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What Is Myopia And How Does It Impact Our Children?

Eye Freedom - What Is Myopia And How Does It Impact Our Children?

Myopia (nearsightedness) is a common eye condition characterized by objects in the distance appearing blurry. Myopia typically occurs during childhood years when the eye is growing, meaning that distance between the front of the eye and the light sensitive part of the eye, the retina, becomes longer. Blurry vision due to myopia is the result of light rays focusing at a point in front of the retina rather than directly on the retina. Myopia can progress or worsen over time if appropriate interventions are delayed.

In the early 1970’s, only 25% of Americans were nearsighted. Today more than 40% of Americans have myopia and that number is increasing especially among school age children. By 2050 58% of the North American population is predicted to be myopic. The prevalence of high myopia (myopia in excess of 6.00 diopters) is also increasing and becoming more severe.

One in four parents have a child with myopia and about 75% of children with myopia are being diagnosed between the ages of 3 and 12.

As children grow, their myopia may progress, resulting in a stronger prescription to see distant objects clearly. Myopic progression generally stabilizes when the child reaches early adulthood. Among some populations, such as Asian and Indian children, the incidence of myopia is likely to be even higher, in line with the incidence in those countries.

WHAT ARE THE CAUSES OF MYOPIA?

Myopia is becoming more common and can be attributed to genetic and / or lifestyle factors. These include:

  1. Family history affects a child’s risk of myopia
  2. If neither parent has myopia, the chance the child will develop myopia is about 1 out of 4. If one parent had myopia it increases the child’s chance of developing myopia by 3X. If both parents have myopia, the risk doubles to 6X.
  3. Reduced time spent outdoors, vitamin D intake, and time spent in poor lighting increases the risk of a child developing myopia.
  4. Increased amount of time spent on computer screens, phones, video games, and other electronic devices may increase the risk of developing myopia.

WHAT ARE THE LONG TERM IMPLICATIONS OF MYOPIA?

Leaving myopia unaddressed may contribute to more severe sight-threatening complications later in life, including:

  1. Retinal detachment – The risk of retinal detachment is anywhere from 3-20X greater compared to people without myopia, depending on the level of myopia.
  2. Myopic maculopathy –  Myopic maculopathy can result from vision loss earlier in life than glaucoma or other retinopathies.
  3. Glaucoma – Studies show those with myopia have a 2-3 X greater risk of developing glaucoma than those without myopia. Glaucoma can lead to permanent loss of vision in affected eyes.
  4. Cataracts- Though cataracts can affect anyone as they age, they often develop sooner in those who have myopia.

HOW CAN MYOPIA AND MYOPIA PROGRESSION BE MANAGED IN CHILDREN?

Recently the FDA has approved several soft and gas permeable lenses for managing myopia and myopic progression in children. Myopia management with contact lenses provides the opportunity for providing our children with clear vision and the potential to slow and even stop myopic progression.

The recently FDA approved daily disposable soft contact lens known as the MiSight 1 Day lens has been clinically proven to slow or stop the progression of myopia in children between the ages of 6 and 12. Children who develop myopia between the ages of 7 and 8 often have their myopia progress the fastest. Therefore, starting myopia management early is important to help keep prescription strength stable, which helps to reduce future risks of ocular complications from progressive myopia.

MiSight 1 day is the first and only FDA approved contact lens to slow the progression of myopia in children between the ages of 6 and 12 at the initiation of treatment. In several long term studies done on myopic children with MiSight 1 day contact lenses, almost all of the children were able to achieve full time lens wear, were able to handle their lenses confidently and had a positive response to contact lens wear. The MiSight 1 day contact lens uses vision correction zones and treatment zones  within the lenses to slow the elongation of the eyeball and therefore the progression of myopia. By including both types of zones in the lens, it simultaneously corrects the child’s vision today while influencing the eye to resist getting longer, with the goal of preserving quality vision and ocular health in the future.

ARE THERE NON-SURGICAL TREATMENTS TO REDUCE OR EVEN ELIMINATE MYOPIA?

Yes. Orthokertology also known as ORTHOK is a revolutionary contact lens treatment designed to reduce or eliminate myopia and astigmatism. Orthok technology involves the use of special high tech rigid gas permeable contact lenses to gently and effectively change the curvature of the front surface of the eye. As the curvature of the eye changes, the patient’s myopia is reduced and the patient’s natural vision is improved. Additional lens changes may be needed to continue the patient’s vision improvement treatment. At the end of the therapy, retainer lenses may need to be worn. Recently, several orthok lens designs received FDA approval for night time wear. Patients with myopia and / or astigmatism wear these lenses while sleeping. This gentle corneal reshaping therapy works very well during sleeping hours. When our patient awakens in the morning, the lenses are removed allowing the patient to see clearly and comfortably for the remainder of the day. Often the patient’s improved vision lasts for several days or longer before the patient needs to wear the orthok lenses again during sleeping hours.

WHAT ARE THE BENEFITS OF ORTHOKERATOLOGY FOR PATIENTS WITH MYOPIA?

  1. Within days the myopic patient will see much better without the help of eyeglasses or conventional contact lenses.
  2. Vision improvement occurs within days
  3. Free of surgical risk, the treatment is convenient and comfortable, without disruption of the patient’s visual performance.
  4. Natural vision for recreation, sports and leisure is enhanced dramatically.
  5. Occupational unaided vision demands can be met for careers such as pilots, policemen, firemen or any job that requires clear vision without eyeglasses or contact lenses.
  6. The most effective method of maintaining and reversing myopia in children. Orthok is a safe, non surgical treatment for improving and restoring quality vision and comfort to patients with myopia.

WHAT IS CORNEAL REFRACTIVE THERAPY (CRT)?

CRT is an FDA approved procedure designed to reduce and eliminate myopia with a gas permeable lens made by Paragon laboratories. The CRT technology is designed to be used only during sleeping hours. The CRT lens is the first FDA approved therapeutic lens designed to gently reshape the corneal surface during sleep and provide clear, natural vision when the lenses are removed upon awakening. Eye irritation or dryness, sometimes associated with contact lens wear due to dust and pollutants is eliminated.

CAN PATIENTS WITH POST-LASIK CORNEAL ECTASIA BENEFIT FROM ORTHOKERATOLOGY OR CRT THERAPY?

The answer to this question is possibly yes. However, several issues with this patient population need to be considered:

  1. Most post-LASIK corneas have a compromised dry ocular surface. Wearing a rigid gas permeable lens on an ocular surface like this may prove to be very uncomfortable and even painful.
  2. There are many post-LASIK patients who have issues with the LASIK created corneal flap. The ocular surfaces of these eyes can be severely compromised. Many of these patients have undergone multiple refractive surgeries leaving the LASIK unstable with a “wavy” surface.
  3. For above reasons I prefer not to treat this patient population with Orthok or CRT lenses.