November 5, 2020

It can be concerning when your child’s myopic (near-sighted) prescription continues to progress. Luckily this is a very exciting time for near-sighted people! There are more options available for slowing the progression of myopia than ever before, so if it is the right choice for your child and family, you can be proactive with respect to myopia control.

One of the easiest ways to help slow myopic progression is to get outside! Evidence shows that the more time kids spend outdoors, the lower their myopia. It is thought that the light exposure, as well as the fact that being outdoors forces one to look at further distances, can contribute to lower myopic progression. It is also important to take breaks from long close work, keep an appropriate working distance and use sufficient light.

There are also therapeutic products and treatments that have been shown to reduce myopic progression. We will briefly outline these options so you can decide if there is one that you feel would work best for your child and family.

1. Miyosmart lenses by Hoya.

  • These innovative spectacle lenses are based on award winning D.I.M.S (Defocus Incorporated Multiple Segments) technology.
  • The lenses have a clear central optical zone which corrects the refractive error and a midperipheral therapeutic zone of multiple defocus segments, which provides myopic defocus and interferes with the message to the brain to grow the eye longer. The reduction in myopia progression is about 60%.
  • The lenses look essentially the same as a regular optical lens, and your child’s blurred vision will still be corrected.
  • The lenses must be worn full time to achieve the full therapeutic effect. They are specially fit by our opticians and technicians.

2. Misight 1-day Contact Lenses by Coopervision. Brilliant Futures Myopia Management Program.

  • A daily disposible contact lens with a similar therapeutic technology to the Miyosmart lens, with a midperipheral therapeutic zone creating targeted myopic defocus while still maintaining clear vision. The reduction in myopia progression is also about 60%.
  • Children as young as 6 can successfully wear this lens, and most enjoy the freedom from glasses even at a young age.
  • You and your child would participate in a training session to learn how to properly insert, remove and care for the lenses. As these are daily disposible lenses, you get the convenience and reassurance of not having to clean and store the lenses and if one becomes lost it is easily replaced.
  • The contact lenses must be worn at minimum 10 hours per day, 6 days per week, but can be worn more as well.

3. Low-dose atropine therapy

  • Atropine is an eye drop used rarely at this time for treating amblyopia (lazy-eye) in children, and has been used historically for pupil dilation, vision improvement for people with cataracts before cataract surgery was widely available and a variety of other reasons. It has been used to slow myopic progression for over one hundred years. Despite this, the mechanism by which it works is still not understood. Reduction in myopia progression can be up to 60-70%.
  • At full strength atropine (1.0% solution) causes significant pupil dilation and cycloplegia (loss of accommodation or focusing ability) and is therefore not appropriate for children who play outside and are in school, needing to read as these side effects are not tolerable. However studies have shown that myopia control can be achieved with much lower concentrations. Typically we use 0.01% to 0.05% atropine in children choosing this option of myopia control and at this concentration, the side effects are minimal or non-existent for most children.
  • The drop is typically given at night before bed, to further minimize any day time symptoms.

4. Orthokeratology (Ortho-K)

  • Ortho-K is typically used as a method of correcting myopia. It can be an alternative to wearing glasses or contact lenses. With Ortho-K a patient sleeps in a specially designed rigid gas permeable (RGP) hard contact lens, which changes the shape of the cornea, effectively correcting the myopia for the daytime hours. The patient sleeps with the lens in nightly to maintain the correction.
  • Ortho-K has also been shown to reduce myopic progression in a similar way as Miyosmart and Misight lenses. Peripheral myopic defocus is induced by the change in corneal shape effected by the Ortho-K lens. The reduction in myopic progression is similar to the other methods, up to 60%.
  • While we do not do Ortho-K fitting and follow up here at eyeDOCS Kanata, our eyeDOCS Westboro location does, and we are happy to refer there for a consultation.

 

It is important to stress that you should not feel obligated to choose one of these options. We are just excited that we have so many options available and if you feel that you would like to discuss any of them further, please do not hesitate to ask. With any of the above options follow up would be scheduled depending on the method, and prices are available to discuss at any time.

 

eyeDOCS Kanata Team