Myopia, or nearsightedness, is the eye condition where close objects are clear but objects that are far away are blurry. The percentage of people who develop myopia is increasing dramatically, and there are both genetic and environmental factors determining onset and progression. For example, myopic parents have more myopic children than non-myopic parents. People in urban environments have more myopia than rural environments.
Slowing the advancement of myopia can not only avoid developing a high prescription, but high levels of myopia have also been linked to early cataracts, glaucoma, and retinal detachments.
Our plan is to keep myopia from getting worse or perhaps prevent it from ever starting, but it is not a plan to cure myopia. True myopia means that the eyeball has grown too long. That physical change cannot be reversed – we can’t make the eyeball shorter without cutting part of it off. Various studies have shown that it is possible to slow down myopia in children and teenagers through several treatment strategies:
Treatment Options and Alternatives to Stronger Glasses Each Year:
1. Corneal Reshaping (Orthokeratology)
- Small-diameter contact lenses made of oxygen permeable rigid materials are used to reshape the cornea to reduce refractive error. Lenses are worn during sleep and removed after waking up. This treatment allows users to see clearly in the daytime without contact lenses or glasses, so long as they continue to wear the lenses regularly at night.
- The lenses are comfortable and do not interfere with sleep. They last approximately a year and are worn as long as myopia progression is considered a risk, or until freedom from daytime lens correction is no longer desired. Of all the optical solutions that have been studied in controlled clinical trials, Ortho-K has been shown to slow myopic progression the most.
2. Soft Multifocal Contact Lenses
- Multifocal contact lenses are specially designed lenses that have different powers in different zones of the lens to correct presbyopia (an age-related condition when the eye’s lens doesn’t change shape as easily as it once did, making it more difficult to see up close) in adults, as well as nearsightedness or farsightedness.
- Researchers and eye doctors found that multifocal soft contact lenses are also effective tools for myopia control.
- Low dosage Atropine drops taken nightly have been shown to reduce myopia progression with few side effects. In the United States, atropine is not approved by the FDA for myopia control, but is often used “off-label,” with proper informed consent.
4. Bifocal or Multifocal Glasses:
- Bifocals (clear distant vision on top, reading vision on the bottom) or progressive addition lenses (bifocals without a line and with variable power extending to the bottom for reading) may have a slight advantage for some specific conditions associated with myopia. Overall, studies do not show myopia progression to be as effective with this option versus other treatment options.
5. Lifestyle Changes
- Children who spend more time outdoors have less risk of developing myopia, even if they have myopic parents and even if they read a lot. Children should strive to be outdoors at least two hours a day. We do not know if this is the critical amount of time, but children who were outdoors at least that long did not progress in their myopia as quickly.
Most people can slow down or stop their eyes from becoming more myopic (nearsighted or shortsighted). Stronger glasses each year should not be normal. There is no cure for myopia, but you can most likely improve how your eyes are changing. While there are no guarantees with any of these treatments, doing nothing is no longer the only option.
Regardless of the type of treatment, it is always best to start at the earliest age possible. Low levels of myopia and the opportunity they afford for more effective treatment are often missed quickly as the change is usually most rapid in the first year or two. There are advantages at any level but there is no advantage in waiting. The doctors at HREC can help you understand and begin the treatment option that is best for you and your family.
Assess your child’s risk at: