued until your child is in their late teens. If myopia management is stopped before your child’s eyes have stopped growing, the myopia may start to get worse again.
It is important to remember that myopia management does not cure or reduce existing myopia but aims to slow down the growth of the eyeball, and so limit how short-sighted your child becomes.
Ortho-keratology, often called Ortho-K, involves the use of specially designed gas-permeable contact lenses that temporarily reshape the cornea to reduce myopia (short-sightedness). These lenses are worn overnight and removed in the morning, allowing for clear vision during the day without the need for glasses or daytime contact lenses.
How Ortho-K Works
Ortho-K lenses gently flatten the central part of the cornea, which changes the way light is focused on the retina. This process creates a temporary correction of myopia, allowing for improved vision. The reshaping effect typically lasts for about a day, so the lenses need to be worn regularly each night to maintain clear vision.
Effectiveness
Numerous studies have demonstrated that Ortho-K is effective at slowing the progression of myopia in children. For example, research indicates that Ortho-K can slow myopia progression by about 40-60% compared to no treatment. This reduction in progression is significant in reducing the risk of developing high myopia and its associated complications.
Benefits
- Non-Surgical: Ortho-K offers a non-surgical alternative to vision correction, making it suitable for children and those not eligible for refractive surgery.
- Daytime Freedom: Since the lenses are worn overnight, users enjoy clear vision during the day without the need for glasses or contact lenses.
- Myopia Control: It helps in controlling the progression of myopia, potentially reducing the risk of future eye health problems like retinal detachment and glaucoma.
Risks
- Infection: Like all contact lenses, Ortho-K lenses carry a risk of eye infections, particularly if not cleaned and handled properly.
- Discomfort: Some users may experience initial discomfort when first using the lenses.
- Variable Results: The effectiveness of Ortho-K can vary between individuals, and some may not achieve the desired level of vision correction.
Overall, Ortho-K is an excellent option for managing myopia, particularly in children, offering both vision correction and control of myopia progression. It requires careful adherence to lens care and regular follow-up to ensure safety and effectiveness.
Soft myopia management contact lenses, such as MiSight and NaturalVue, are innovative solutions designed to slow the progression of myopia in children. These lenses utilize a technology that creates peripheral defocus, which alters how light is focused on the retina. This defocus signals the eye to slow its elongation, thereby reducing the progression of myopia.
Effectiveness
Studies have shown that MiSight lenses can reduce myopia progression by approximately 59% over three years. Similarly, NaturalVue lenses have demonstrated significant efficacy in controlling myopia progression. These lenses are typically worn daily and are replaced either daily (in the case of MiSight) or on a regular schedule (for other brands), making them convenient and hygienic.
Benefits
- Non-invasive: These lenses offer a non-surgical method to manage myopia.
- Convenience: Daily disposable lenses, such as MiSight, reduce the risk of eye infections associated with lens wear.
- Effective Control: Proven to significantly slow down the progression of myopia, reducing the risk of high myopia and associated complications like retinal detachment and glaucoma.
- Improved Quality of Life: Children can enjoy clear vision during the day without the need for glasses.
Risks
- Infection: There is a risk of eye infections if lenses are not handled and cleaned properly.
- Initial Discomfort: Some users may experience discomfort when they first start using the lenses.
- Variable Results: Not all users may experience the same level of effectiveness, and some adaptation may be required.
Overall, soft myopia management contact lenses provide a practical and effective approach to controlling myopia progression in children, promoting better long-term eye health and quality of life.
Myopia management spectacle lenses, such as Miyosmart and Stellest, are designed to slow the progression of myopia in children. These lenses incorporate innovative technology to create a treatment zone that alters how light is focused on the retina.
How They Work
Miyosmart lenses use Defocus Incorporated Multiple Segments (DIMS) technology. This design includes a central optical zone for clear vision and multiple defocus segments around it, which create myopic defocus. This defocus signals the eye to slow down its elongation. Similarly, Stellest lenses use H.A.L.T. (Highly Aspherical Lenslet Target) technology with multiple aspherical lenslets that achieve a similar effect of myopic defocus.
Efficacy
Studies have shown that Miyosmart lenses can reduce myopia progression by up to 62% when worn the majority of the time.
Benefits
- Non-invasive: These lenses offer a non-surgical approach to myopia management.
- Ease of Use: They are worn just like regular glasses, making them easy for children to adapt to.
- Effective Myopia Control: Proven to significantly slow the progression of myopia, reducing the risk of developing high myopia and associated complications such as retinal detachment and glaucoma.
- Better Vision Quality: Children can enjoy clear vision while also managing their myopia.
Risks
- Adaptation Period: Some children may require time to adapt to the new lens design.
- Cost: These specialized lenses can be more expensive than regular glasses.
- Variable Results: The effectiveness can vary among individuals, and not all children may experience the same level of myopia control.
Overall, myopia management spectacle lenses like Miyosmart and Stellest provide an effective and user-friendly method for controlling myopia progression in children, promoting better long-term eye health.
Spending time outdoors during daylight hours can help delay the onset of myopia in children. This can limit the degree of myopia they develop and reduce the risk of future eye health complications. For children who are already myopic, outdoor activities may slow its progression, though the evidence for this is less certain. Current research suggests that children should spend between 80 to 120 minutes (1 hour and 20 minutes to 2 hours) outdoors each day.
Increased educational demands are associated with a higher risk of developing myopia, likely due to extended periods of near work. However, current evidence does not strongly support the idea that reducing near work alone will prevent myopia from developing or worsening. Despite the importance of screen-based learning and homework, it’s beneficial for children to take regular breaks from close-up tasks. Encourage them to follow the 20-20-20 rule: after every 20 minutes of screen time, spend 20 seconds looking at something at least 20 feet away. This practice helps reduce eye strain and may contribute to better eye health.
Repeated low-level red light therapy is a newer method for managing myopia progression. This involves your child looking into a small device at home that emits specific red light. The treatment is done five days a week, for three minutes twice a day, with sessions separated by at least four hours. Research from China indicates this method can significantly slow myopia progression in some children. However, the long-term effects and safety of red light exposure are not yet fully understood, as studies have been limited in scope.
*Not currently available at Taylor-West & Co
Atropine is used in various countries to manage myopia, though it is not licensed for this use in the UK. High concentrations (1%) effectively slow myopia progression but cause side effects like light sensitivity, difficulty focusing on near objects, and allergic reactions. Lower doses (0.01% and 0.05%) have shown promise in reducing myopia progression with fewer side effects. However, ongoing research aims to determine the optimal concentration and duration of treatment.
*Not currently available at Taylor-West & Co
If you are concerned about your child’s myopia or wish to explore effective management options, we encourage you to make an appointment with us.
Several factors contribute to the development of myopia, including genetics and environmental influences.
Children with one or both myopic parents are more likely to develop myopia. Environmental factors such as prolonged near work (reading, screen time) and insufficient time spent outdoors also play significant roles. Studies suggest that increased time outdoors can reduce the risk of developing myopia.
The prevalence of myopia is rising at an alarming rate globally. Currently, about 30% of the world’s population is myopic, and this figure is projected to increase to 50% by 2050, affecting nearly 5 billion people. High myopia, which can lead to severe vision impairment and eye health issues, is also expected to rise significantly, potentially affecting 10% of the global population by mid-century.
Preventing and managing myopia is crucial due to its potential impact on eye health and quality of life.
High myopia increases the risk of serious conditions such as retinal detachment, glaucoma, and myopic maculopathy, which can lead to permanent vision loss. Furthermore, the economic burden of treating myopia and its complications is substantial.
Implementing myopia management strategies is essential. These include encouraging outdoor activities, reducing prolonged near work, and using interventions like special glasses, contact lenses, Ortho-K lenses and low-dose atropine eye drops to slow myopia progression in children.
Addressing the myopia epidemic involves awareness, early detection, and proactive management to preserve vision and enhance quality of life for those at risk.
What are the risks associated with Myopia?
Being myopic increases the risk of certain eye conditions, and this risk increases the more myopic you are. If your child is myopic, they are more at risk of developing the following conditions at some point during their life.
Myopic maculopathy
This refers to a condition which damages the central vision. If your child has a high level of myopia, they are at greater risk of developing myopic maculopathy.
Retinal detachment
This is where the retina pulls away from the other layers of the eye. It can lead to permanent sight loss if it is not treated quickly. Higher levels of myopia increase the risk of this happening.
Cataracts
This is where the lens of the eye becomes cloudy. Cataracts are very common and mostly develop in older age. There is some evidence that suggests higher levels of myopia mean cataracts may develop at a younger age. Treatment for cataracts is normally straightforward and effective.
Glaucoma
This is a condition where the optic nerve becomes damaged. It affects the peripheral vision (side vision) first but can lead to severe sight loss. There is some evidence that myopia may slightly increase the risk of developing glaucoma. Early treatment can significantly slow the development of glaucoma and reduce the risk of permanent sight loss.
Personalised advice to help you understand the best treatment options for Myopia.
Our team will provide personalised advice and help you understand the best treatment options for your child’s unique needs. Early intervention can make a significant difference, so don’t hesitate to reach out and ensure your child’s eye health is protected for the future.
