Myopia Control

Myopia, also known as nearsightedness, is one of the most prevalent vision conditions plaguing the world today. It is caused by the elongation of the eyeball, (therefore an increase in the axial length of the eyeball), which prevents light from focusing properly on the retina. As a result distant objects will appear blurry. Alarmingly, half the world is estimated to be affected by this visual disorder by 2050, that’s 5 billion people!

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Dr Dylan Joseph

Cataract and Refractive Surgeon

MBChB(Pret), Dip Ophth(SA), FC Ophth(SA),
MMed Ophth UFS (cum laude)

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Once you understand more about Myopia and all that it entails, you will be able to make a more informed decision about the way forward. Allow us to walk you through the ins and outs of this condition.

Research shows that one of the biggest risk factors associated with myopia progression is prolonged near work activity, reduced time spent outdoors, the high value placed on educational performance etc. Living in the digital age necessitates the use of screens, which contributes to the pandemic and children are being introduced to them at an increasingly earlier age.
As their vision is still developing, it comes as no surprise that our young ones are the most vulnerable to myopia. As parents it is important to help our children manage their screen time & prevent myopia from progressing.

Researchers found that the axial length of the eyeball is affected by the position of an image projected in relation to the retina. This indicates that projecting images in front and on the retina at the same time, can control axial growth and myopia progression.

Myopia Management options

Children with short-sightedness (myopia), tend to show regular progression or worsening of their vision over  time. However, there are ways to slow down this deterioration – by means of myopia control or myopia management. It is our duty as optometrists & ophthalmologists to manage myopia, because it is a risk factor for visual impairment & sight- threatening ocular pathologies that manifest in later life.

Spectacles

Industries specialising in this field, developed a technology to control myopia progression using ophthalmic lenses. It is a myopia control specific lens design – these include peripheral plus and multi-segment designs.

By the use of this award-winning ophthalmic lens, myopia can be controlled by simultaneously providing clear vision & constant myopic defocus – therefore simultaneously slowing down the growth of the eyeball as well as providing clear vision.

To effectively control myopia progression, peripheral myopic defocus has to be experienced by the wearer constantly. This requires a significant quantity of defocus segments to be evenly distributed on the lens surface as seen below.

Standard types of single vision spectacles DO NOTHING to help slow down the progression or worsening of vision, which is typical in children with myopia. They should NOT be the 1st choice for your myopic child.

Contact Lenses

For these children with myopia, research and clinical practice proves that special types of contact lenses are far more advantageous than wearing regular glasses. Not only do these contact lenses provide clear vision without the hassle of wearing spectacles, but they also help slow down a child’s progressive vision deterioration that occurs with myopia.

Kids and contact lenses make a great combination. The truth of the matter is that most children can wear contact lenses safely, happily & successfully. Watch this short and interesting video that explains the benefits of contact lenses for kids as well as how safe they can be: https://vimeo.com/421373065

If your child isn’t quite ready for contact lenses, there are spectacle lens options available for myopia control and atropine eyedrops. Contact lenses have the advantage though, of both correcting the blurred distance vision of myopia & being the most widely available and consistently successful option regarding the control of myopia progression.

Atropine Eyedrops

Atropine eye drops are usually used in combination with either spectacles and/or contact lenses.

The concentration of atropine eye drops which have been researched for myopia control vary from 0.01% up to 1%. The stronger the concentration, the more likely the risks of side effects may be.

Atropine causes pupil dilation & loss of accommodation. Side effects include sensitivity to light due to enlarged (dilated) pupils, & problems with close up reading vision due to reducing the eye’s focusing mechanism (accommodation). These side effects can be managed with spectacle lenses which darken when outside (called photo-chromatic) that may also incorporate a stronger power in the lens to support reading. Side effects can also include stinging of the eye drop on installation & sensitivity reactions. Together with Dr Dylan Joseph, we will explain all side effects thoroughly & address any concerns you may have. Atropine eye drops are usually used once daily, preferably at night.

Orthokeratology/Ortho-K

This treatment entails specially designed contact lenses to temporarily reshape the corneal surface. These lenses are worn overnight to allow users to go without myopic correction during the day.

Ortho-K lenses do two things for children with myopia

  1. Restores clear vision & helps eliminate or decrease dependency for glasses or contact lenses during the day.
  2. Slows & sometimes halts the progression of myopia & vision deterioration over time. It works by gently reshaping the curvature of the eye using specially designed contacts while you sleep.

The reshaping process of the eye surface is achieved by flattening the central area of the cornea (to restore clear vision) & the mid-peripheral area is steepened (to control myopia progression)

This independent focusing of central & peripheral vision is an effect that regular glasses cannot achieve. It has been shown to be safe & effective in slowing the progression of nearsightedness. Atropine 0.01% in combination with Ortho-K lenses appears to work better than just Ortho-K alone.

What Is Best?

So – How will we best manage myopia & meaningfully slowdown such progression?

Together with Dr Joseph we will consider all relevant factors before we decide which myopia control option is most suitable for your child, as it can depend on their level of myopia, age and other factors. It’s important for you to also understand the influence of your child’s visual environment – outdoor time & screen time – on successfully managing their myopia.

TOGETHER WE CAN TACKLE MYOPIA IN CHILDREN SUCCESFULLY

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