What is Myopia Management?

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A Layman's Guide to Stop Progression of Myopia

Myopia is the medical term for nearsightedness, an ocular condition that affects distance vision. It is rapidly becoming more pervasive worldwide. If left untreated in childhood, it can lead to deteriorated eyesight and the development of more serious ocular disorders such as glaucoma, cataracts, and retinal detachment. Early intervention is essential to slow its progression and prevent these more severe complications. Fortunately, there are many interventions to improve vision and stop myopia progression. With appropriate measures, children can achieve a higher quality of life with improved distance vision.

The following article is intended as a general overview of the symptoms and treatments of this disorder, and not as a diagnostic tool. Contact an optometrist if you suspect that you or your child may have myopia or if you want to follow-up on a previously diagnosed case of myopia.

Causes of Myopia

Years of research provide evidence that environmental and hereditary risk factors play a role in this disease. These include:

Hereditary and Genetic Factors: "Eye lengthening" and "corneal curvature" are ocular growth irregularities associated with this condition which may be hereditary.
Environmental Factors:
Under correction of glass: For low level nearsightedness may be a risk factor for its progression in childhood
Eye Strain: Excessive strain from digital devices and computer screens, or strain from close up work (such as time spent reading books up or extensive homework sessions) may also contribute
Insufficient Outdoor Activity: There is evidence that children who spend more time outdoors are less prone to developing this condition

Symptoms of Myopia

Common signs of nearsightedness include:

Difficulty with distance vision (sometimes at night)
Squinting
Eye strain/discomfort
Having to come close to an object to see it.

Nearsighted children often have to stand close to the classroom whiteboard to take notes.

Treating Myopic Progression

Routine eye examinations are essential for detecting and treating ocular disorders, as well as for checking general visual acuity and overall ocular health.There are various ways to treat myopia. These include various forms of corrective prescription contacts, corneal reshaping measures such as ortho-k, multifocals, low-dose medicated eye drop therapy, and refractive surgery. The latter option is usually inappropriate for children.

Multifocals: Allow for a harmonious blending of vision using a pair of glasses or contacts that feature multiple prescriptions.
Low-dose medicated eye-drops: These drops have been shown to improve vision. non-invasive.
Ortho-k or orthokeratology treatment: A corneal reshaping intervention where contacts are worn overnight to reshape shape the eye and allow for glasses/free clear daytime vision. This intervention requires maintenance with the use of retainers. With cessation of this treatment, the eyes will revert to their original shape, and vision will revert to its pre-corrected state.

Homecare Prevention for Nearsighted Children

Parents need to help manage their nearsighted child's eye care and inculcate the importance of good practices, in accordance with their age and maturity. This includes:

reducing excessive use of digital devices to prevent eye strain
discouraging eye-rubbing and touching
teaching children them how to manage and use their contacts, and to follow appropriate sanitary measures for storing and cleaning them
encouraging outdoor activity.

Common Questions

How does the Ortho-K slow the progression of childhood myopia.

Ortho-Keratology lenses are specialized custom-made hard contact lenses that are worn overnight that gently reshape the front curvature of the eye to temporarily reduce the amount of myopia (nearsightedness) during the day. It can take up to 1-2 weeks to get the eye to get to the shape it needs to be in order to see clearly throughout the whole day without any correction. The ortho-K lenses that are worn overnight will mold the cornea in a specific shape such that then when light enters the eye it focuses properly on the central and peripheral retina allowing the patient to not only see clearly but this helps to slow down the progression of myopia. According to the peripheral defocus theory, the whole issue with progressing myopia is that light does not land properly at the peripheral retina, resulting in a biochemical feedback loop to cause the eyeball to elongate and increase in myopia. But, with this corneal reshaping therapy this ensures that light will then land properly at the peripheral retina, thereby reducing the signal for the eyeball to elongate and essentially slowing down the progression of myopia.

Is myopia dangerous?

If it is allowed to go untreated, myopia will lead to worsening vision and the possible development of more serious ocular conditions later in life. Fortunately there are many effective options today to detect and treat nearsightedness. With proper management, children can achieve good vision and maintain their health by slowing down the progression of the disorder.

What is severe or high myopia?

Severe or high myopia is when your refractive error is greater than or equal to 5-6.00 Diopters of myopia.

What is the difference between myopia “control" and "management"?

These are different terms for the same thing. Both refer to the measures taken by optometrists to improve vision in nearsightedness and to slow its progression.

What is myopia management?

Myopia management is an active treatment seeking to slow down the progression of myopia, and thereby reducing the risk of developing vision threatening ocular diseases associated with high levels of myopia. With myopia management this will not only provide clear vision but aim to slow the growth of the eye and thus slow the change in prescription over time. There are various myopia management treatment options including ortho-keratology specialty hard lenses, specialty multifocal contact lenses, and atropine eye drops. Consult your eye doctor today to determine which treatment option is right for you.

What is the cause of myopia?

Myopia is when the cornea, the front curvature of the eye, is too strong or the eyeball is too long, resulting for a person to see blurry far away. There are both genetic and environmental causes for myopia. In regards to family history, if both parents have myopia, there is a 50% chance the child will develop myopia. If one parent has myopia, there is a 33% chance the child will develop myopia. But even if neither parent has myopia there is a 25% chance the child will develop myopia. There are also environmental factors that can cause/be risk factors of myopia. For example if a person does excessive near work, spends more than 2 hours per day on digital devices, or spends less than 90 minutes a day outside, these can all increase the risk of developing myopia.

How do I find a good optometrist?

Ask around for good recommendations. Do your research to find good doctors in your region. The internet provides opportunities for finding like minded people. With diligent research, it has never been easier to find quality information.

What is the best type of management for a nearsighted child?

The best management intervention is different for everyone, including children who are not viable candidates for refractive surgery. Depending on different factors, contacts, eye drops, and corneal reshaping interventions such as ortho-k therapy (or a combination) may be viable options. For young children, parents will be responsible for applying low dose eye drop therapy and managing any contacts that might be part of a treatment regimen. There is also the risk of infections with contacts that parents will need to consider. Contact your child’s optometrist right away if you notice any signs that suggest there might be an infection.

Can I purchase these lenses without a prescription?

No. These lenses (as with all contact lenses) require an individual fitting so that the lenses match the specific measurements of your eyes.

Myopia Control for Children

The prevalence of myopia across the world has been recognized for some time now. Thanks to advances in medical technology, there are many effective treatments to treat myopia, by improving distance vision and preventing the progression of this disorder. If your child is showing possible signs of myopia, or if you just want to discuss options for previously diagnosed nearsightedness, speak with your optometrist to find out more.

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