What is myopia?
Myopia, also called nearsightedness, is a condition where the eye elongates, making it more difficult to see objects at a distance. In myopia, the eye focuses on incoming light rays in front of the retina, rather than where it should—right on the retina. Patients with myopia can still clearly see objects that are at close range.
Myopia often begins in childhood and progresses as children grow, before stabilizing around age 16. It is easily corrected with eyeglasses, contact lenses or surgery.
Myopia is a common eye disorder, affecting an estimated 40% of Americans. However, on rare occasions, patients can develop “high myopia,” which causes degenerative changes in the retina. High myopia is one of the primary causes of blindness.
How is myopia treated?
Treatments for high myopia are designed to slow the progression of the retinal degeneration. While new treatments are being tested all the time, the most effective methods are orthokeratology contact lenses, soft multifocal contact lenses and the topical drug atropine.
Orthokeratology, or ortho-k, is a non-surgical method to treat myopia. It uses specially fitted gas permeable contact lenses that are worn at night. The rigid lenses are designed to gently reshape the cornea to slow progression and improve vision without the need for daytime correction.
The cornea is a clear, dome-shaped window in the front of your eye that focuses light onto the retina and is responsible for most of the eye’s ability to focus. The lenses work to flatten the center of the cornea, which is very flexible, altering how light is bent as it enters the eye. Improvements in vision are temporary but can be maintained when the lenses are worn regularly.
Your ophthalmologist will map and measure the surface of your cornea using an instrument called a corneal topographer and then design a lens especially for your eye. The cornea map is created by reflecting light off the surface of the eye. The machine doesn’t touch your eye, and there is no pain. The corneal topography map shows your ophthalmologist the shape and curves of your cornea.
Clinical studies report that FDA approved Ortho- K lenses can provide significant vision improvement of 20/40 or better. A series of three lenses with progressive correction may be necessary to reach the desired correction. Once the desired correction is reached, wearing the lenses regularly at night can maintain the correction.
Ortho-k is sometimes recommended to correct children’s vision, since their vision can change into their teens and beyond. There is no firm evidence that ortho-k can slow down the progression of myopia in children, but clinical studies are continuing. The most common risk is infection.
Soft Multifocal Contact Lenses
Like ortho-k treatments, soft multifocal lenses slow progression of myopia, but are worn during the day. Multifocal contact lenses are used to correct myopic vision in children, while simultaneously slowing myopia progression by slowing eye growth. While single vision prescription glasses and contact lenses can correct myopic vision, they do not treat the underlying problem.
Soft multifocal contact lenses have two areas on the lens for focusing light. Shaped like a bullseye, the center of the lens corrects distance vision associated with nearsightedness, and it focuses light directly on the retina. The outer portion of the lens adds focusing power to bring the peripheral light rays into focus in front of the retina. Animal studies show that bringing light to focus in front of the retina cues the eye to slow growth. Single vision glasses and standard contact lenses, on the other hand, focus peripheral light to a point behind the retina, which prompts the eye to keep growing.
Clinical studies have shown that this approach can slow the progression of myopia in children by almost 50%.
Prescription topical atropine drops can be used to slow the progression of myopia. Atropine drops are commonly used to dilate the pupil of the eye, often used during eye exams or before eye surgery. At a low dosage of 0.01% atropine, the drug has been shown to be effective in slowing the progression in some children. Doctors and scientists aren’t sure exactly how the drug works for myopia, and it does not cure or reverse the effects. However, eye drops allow for the treatment of myopia in children without the use of contact lenses during the day or night.
Talk with your Union Square Eye ophthalmologist about whether atropine may be beneficial for your child. Our board-certified ophthalmologists and internationally renowned specialists offer compassionate, comprehensive eye and vision care for children and adults.
Contact Union Square Eye today to schedule a consultation to see how we can help you or your child address myopia.