Managing Myopia

My Child Is Becoming More Near-Sighted Every Year ... What Can I Do?

by Tyler Stiegemeier, OD // January - February - March 2018

Near-sighted, or myopic, individuals can see well up close, but have blurred distance vision without the help of glasses or contact lenses. Myopia is a growing concern in the United States and other industrialized countries around the world. If you feel that more children are now wearing glasses to correct their distance vision than ever before, it is not your imagination. Current statistics suggest that half of the world’s population will be near-sighted by 2050. If myopia can be corrected with glasses or contact lenses, why are the experts worried?

Myopia is irreversible and tends to worsen over time. Later in life, high levels of myopia can lead to blinding complications such as retinal detachment and types of macular degeneration. During childhood, myopia can impede learning, limit physical activity, and cause emotional stress for children who are opposed to glasses or contact lens wear. Dealing with glasses and contact lenses on a daily basis can be a nuisance for kids and parents alike. 

Why are more young kids myopic now than say 50 years ago? The answer is complex and still not completely understood. However, one leading theory strongly associates “close work” to the development of myopia. The intense strain put on the eyes by viewing objects at a close distance such as tablets, phones, books, and computers for long periods of time cause the developing eye to grow longer, thus causing myopia. Children are now being introduced to electronic hand-held devices at very young ages and because the eyeballs of young children are very plastic, myopia can develop very quickly. Other research attributes limited time outdoors and having myopic parents as other potential causes of myopia.

A subspecialty field of “Myopia Control” is exploding in the world of eye care. Doctors involved in myopia control go beyond simply providing a stronger glasses prescription year after year, but rather work to achieve a temporary correction and also slow down or prevent further progression. The goal of these non-surgical treatments is to slow down eyeball growth. There are three main treatment options for myopia control. Two options use unique styles of glasses or contact lenses, either no-line bifocal glasses or multifocal soft contact lenses for daytime wear. The other is orthokeratology, also known as Ortho-K, which is the use of rigid contact lenses at night only. All of these treatment methods have been shown to slow down the progression of myopia. Other recommendations to help reduce the progression of myopia include taking breaks while doing close work, spending time outdoors, and if possible, limiting the duration of time doing close work. Current research about outdoor light exposure and myopia is fascinating and provides compelling evidence to get your kids out-doors as much as possible. No matter the treatment, early treatment is critical. Childhood is a high-risk period where the eyeball is subject to rapid elongation, so earlier treatment will result in a better outcome.

Ortho-K lenses are a specialized type of contact lenses that are fit by eye doctors with advanced training and a keen interest in myopia control. Ortho-K has been a very popular method of myopia control because the treatment is done safely during sleeping hours and provides clear vision during the day without any glasses or contact lenses. Ortho-K works by temporarily changing the curvature of the surface of the eye. To maintain the treatment, lenses must be worn every night, at least until young adulthood when the eye becomes less prone to rapid change. The results are dramatic and quick. It is not unusual to achieve a 50% reduction in myopia after only one night of Ortho-K lens wear and full reduction of myopia after seven to 10 days. The safety profile is also very appealing, as the treatment is easily reversible by discontinuing lens wear. Parents often question if their child is old enough to try Ortho-K. Age is not the most important factor when determining whether or not a child is a good candidate. The maturity level of the child and the involvement of the parents are the most important factors. While wearing Ortho-K lenses is not all that different from wearing traditional soft contact lenses, patients must be self-motivated, independent, and aware enough to report any problems that arise. Parents must understand the process and monitor the patient until they are confident that the child fully understands the proper care and handling of the lenses. One of the most rewarding things about treating children with Ortho-K is hearing parents say that their children have become more confident and responsible since starting treatment. 

You do not need to merely accept advancing myopia as a normal part of growing up. Research in the field of myopia control is dynamic with new information becoming available at a rapid pace. An eye doctor with a special interest in myopia control will be your best resource for discussing the latest developments and determining if any treatment options are a suitable fit for your child and family.

Tyler Stiegemeier, OD

With Myopia Control Clinic, a subspecialty clinic of McPherson Family Eye Care.