Myopia Control
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Myopia Control
What is Myopia?
What does it increase?
Contact Lens Advice
Control Methods
How does it work?
Published Articles
Frequently Asked Questions
Myopia Control
Shortsightedness is the most common eye problem in the world.
Myopia (short sightedness) is an extremely common eye condition which generally allows close objects to be viewed clearly but distant images are blurred. The eye is its own optical system and for it to work perfectly light must enter the eye via the pupil and be focused on the retina. In a myopic (short sighted) eye the focusing system is not perfect and the light is actually focused in front of the retina so by the time the light does actually reach the retinal surface the image is blurred.
What is Myopia?
Myopia (short sightedness) is an extremely common eye condition that generally allows close objects to be viewed clearly but distant images are blurred. The eye is its own optical system and for it to work perfectly light must enter the eye via the pupil and be focused on the retina. In a myopic (short sighted) eye the focusing system is not perfect and the light is actually focused in front of the retina so by the time the light does actually reach the retinal surface the image is blurred.
Myopic Vision:
Myopia Causes
During childhood, your eyes, along with the rest of the body, grow in size. For the myopic (short sighted) eye, the retina grows further and further away from the point where the light is focused, and so this myopic (short sighted) problem gets worse. This constant lengthening of the eye during childhood is why many of us end up so short sighted. If the rate at which the eye’s length grows could be reduced or stopped, then the myopic (short sighted) increase we so often see in our children could also be reduced.
There have been many studies conducted into myopia (short sightedness) and the evidence certainly seems to suggest that the problem of myopia (short sightedness) in the developed world is on the increase. So why are we becoming more and more myopic (short sighted)? There are a number of theories but as yet none of them is proven. Here are a few of the possible reasons for this increase in myopia (short sightedness).
Parental Myopia. It is pretty certain that there is a genetic link between myopic (short sighted) parents and their children.
A natural adaptation to the modern world’s near vision requirements. Much of our education involves a constant need for close work. It is possible that the human eye is naturally evolving in a more myopic (short sighted) way to help cope with all this near vision.
It is known that a drop in outdoor activity can lead to insufficient levels of Vitamin D which is obtained from sunlight. Could a drop in our Vitamin D be contributing to all this myopic (short sighted) increase?
It has been suggested that a modern diet may also be contributing to this myopic (short sighted) shift.
As mentioned before these are only theories and are as yet unproven. However, as suggestions, they are both interesting and plausible. What is undisputed is that there is an increase in myopia (short sightedness) and it would be beneficial to those suffering from it if there was a way of reducing the problem.
Myopia Symptoms and Treatment
Chances are the only symptom is that more distant objects are blurred. You may also notice:
- Headaches
- Squinting
- Eye strain
- Eye fatigue when you try to see objects more than a few feet away
- Children with myopia often have trouble reading the blackboard at school
An eye exam at Bill Opticians can show you if you’re myopic. Glasses, contacts, or refractive surgery can usually correct the problem.
When you have myopia, your prescription for glasses or contact lenses will be a negative number. The more negative the number, the stronger your lenses will be. Your prescription helps the eye focus light on your retina. That clears up your vision.
Book an appointment with us today or get in touch for more information about Myopia.
Why does it increase? – Myopia Control
What should I do?
The average increase in myopia for those who are progressing is about 0.37 diopters/year. That means an 8 year old child with low myopia most likely won’t be able to read the big “E” on the eye chart without glasses by the time they are 13! 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.
HAVE YOUR EYES EXAMINED
You need an eye exam. You need an eye exam at an age before you can even read this web site. Research is showing that specific findings during an eye exam identify those who are most helped by treatment. Eye exams are also useful because blurred vision does not mean you have myopia. There are many other reasons for blurred vision that require treatment. People with clear vision also can have significant eye problems. Don’t try to guess what you have. Find out.
SPEND TIME OUTDOORS
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. Participation in sports or other strenuous activities is not the requirement as indoor sports such as basketball do not give the same protection. Studies indicate that the activity might best be focused on distant objects, such as when bike riding, as opposed to near activities like playing cards. Just play outside instead of watching TV or computer screens.
How is the idea of “outdoor time” used for myopia control?
One of the big surprises of recent research is the importance of how increased time spent outdoors helps in preventing myopia. At the present time it appears that 14 hours a week or more outdoors are significantly effective in reducing myopia progression.
How does increased outdoor time work for myopia control?
We don’t know. There are many possibilities and studies are under way to help determine what is happening.
What might be gained by outdoor activity?
- Sun exposure with Vitamin D production (Vitamin D is produced by the skin with the aid of sunlight.)
- Exposure to bright light releases chemicals in the retina such as dopamine that can control growth
- Exposure to visual opportunities for far distance vision
- Exposure to beneficial microorganisms
- Unknown events that may be caused by being outdoors or that often happen to people who spend time outdoors.
- We do know that it is not sports or physical activity. The benefit happens for children playing outdoors with no organized sport activity.
“Outdoor activity” presents a complicated, broad area of research. An example of unexpected findings about outdoor activity is that exposure to the common soil bacterium Mycobacterium vaccae is believed to have anti-depressant qualities and has been shown to increase learning behaviour. It increased serotonin levels in the brain. Serotonin is part of the signalling system within the retina controlling eye growth. While no one has studied the possible connections to myopia control, the results indicate the complexity of trying to find exactly what outdoor time does to control myopia.
The outdoor benefit is not due to children outdoors reading less. Outdoor children do better regardless of their indoor reading activity. This means that it is not the “bookworm”, the child who reads a lot, who is more likely to become nearsighted. It is the child who doesn’t go outside, whether they are a reader or not.
Contact Lens Advice – Myopia Control
Do you want to know more?
If you are interested in Myopic Control Contact Lenses then you need to find an eye care practitioner who you are comfortable with. You are looking for a practice that has experience of working with children as well as a good knowledge of current contact lens techniques.
Once you have found an optician who can advise you then the actual contact lens fitting procedure is fairly simple. Your child will need an up to date eye examination and then the optician will check to see if they are suitable for contact lenses.
The lenses themselves are very soft and made of a plastic and water type material. The initial feeling is often surprisingly comfortable. Your optician will be able show you some soft lenses so you can see how they look and feel.
Once the correct lenses have been decided on they will be placed on the eye to confirm their fit and to ensure that a good level of vision can be achieved. Your child will be taught how to insert and remove the lenses and cleaning instruction will be given. It is normal for a pair of lenses to last either two weeks or a month and then they are replaced with a fresh pair. This frequent replacement of the lenses improves the hygiene of contact lens wear whilst keeping the whole system simple and affordable.
It is then normal for a trial to be organized so that a week or two of contact lens wear can be experienced before any final decisions are made. This gives you and your child the opportunity to make sure contact lenses are right for you. It also allows the eye care practitioner a chance to asses how suitable contact lens wear is and to see if there are any hidden problems that need to be taken into account.
Once the trial is completed and everyone is happy then the contact lenses would be prescribed. It is usual for the contact lenses to be supplied in three month batches with routine after care visits conducted every three to six months. Of course we are all individuals so the advice given by the optician will vary slightly from person to person..
Control Methods – Myopia Control
CAN YOU SLOW THE EYE’S CONSTANT GROWTH DURING CHILDHOOD AND SUBSEQUENTLY REDUCE THE INCREASE IN MYOPIA (Short sightedness)?
YES!
SO WHAT METHODS ARE AVAILABLE AND DO THEY WORK?
BIFOCAL and VARIFOCAL SPECTACLES
It would appear that the use of bifocal and varifocal spectacle lenses may reduce the rate of growth within the eye. The studies we have looked at suggest that the reduction achieved by this method is at best very small.
UNDER CORRECTING THE DISTANCE PRESCRIPTION
In some countries it has been common practice to not use the full myopic (short sighted) prescription when prescribing children with spectacles or contact lenses in the hope that this will encourage a reduction in myopic (short sighted) growth. Studies now show that this method is not only unsuccessful but that there is a possibility of making the myopia (short sightedness) worse.
Specialist Peripheral De-Focus Spectacle Lenses
There are many new innovations with spectacle lenses such as the Hoya Miyosmart.
As well as correcting the short-sighted error in the eye, a two year clinical trial shows that on average Miyosmart lenses will slow down the progression of myopia by 60%.
Accurate measurements and fitting of such spectacle lenses is critical to their effectivity so it is important to find an experienced practitioner to dispense them.
INSTILLING ATROPINE
Several studies have shown that by instilling Atropine eye drops a reduction in myopic (short sighted) growth can be achieved. It achieves this by temporarily paralyzing the near vision focusing muscle within the eye. However there can be some side effects. As well as paralyzing the focusing system Atropine also causes the pupils to be fully dilated this can create some problems with sensitivity to light and can even contribute to social problems at school with children whose eyes may look slightly odd.
DUAL ZONE (MULTI-FOCAL) SOFT CONTACT LENSES
This is by far our most favoured method. It has been shown that the use of this type of contact lenses can reduce the growth in a child’s eye by as much as 50%. This of course means that any increase in myopia (short sight) can be significantly reduced. The other great advantage of this method is that these lenses are available in soft, disposable type formats, which makes them both comfortable and affordable. There are a number of multi focal type lenses on the market and it is essential that the correct power combinations are used in order for the myopia (short sightedness) to be controlled but providing you find an experienced contact lens practitioner the fitting of these lenses is relatively simple.
ORTHO K – CORNEAL RESHAPING RIGID CONTACT LENSES
This is a custom made treatment option that uses overnight reverse-geometry contact lenses (the lenses are worn whilst you sleep) to reshape the cornea and allow for clear unaided vision throughout the next day once the lens has been removed. The altered refractive power of the cornea bends peripheral light rays entering the eye in a way which suppresses the stimulus which causes the eye’s continuous growth. Multiple studies have shown that orthokeratology may be successful in reducing the axial elongation of the eyeball subsequently preventing myopia (short sightedness) progression. It’s an optimal option for patients involved in sport and other recreational activities. Unlike laser eye surgery, orthokeratology is reversible, making it the best choice for anyone who has considered refractive surgery, but are concerned with the risks. The effect of orthokeratology lasts as long as the lenses are being used therefore they should be worn on regular basis.
How does it work? – Myopia Control
SO HOW DOES IT WORK?
In order for an eye to see clearly light must enter the pupil and be focused on the retina. If an eye is myopic (short sighted) then the light focuses too quickly so by the time it reaches the retinal surface it is blurred. In order to alter where the light is focused spectacle or contact lenses can be prescribed. This is how we routinely improve our vision but this will not slow the increase in myopia (short sightedness) in a child’s eye.
The very central area of our retina is known as the macula and this area of the eye is responsible for the critical portion of our vision. If we are too see clearly the light must be focused on the macula perfectly. The human eye is also stimulated by light as we move away from the macula, towards the periphery of the retina. It seems that if the macula is corrected perfectly but the peripheral areas of the retina are not corrected fully then the eye’s tendency to grow longer is reduced. So what is needed is a lens that can give perfect focusing in the centre but reduced focusing around the edge.
Dual Zone or Multi Focal contact lenses do exactly that. They have two area of focus, a central one which can provide clear focusing to the macula region and a peripheral one which can have a different optical power so the constant growth to a child’s eye can be reduced.
Published Articles – Myopia Control
Contact Lenses Paediatric
There has been a lot of interest and research in optometry for many years regarding the aetiology of progressive myopia. The previously held theory of genetic causation is generally now disputed with a greater acceptance of environmental factors playing a significant role in myopia development.
Liz Wason
A Case for Peripheral Optical Treatment Strategies for Myopia
It is well established that refractive development is regulated by visual feedback. However, most optical treatment strategies designed to reduce myopia progression have not produced the desired results, primarily because some of our assumptions concerning the operating characteristics of the vision-dependent mechanisms that regulate refractive development have been incorrect.
Earl L. Smith
Effect of Dual-Focus Soft Contact Lens Wear on Axial Myopia Progression in Children
Purpose: To test the efficacy of an experimental Dual-Focus (DF) soft contact lens in reducing myopia progression.
Design: Prospective, randomized, paired-eye control, investigator-masked trial with cross-over.
Participants: Forty children, 11–14 years old, with mean spherical equivalent refraction (SER) of 2.711.10 diopters (D).
Nicola S. Anstice
Frequently Asked Questions – Myopia Control
Is it dangerous for children to wear contact lenses?
Studies have shown that there are only small differences between a child’s cornea and that of an adult. They require similar levels of oxygen and so the contact lenses we are already using provide an excellent choice for children. Contact lenses are invasive so there are some risks involved (the same as for adults) but frequent replacement of the lenses and a thorough cleaning regime will help keep these risks to a minimum.
Will this process mean my child never has to wear spectacles?
No I am afraid there is no guarantee of that. It is known that the constant lengthening of the eye during childhood contributes to an increase in myopia (short sightedness). This technique is aiming to reduce how much the myopia (short sightedness) increases over this period. On average studies have shown that the rate of increase can be reduced by as much as 50% but it is not able to eliminate your child’s prescription.
What age do we need to start this kind of treatment?
Once your child has been diagnosed as myopic (short sighted) and you really want to try and limit how myopic (short sighted) they might become, then the sooner they are fitted with contact lenses the better. It is of course important that they can responsibly handle and look after their contact lenses.
I really want my child to have contact lenses but they are not keen?
Ultimately the decision lies with you but in our experience trying to make a child wear lenses is usually unsuccessful. I believe everyone needs to be comfortable, parent, child and eye care practitioner. You and your child should discuss the subject with your optician.
Do contact lenses hurt?
The contact lenses are very soft and so are much more comfortable than lenses have been in the past. Patients often describe an “awareness” of them when they are first inserted but adaptation is normally very quick.
Are contact lenses difficult to put in?
It can be more challenging to teach younger children to insert and remove lenses but once this has been mastered the system itself is straight forward. It is important to find a practice where they have the time and patience to take your child through the process at their own speed.
Can contact lenses disappear behind the eye?
No. The furthest that a contact lens can travel is underneath your top eyelid and fortunately from there the lens is easily removed by a contact lens practitioner.
Do contact lenses come in all prescriptions?
Don’t forget at the moment we are talking about myopic (short sighted) prescriptions, if your child is long sighted these lenses are not appropriate. Most myopic (short sighted) children can be helped however the contact lenses do have some prescription limitations so although unusual, there are some patients who fall outside the normal prescription range. Often a pair of spectacles over the top of the lenses can boost the vision up to a sensible level whilst the contact lenses help to slow the myopic (short sighted) progression..
Contact Lenses Paediatric
There has been a lot of interest and research in optometry for many years regarding the aetiology of progressive myopia. The previously held theory of genetic causation is generally now disputed with a greater acceptance of environmental factors playing a significant role in myopia development.
Liz Wason