Myopia Management

Myopia is the clinical term for nearsightedness. People with this condition can see clearly up close but not at a distance. Myopia is often first diagnosed in school-aged children and arises from a complex interplay of genetic and lifestyle risk factors including; having one or both parents who are myopic, less time spent outdoors, intensive near work, or poor lighting levels.

Myopia Management

Myopia, the clinical term for nearsightedness, is blurry distance vision that results when light rays are focused in front of the retina due to a longer than average eyeball.  Myopia is often first diagnosed in school-aged children and arises from a complex interplay of genetic and lifestyle risk factors including:

• Having one or both parents who are myopic
• Less time spent outdoors
• Intensive near work 
• Poor lighting levels

While glasses and traditional contact lenses can provide clear vision, neither can stop myopia from worsening. Why is progression concerning?  Increasing myopia is the result of excessive eye lengthening which stretches the retina and places your child at risk for developing vision-threatening pathologies later on. The younger the child, the faster their rate of progression and the greater their risk for high myopia (> -5.00 diopters) and eye pathologies including: 

• Retinal detachment
• Glaucoma
• Cataracts
• Myopic macular degeneration 

Research has shown that no amount of myopia is safe.  Each diopter or “unit” of correction that can be prevented will improve your child’s quality of life, lower their risk for visual impairment, boost their self-esteem as well as maximize their potential for sports, academics and laser correction in the future. Early intervention is key to avoid high myopia.

Myopia is now recognized as a disease that should be proactively managed. The good news is there are steps you can take to slow your child’s increasing glasses prescription. There are well-studied optical and pharmaceutical interventions that can effectively control myopic progression by an average of 45-60%.  These treatments can be prescribed alone or in combination based on your child’s degree of myopia, maturity and progression history:

Low dose atropine: These are topical eye drops in concentrations of 0.01 to 0.05% available by prescription from a compounding pharmacy. Atropine drops are to be instilled in each eye nightly.  Risks of side effects are usually very low at this dose and can include pupil dilation, light sensitivity and blurred near vision. 

Orthokeratology (ortho-K):  This corneal reshaping therapy requires the child to wear a custom made permeable retainer lens nightly to slow myopia progression with the added benefit of good uncorrected daytime vision. 

MiSight® 1 Day contact lenses: The first and only FDA approved daily disposable contact lenses clinically proven to slow myopia progression when initiated in children ages 8-12. Further evidence from ongoing studies suggest that even those who start treatment in their mid-teens can benefit.

Multifocal contact lenses: Typically used to provide near correction for adults with presbyopia (age related reading loss), the optics of these contact lenses when used in myopic kids can shift the way light rays are focused onto the retina and reduce the growth cues that cause further progression. 

Dr. Rebecca Chung is a fellowship-trained contact lens and myopia management specialist and one of the first eye doctors to be certified in the Brilliant Futures™ Myopia Management program to offer MiSight® 1 Day.