Myopia Control

Take control of your child's myopia

Myopia control

Myopia (short-sightedness) is a common cause of vision loss, with uncorrected myopia being the leading cause of vision impairment across the world. The prevalence of myopia is rapidly rising globally and it is estimated that by 2050, one half of the world’s population will be myopic. Compare this to 2000 when less than a quarter of the world’s population was myopic. Why does this matter? Unfortunately, high myopia is one of the leading causes of legal blindness because of complications associated with excessively elongated eyes, such as myopic macular degeneration, cataract, retinal detachment and glaucoma. These lifelong risks increase as the degree of myopia increases, therefore our aim is to reduce these ongoing risks by managing the growth of the eye.

'The primary aim of myopia control is to limit the axial length of the eye and secondly, reduce the degree of myopia.'

Research has shown that eyes longer than 26mm in axial length are at much greater risk of eye health complications associated with progressive myopia. Therefore the new ‘gold standard’ of eye care in myopia control is not just slowing down the rate of myopic progression, but more importantly, reducing axial length growth rates of the eye.

Why slowing myopia progression is important

High myopia is well known to be strongly linked to higher risk of cataract, retinal detachment, and myopic maculopathy. Even low amounts of myopia triple the risk of retinal detachments compared to those that are long-sighted. A normal eye length is 22-24mm. With eye ball lengths between 26-30mm, the likelihood of being visually impaired by age 75 is around 25%. Research has shown that every part-millimetre increase in axial length in a myopic person brings an increased risk of pathology. If we can keep myopia below -3.00 and axial length below 26mm, this significantly reduces the lifelong risk of visual impairment.

Lifelong risks associated with myopia of -3.00

Increased risk of glaucoma 3x
Increased risk of cataract 3x
Risk of retinal detachment 9x
Risk of myopic maculopathy 9x

World class monitoring of myopia progression

The monitoring of myopia progression is more than simply measuring your child’s prescription at each visit. Research has demonstrated monitoring your child’s eye length growth rates is paramount in preventing significant future myopia related eye disease.

At Dean Samarkovski Optometrist,  we have invested in the Lenstar Myopia device that can non-invasively and precisely measure the length of the eye down to 0.01mm. In fact, the Lenstar’s accuracy is relied upon by many ophthalmologists to measure specific dimensions of the eye so they can calculate the exact intraocular implant power required for cataract surgery. 

At this practice we recommend measuring the axial length of your child’s developing eye every 6 months. These measurements collected over regular periods of time are compiled and reported as a growth chart of the eye, much like following the growth charts of a newborn baby. This information can be used to tailor myopia control, either by adding an extra level of control, or perhaps trialling the removal of a level of control if eye growth appears stable. The success of myopia control interventions can now be accurately monitored providing better health outcomes for your child.

Lenstar Myopia device that is used for the accurate measurment of the axial length of the human eye

The causes of myopia

Myopia has complex and multifactorial causes. One cause is genetic. If one or both parents are myopic there is a higher chance that the child will become myopic. Additionally, lifestyle and environmental factors have been implicated with myopia. These include the digitalisation of a young child’s world,  increased indoor activities, a reduction of natural outdoor light exposure, and higher levels of education. All these factors contribute to the development of myopia.

Risks for developing myopia in children

One myopic parent
0%
Two myopic parents
0%

Lifestyle

Spending less than 2 hours per day outdoors increases risk of myopia

Near work

Spending more than 2 hours per day on close work outside of school increases risk

Tools we have to slow down the progression of myopia

Once a child becomes myopic, it is typical that the myopia worsens as the child continues to develop. The rate of progression of myopia is vitally important to monitor, particularly when first diagnosed, so that interventions can be introduced early whilst the progression is rapid. Currently a single ‘perfect’ treatment does not exist for myopia control, rather management typically involves a combination of optical, medical and lifestyle treatments. At this practice we offer a very wide range of myopia treatment options, and in some cases we may suggest two treatment options. This is because research has shown combining two forms of treatment is more effcctive at slowing rapid myopia compared to a single treatment.

topography scan of a cornea undergoing oath k treatment at Dean Samarkovski Optometrist

Orthokeratology is a treatment where the patient wears rigid contact lenses while sleeping, gently reshaping the cornea overnight. This treatment restore normal vision in the morning so no glasses or contact lenses are necessary during the day whilst awake. This treatment reduces myopic progression by about 55%.

Atropine treatment is an eye drop applied nightly to both eyes which slows down the axial elongation of the eye. Atropine is typically dispensed in a 0.01% formula which is available from a Pharmacy using a prescription we provide. This treatment has been shown to reduce the progression of myopia by about 50% whilst the drops are being used.

Boxes of contact lenses used for the slowing of myopia progression including the MYLO lenses, MiSight lenses, and NaturalVue lenses

Multifocal and EDOF (extended depth of focus) soft contact lenses are available to slow the progression of myopia. These disposable lenses are available as single use lenses or else a reusable lens which is disposed of monthly. The reduction of myopia progression typically with these soft lens options is around 50%

Close up of the Hoya MiyoSmart myopia control lens showing the fine honeycomb like DIM segments within the lens structure.

Custom grind spectacle lenses are now available to significantly reduce the progression of myopia. We can offer the MyoVision Pro lens by ZEISS and the MiyoSmart lens by Hoya. The MiyoSmart lens has been shown to be remarkably effective at slowing myopia progression by up to 60%, utilising a new technology known as D.I.M.S. (Defocus Incorporated Multiple Segments). This technology was developed in cooperation with the the Hong Kong Polytechnic University and is worn as a regular single vision lens.

When to cease myopia control

Research indicates that about 50% of children with myopia stop progressing by age 16. This means that the other 50% of children are still progressing. By the age of 18, about 75% of children will have stabilised, and finally 90% will stop progressing at age 21. When considering to cease myopia management we consider your child’s general lifestyle and visual habits. Those children spending less than 3 hours a day on near work outside of the school environment are more likely to stabilise by age 16.

Ways you can help your child and their vision

In addition to choosing the right myopia control strategy, there are many ways you can contribute to your child’s eye health. Here are some recommendations that will help manage the progression of myopia as well as increasing your child’s overall health.

Encourage outdoor activities

Outdoor sport and play can reduce the risk of your child developing myopia. Research suggests at least 90 minutes a day of outdoor activities is beneficial.

Have regular breaks from near work

When using a digital device, have regular breaks for the eyes. Your child should look across a room or out a window for 20 seconds to relax the focussing muscles of the eyes once every 2 minutes.

Limit the time spent on digital devices

School aged children should not spend more than 2 hours per day additional to school time on close work such as reading and screen time. Children age 2-5 should have a maximum of 1 hour per day of screen time. Children under 2 years of age should have no screen time.

Wear sunglasses for UV protection

Evidence suggests exposure to outdoor light is beneficial in slowing the onset and progression of myopia. However UV protection is still important so remember you child should wear and hat and sunglasses.

Hold reading material at the correct distance

Don't hold reading material or digital screens too close to the eyes. Your child should keep an elbow to wrist distance between anything they are viewing up close, and their eyes. To show your child, place the palm of your hand on your chin and where your elbow rests is the closest any screen or book should be to a child's eyes.

Read in good light

Good lighting is essential for comfortable and accurate focussing of the eyes. Dim lighting or excessive glare and cause discomfort and lead to eye strain.

Get plenty of sleep

Having adequate sleep is important in children aged 5-17 years, particularly when screen time is shortening sleep times. Children aged 5-13 should have an uninterrupted 9 to 11 hours of sleep per night, and 8 to10 hours per night for those aged 14-17 years.

Eat a healthy diet

Currently there is no vitamin or supplements hat prevents or slows myopia. However, having a generally well balanced diet with lots of fruit and vegetables helps your child remain alert and helps promote increased physical activity