Slowing the Progression of Poor Vision in Children
What Parents Need to Know About Myopia (Nearsightedness)
When we determine a child needs vision correction, it is frequently to correct myopia – also known as nearsightedness. Myopia is a common refractive error, which means the shape of the eye causes light rays to bend (refract) incorrectly, focusing images in front of the retina instead of on the retina. Myopia causes children to be unable to see distant objects clearly, though they can see nearby objects well; hence the term, nearsightedness. Children who are myopic struggle to see the words on a classroom whiteboard but can easily see words on a handheld device or a book. Although myopia is common and easily corrected with eyeglasses or contact lenses, it becomes of concern when indications of mild myopia rapidly progress to higher degrees, placing a child at greater risk for ocular complications later in life.
What Parents Need to Know About Myopia (Nearsightedness)
When we determine a child needs vision correction, it is frequently to correct myopia – also known as nearsightedness. Myopia is a common refractive error, which means the shape of the eye causes light rays to bend (refract) incorrectly, focusing images in front of the retina instead of on the retina. Myopia causes children to be unable to see distant objects clearly, though they can see nearby objects well; hence the term, nearsightedness. Children who are myopic struggle to see the words on a classroom whiteboard but can easily see words on a handheld device or a book. Although myopia is common and easily corrected with eyeglasses or contact lenses, it becomes of concern when indications of mild myopia rapidly progress to higher degrees, placing a child at greater risk for ocular complications later in life.
The Epidemic Rise of Myopia in Children
According to the National Eye Institute, the prevalence of myopia is increasing in the U.S. and worldwide. About 42 percent of Americans are nearsighted, up from 25 percent in 1971. In the developed countries of East and Southeast Asia, the prevalence has now reached 80 to 90 percent among children with 12 years of school. Projections suggest almost 50 percent of the world will be myopic by 2050.
Although genetic factors play a role in myopia, the abrupt increase points to environmental factors. Researchers theorize the rapid increase in myopia is due to children overusing their nearsighted vision for close-up tasks (school work, computers, gaming devices, cell phones) while their eyes are still in developing stages. As eyes develop, the curvature of the lens and the length of the eye must coordinate to maintain ability to focus light on the retina. Myopia occurs when the eyeball grows too long from front to back, causing light rays to focus at on the front of the retina rather than directly on its surface.
Several studies have indicated children who spend more time outdoors experience a decrease in myopia. When playing outside, children need to use their distant (farsighted) vision, and also benefit from natural lighting. Countries, such as Taiwan, are making outdoor time part of the school curriculum to help thwart the progression of myopia and are seeing positive results.
Why Is It Important to Control Myopia?
Levels of Myopia:
Mild Myopia: -0.25 to -3.00 D
Moderate Myopia: -3.00 to -6.00 D
High Myopia: more than -6.00 D
Moderate to high degrees of myopia have been linked to the risk of adult vision loss.
Cataracts: Cataracts are the clouding of the eye lens, and become more common with advanced age. Studies have shown the higher the degree of myopia, the faster the rate cataracts develop, requiring surgical removal at an earlier age.
Glaucoma: Glaucoma is an ocular disease affecting the optic nerve, which is often symptomless until permanent vision loss occurs. Studies have shown that nearsighted people have a two to three times greater risk of developing glaucoma.
Detached Retina: A detached retina is when the retina pulls away from eye tissues. This is an eye emergency and must be surgically corrected to prevent permanent vision loss. Higher levels of myopia are associated with greater risk of experiencing a retinal detachment.
Why Is It Important to Control Myopia?
Levels of Myopia:
Mild Myopia: -0.25 to -3.00 D
Moderate Myopia: -3.00 to -6.00 D
High Myopia: more than -6.00 D
Moderate to high degrees of myopia have been linked to the risk of adult vision loss.
Cataracts: Cataracts are the clouding of the eye lens, and become more common with advanced age. Studies have shown the higher the degree of myopia, the faster the rate cataracts develop, requiring surgical removal at an earlier age.
Glaucoma: Glaucoma is an ocular disease affecting the optic nerve, which is often symptomless until permanent vision loss occurs. Studies have shown that nearsighted people have a two to three times greater risk of developing glaucoma.
Detached Retina: A detached retina is when the retina pulls away from eye tissues. This is an eye emergency and must be surgically corrected to prevent permanent vision loss. Higher levels of myopia are associated with greater risk of experiencing a retinal detachment.
How Do We Slow the Progression of Your Child’s Myopia?
It starts with a yearly eye exam.
If your child is myopic, it is important to schedule a comprehensive pediatric vision exam each year. One of our doctors can assess any changes to your child’s vision prescription from year to year, and determine if steps should be taken to try to “control” the progression of their myopia.
Most childhood myopia is corrected with eyeglasses or contact lenses and requires no further intervention from us other than routine eye exams and an occasional adjustment to their vision prescription. However, children whose “prescription keeps getting stronger” each year may benefit from methods we use to slow down the progression of myopia called, myopia control.
The Myopia Control Program of Southern Dutchess Eye Care
If your child is a candidate for our Myopia Control Program, it will be personalized to reflect their vision prescription, overall health, age and degree of maturity, schoolwork demands, and extracurricular activities.
Your child’s doctor may recommend the following:
Atropine Eye Drops: Atropine is the eye drop used to dilate the pupil for an eye exam. For myopia control, we use an ultra-low-dose form of Atropine to expand the pupil without any symptoms such as blurriness. We have found Atropine eye drops to be highly effective and appropriate for children who may be too young for contact lens wear.
Multifocal Contact Lenses: Soft daily contact lenses with a multifocal focus range are used to create a defocus of the peripheral vision. The benefits of this myopia control method is ease of use of soft contact lenses, long history of safe wear (with proper contact lens hygiene), and efficacy at reducing myopia progression.
Bifocal and Multifocal Eyeglasses: For some children, wearing a different prescription for near and far vision is helpful. Unlike multifocal contact lenses that require a level of maturity to properly care for lenses and practice good contact lens hygiene, eyeglasses are easily worn and cared for.
Orthokeratology (CRT – Corneal Refractive Therapy): CRT lenses are custom contacts that work like a “retainer for the eyes.” Lenses are inserted before bedtime and used to gently mold your child’s corneas to the proper curvature while they sleep. The lenses are removed upon waking. The best part – your child experiences 20/20 vision throughout the day without the need for eyeglasses or contact lenses.
Southern Dutchess Eye Care is an early adopter of Corneal Refractive Therapy (CRT), which was FDA approved in 2002. Our practice has been offering the benefits of CRT to patients of all ages for more than 15 years.
