The Myopia Problem

Myopia is a growing epidemic that is now being recognized as a public health risk across the globe. The myopic population has DOUBLED in the last 20 years, and it is estimated that by 2050, over 50% of the world’s population will be myopic. Our very own eye care providers are determining that glasses and traditional contact lenses are no longer the most appropriate options available to manage and maintain the stability of a child’s myopia and ocular health.

“By 2050, over 50% over the world’s population will be myopic.”

Changing The Definition Of Myopia

Myopia (nearsighted or shortsighted) is commonly understood as the inability to see far away objects clearly without glasses or contact lenses. It is, in fact, much more than that. Myopia is a risk factor for development of ocular conditions that result in vision impairment. More importantly, myopia is a chronic, progressive disorder where continued eye growth not only worsens distance vision, but it also increases future risk of sight-threatening complications.

Myopia – A Risk Factor For Vision Impairment

Myopia is associated with several eye conditions that result in vision impairment. Myopia is a risk-factor for the following progressive and sight-threatening conditions:

• Myopic Maculopathy

• Glaucoma

• Retinal Detachment

• Cataracts

The Impact Of Myopia In Children

Myopia impacts education – Uncorrected myopia greatly impacts a child’s ability to learn. If a child cannot see clearly then they cannot see to understand the subjects that are being taught in a classroom. Children that have progressive myopia continue to have unclear vision in their glasses and contact lenses which further impacts their ability to learn. Children with progressive myopia need to have their glasses updated several times a year to maintain clear vision throughout the day.

Myopia impacts self-esteem and confidence – Although a child may see clearly with glasses, they may develop lower self-esteem and decrease confidence. A child with glasses may question why they must wear glasses while their classmates and friends do not wear them. The child with glasses may be picked on or discriminated by other children for wearing glasses. A child that is dependent on their glasses to see clearly will find more challenges with extracurricular activities, sports, and outdoor play time. These are several of the reasons why children will frequently lose or break their glasses.

Myopia requires a dependence on glasses – As previously mentioned, as the myopia progresses to higher levels, a child will require more dependence on glasses for task throughout their day.

Picture this scenario: A child with myopia waking up from a full night’s sleep. The child must grab their glasses from the nightstand before brushing their teeth and going to eat breakfast. After getting ready, the child then heads to school where they will need their glasses to see print on the board, read textbooks, and interact with friends. After school, the child may attend an after-school activity, where they will be dependent on the glasses for swimming, gymnastics, baseball, or karate. The child then returns home for the evening, gets ready for bed, and continues the same process the next day. What happens to the child that loses or breaks their glasses? Their entire day from morning to evening is impacted.

Myopia impacts athletic success – The dependence on glasses and contact lenses for clear vision during athletics can impede the success that a child has during their adolescent and teenage years. Athletics may not be the first thought for many parents during childhood, however, myopia can become an obstacle later in life when athletics become an important part in a teenager’s daily life. As sports continue to evolve at the highest levels of competition, they require that the individual have excellent vision, depth perception, and hand-eye coordination to succeed. Glasses and contact lenses can interfere with vision during competitions if they break or fall off the eyes. The child that requires a dependence on glasses is at a disadvantage compared to the child that does not require glasses to see clearly.

Slowing Myopia Progression

There is no safe level of myopia. The earlier that a child becomes myopic, the higher risk of myopia progression and developing high myopia. Intervening before a patient becomes myopic ensures the best visual outcomes for the child. Reducing a child’s level of myopia by 1.00D results in 40% reduction of developing myopic maculopathy. Three key areas of myopia control include:

• Age: The younger a child is when they become myopic, the faster the myopia will progress. Any level of myopia that is detected from birth to 12 years old is abnormal and should be closely monitored for progression. Myopia management can be initiated as early as 3-4 years old but is more frequently performed from 6-12 years old.

• Family History: Children with two myopic parents have the highest rate and likelihood of progression at 50%. A child with one myopic parent has a higher likelihood of progression compared to children without myopic parents.

• Visual Environment: Extended near work at 20cm for longer than 45 minutes results in increased risk of myopia progression.

“Reducing a patient’s final level of myopia by 1.00D reduces the lifelong risk of myopic maculopathy by 40%.”

How Do I Know If My Child Has Myopia?

Children do not understand blurry vision. Therefore, many children have myopia without symptoms. The only way to determine if your child has myopia is through an eye examination. A child with myopia may have symptoms that include squinting, moving closer to objects, eye strain (asthenopia), headaches, tired eyes, and eye rubbing. How do I know that my child’s myopia is progressing? The only way to determine that your child’s myopia is progressing is to have an eye examination every 3, 6, or 12 months. Again, children do not understand blurry vision therefore a child may not have any symptoms.

Myopia Management

Myopia can be slowed in children with orthokeratology, atropine eye drops, and specially designed soft contact lenses. Click on each option to learn more about how it slows progression of myopia in children.

• Orthokeratology – A lens that is worn while you sleep to reshape the cornea and slow progression of myopia.

• Atropine – A prescription eye drop used at bedtime that slows progression of myopia.

• Dual-Focus Soft Contact Lenses – A soft contact lens worn during the day that slows progression of myopia.

Adults with Myopia

Ortho-k is a safe and effective alternative to refractive surgeries, such as LASIK, and is approved for adults with myopia (nearsightedness), farsightedness, astigmatism, and presbyopia. Ortho-k can even be used in patients with LASIK regression.

Myopia Management – Why We Do It

To reduce the lifelong risk of myopia-associated pathology and visual impairment. The benefits of slowing myopia are threefold: better uncorrected vision, better refractive surgery outcomes, and, most importantly, reduced likelihood of vision loss in later life.