Myopia Management

WHAT IS MYOPIA?

Myopia, also known as nearsightness, is the vision condition that occurs when the eye is too long so that light entering doesn’t focus correctly and creates blurry vision in the distance. Cases of myopia have increased dramatically worldwide and is now the leading cause of visual impairment. Today, about 42% of the US population has myopia compared to just 25% in the 1970s. Myopia typically develops between 6 and 18 years of age.

RISK FACTORS

GENETICS

If one parent has myopia, the child has 3 times the risk of developing myopia. If both parents have myopia, the child has 9 times the risk of developing myopia.

LIFESTYLE

Children who spend less than an hour outdoors during the day and have little exposure to sunlight, increase their risk of developing myopia. Visual stress, such as excessive reading and digital device use (i.e., computers and video gaming), can increase myopia risk.

OUTDATED PRESCRIPTIONS

If children have myopia but are not corrected with the use of glasses or contact lenses, or if children are wearing outdated glasses or contact lenses and are not fully corrected, then myopia can increase significantly.

MANAGING MYOPIA

What can parents do to reduce the risk of myopia or reduce its progression in children once it develops?

YEARLY EYE EXAMS

It is recommended that children with myopia get an eye exam at least every 12 months. Children’s eyes can change every year from environmental factors because eyesight does not stabilize until about 22 years of age. Children’s eyeglasses should be updated as soon as there is a change in prescription because it is believed that not being fully corrected in a eyeglass’s prescription can lead to an increase in myopia.

SPEND MORE TIME OUTSIDE

It is recommended that children spend 2-3 hours outside during the daytime in order to get bright sunlight exposure to slow the progression of myopia. Indoor lighting is only about 10% of the brightness of a sunny day.

FOLLOW YOUR DOCTOR’S MYOPIA MANAGEMENT RECOMMENDATION

Your child’s optometrist may prescribe one or more of the following treatments for slowing down the progression of myopia.
  • Atropine is a prescription eye drop used to dilate the pupils of the eyes and historically used to treat lazy eye. The specific mechanism of atropine is not fully understood in regards to myopia management however it has shown to slow the growth of the eye therefore slowing down the progression of myopia.
  • We prescribe a very low concentration Atropine eye drops that are used once nightly 1 hour before bedtime. Your child will still need to wear glasses and or contacts to correct their vison.

A new FDA approved soft contact Lens called MiSight have also been shown to slow down the progression of myopia. An optometrist will determine if you are a good candiate for MiSight by Cooper Vision, a soft single use daily replacement lens which is FDA approved for Myopia Management. Lenses will be put in and taken out daily. Kids can easily adapt to contact lenses, play in sports and continue their daily activities.

A GOOD CONTACT LENS CANDIDATE WILL HAVE:

  • A desire to wear them
  • Realistic expectations about contact lens wear
  • The ability to follow directions regarding inserting and removal independently
  • A prescription that lends itself to contact lenses
  • No adverse eye health problems

FITTING APPOINTMENT(S) AFTER YOUR EXAM

Contact lenses are fit individually to each person and follow up appointments are needed to ensure appropriateness. For most people this takes 1-2 visits that are covered by the fitting fee. Your child will be taught how to insert and remove the contact lenses and once the contact lenses have been confirmed as a good fit, your optometrist will finalize your contact lens prescription.

FOLLOW UP EXAM

Your child’s Optometrist will schedule follow up visits to monitor the progression, usually every 6 months.

Ortho Keratology (ORTHO-K) is another treatment of progressive myopia using a rigid contact lenses worn over night for slowing progression of Myopia.

This service is currently only available at the Kaiser Baldwin Park Medical Center.

What is Myopia?

Difficulty seeing clearly at distance that typically develops between 6 and 18 years of age.

Why does myopia progression in children matter?

In addition to blurry distance vision, there is an increased risk for eye diseases such retinal detachment, myopic macular degeneration, early cataracts and glaucoma. High myopia may also limit a child's choice of their future occupational or athletic prospectives.

How do I know if it is working? What to expect?

Natural myopia progression is difficult to predict, so it is also difficult to determine precisely how effective the treatment will be. Follow up care will allow us to closely monitor the progression of myopia.

How long does treatment need to be used?

This will be determined by your child's optometrist. In general, treatments last at minimum 2 years.

Does the computer make it worse?

It is recommended that if a child will spend prolonged time performing near tasks to take a break every 20 minutes, for 20 seconds, by blinking their eyes and looking far away (20 ft) outside a window or down a hall to give the eye muscle a break. Using computers or reading without taking breaks may increase the risk of myopia.

What else can I do?

Studies suggest that spending at least 2-3 hours outdoors daily can help slow development and progression of myopia.

Are these treatments FDA approved?

MiSight and Ortho K are FDA approved. Low dosage atropine for myopia management is under FDA review.

Can my child be placed on more than one of these modalities at once?

Yes, your doctor may suggest your child to use atropine drops along with contact lenses. Please make sure to use atropine drops at least 15 minutes before contact lens insertion or after the removal of contact lenses, and never at the same time.
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