Myopia Management

By December 2, 2021Eye Care, Eye Conditions

Myopia, or nearsightedness, is a condition in which distant objects are blurry, but near objects are clear. Depending on the severity of your nearsightedness, you might need help with glasses or contact lenses to see objects that are more than ten feet away, or maybe even more than a few inches from your face. Over the last few decades, the number of people with nearsightedness in the United States has nearly doubled, going from 25% to 42%. So, almost half the people in the U.S. are nearsighted. Researchers expect that this trend will continue, and that 50% of the world, or 5 billion people, will be nearsighted in 2050.

When your eye is nearsighted, the length of your eye is generally longer than average, or, your cornea, the front clear wall of your eye, is steeper than average. Since our eyes grow during childhood, there has been much interest in looking at what children do that could cause the development of nearsightedness.

The causes of nearsightedness are still being investigated, but it appears that genetics and environmental factors play a role. If neither parent is nearsighted, your child has a 25% chance to be nearsighted; but, if both parents are nearsighted, that raises your child’s chance to 50%. The other factor that increases your child’s risk of becoming nearsighted is too much time spent indoors. Children who spend more time playing outside have a lower chance of becoming nearsighted than children who spend more time doing indoor activities. It is not yet known why this link exists; one theory is that when we are inside, we are more likely to be looking at near objects, such as a computer or tablet, and this increased time spent doing near work stresses our eyes and causes them to become nearsighted. The other theory is that sunlight is the factor that slows nearsighted progression, but more research to determine the exact cause is needed.

Some things we do know can cause nearsightedness. Premature babies are commonly more nearsighted as they grow up, compared to full-term babies.

We commonly treat nearsightedness with glasses or contact lenses. Some people have LASIK surgery for nearsightedness when they reach an age where the progression of their focusing change slows down and stops. But, now we want to find things that can be done to prevent the development of nearsightedness in our children.

Even as recently as 10 years ago, if your child was nearsighted, there was not much that could be done to stop their glasses prescription from getting stronger. Your eye doctor likely handed you the new prescription and joined you in crossing your fingers that this trend wouldn’t continue. Thankfully, recent research has produced a few options that can slow down how quickly your child’s nearsightedness worsens, and possibly stop the progression completely. The process of attempting to slow down the progression of nearsightedness is known as “myopia management.”

The options for slowing down nearsighted progression are specialty contact lenses. Just like normal contact lenses, these lenses correct your child’s vision so that they can read the 20/20 line, but they also have additional optics that change the focus of light in the periphery, or side vision, to slow down the “growth signal” for nearsightedness. In 2019, the FDA approved the first official myopia management contact lens: the Cooper Vision MiSight contact lens. On average, this lens decreased nearsighted progression by nearly 60%. This could mean the difference between your child becoming highly nearsighted (stronger than a negative 6 prescription), and staying in the low or moderate range of nearsightedness. Even though the MiSight lens is the only FDA-approved myopia management lens, there are other options that studies have shown are just as effective, but have not received FDA approval yet. These options include daily replacement contact lenses, and standard monthly replacement lenses.

If your child would like to have freedom from wearing contact lenses or glasses during the day, they could be a candidate for a myopia management option called orthokeratology. This is a contact lens that is worn while your child sleeps to gently reshape their cornea, the clear part of the front of their eye, to change how light focuses in their eye. When your child wakes up in the morning, they will remove the contact lenses and have clear 20/20 vision without glasses, with the added benefit of slowing down how quickly their nearsightedness worsens.

We are likely all familiar with what really strong glasses look like, the infamous “coke bottle” lenses, but with myopia management options, these lenses could be a thing of the past. The other reason you should consider myopia management for your child is their ocular health. The more nearsighted you are, the longer your eyes are, which can lead to the development of eye diseases later in life. If you are highly nearsighted, your eye doctor has likely told you that you should call their office if you start to have symptoms such as flashes or floaters – these symptoms can be the first warning sign of an issue with your retina, which occurs at a higher frequency in highly nearsighted patients. It is the goal of myopia management to lower your child’s risk of developing vision-threatening complications from high nearsightedness when they are an adult. Because myopia management is so new, there are no adults that have gone through this program, but there is hope that by keeping patients from progressing to high nearsightedness, the number of patients who lose vision to eye diseases in adulthood will also decrease.

If you are highly nearsighted, or you are concerned that your child’s prescription keeps increasing each year, contact our offices to schedule an appointment with a SureVision eye doctor to see if your child is a good candidate for myopia management.

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