Take control of your child's myopia
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
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.
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
Spending less than 2 hours per day outdoors increases risk of myopia
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.
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.
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%
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.