Why is Myopia Control important?
The cost of doing nothing
The consequences of high myopia are more than just thick glasses. With our children spending more time in front of screens and less time outdoors, myopia is fast becoming an epidemic. Myopia, or nearsightedness occurs when the eyeball grows too long and the image no longer focuses properly on the retina. The higher the myopia, the more stretching of delicate tissues inside the eye, increasing the risk of sight threatening diseases.
Those with myopia have a higher risk of blindness or vision impairment due to retinal detachment, myopic macular degeneration (MMD) and glaucoma. In addition to increased screen time, there are a number of other risk factors associated with the progression of myopia.
Perhaps the most compelling reason to do something is the fact that a child’s lifetime risk of irreversible damage to central vision (myopic macular degeneration) is 40 times greater in myopia over –5.00D, and over 126 times greater over –7.00D! Retinal Detachment risk also increases by over 20 times in myopia over –5.00D. This sight threatening condition requires invasive surgical repair within 48 hours in order to avoid permanent vision loss. Even the risk of glaucoma and cataracts increases more than 3 times at just –3.00D. Risk increases further with family history.
See the myopia risk assessment below to assess your child’s risk of myopic progression.
The Myopia Solution
There are Treatments to slow the Progression of your Child’s Myopia
At Mission Eye Care, we are proud to be the only clinic in Alberta with 2 optometrists residency trained in myopia control using specialty contact lenses. Our Myopia Control Academy Program will give you and your child the highest level of care. We have the latest technology required to take the baseline measurements needed to accurately monitor progression and modify treatment based on the latest evidence.
At least 1-2 hours per day of outdoor time has been shown to be correlated with later onset and reduced progression of myopia. However, if there is ANY amount of myopia prior to age 11, additional clinical myopia control strategies are strongly advised.
There are four main options for myopia control, depending on the unique lifestyle and visual requirements of each individual patient:
Soft and Hybrid Multifocal Contact Lenses
There are special types of soft contact lenses that work to limit the elongation of the eye by focusing peripheral light in front of the retina. Research shows that this slows down eye elongation and therefore myopia. This method is known as peripheral defocus. Because light still focuses accurately on the central retina, clarity of vision is maintained.
These contact lenses are worn during the day and removed at bedtime. There are options for almost all prescriptions as well as daily disposable lenses approved by Health Canada for this purpose.
Studies show that axial elongation (eye growth) is slowed by 46-87% with this method.
OrthoK or orthokeratology can be thought of as the optical equivalent of dental braces. Treatment involves overnight wear of rigid contact lenses that gently reshape the surface of the eye while sleeping. This treatment has been used for decades as an alternative to wearing glasses or contacts and for adults wanting a non-surgical alternative to laser eye surgery. Modern versions of these lenses are now used for myopia control.
Like Soft Multifocal Lenses, the idea is to create peripheral defocus and thereby reduce eye elongation. Upon waking in the morning, the contact lenses are removed and the corneal reshaping lasts all day, eliminating the need for daytime glasses! This is ideal for active kids who may otherwise be limited by eyeglasses during sports and other activities.
Unlike braces, this reshaping is not permanent. The custom retainer lenses must be worn every night to maintain the effect. Studies show that axial elongation is slowed an average of 43% with this method but more recent data suggests it is much higher. Newer lens designs have demonstrated up to 90% reduction in progression in some cases.
For best results, it is recommended to start when the prescription is lower than -4.00D of myopia, and ideally as young as 7-10 years of age. The efficacy and safety of these lenses is well documented. Our residency trained optometrists at Mission Eye Care are skilled in all methods of myopia control, including Orthokeratology Calgary care.
Myopia Control Eyeglass Lenses
These custom spectacle lenses use the same principle of peripheral defocus explained above. Newer designs use tiny “lenslets” embedded in the lens to create this effect and research shows they can reduce myopia progression by as much as 60%! Proper fitting of the frames and lenses is critical to success as the lenses must be properly centered for maximum effect. At Mission Eye Care, our choice of lenses is guided by the latest research. There are a few older designs on the market, but we have found the greatest success with newer designs such as the new CooperVision MiSight™, and HOYA MiyoSmart™ with more options currently in research and development.
Both of these options are used at our Myopia Control Academy and can be combined with low dose atropine eye drops (see below) for even higher levels of control. Watch the videos below to learn more about these lenses and talk to your optometrist to see if they may be right for your child.
Atropine Eye Drops
Recent studies show that 0.01 to 0.05% atropine decreases progression of myopia by 50-87%. It appears to act by thickening the layer of the eye just under the retina called the choroid. This may increase the structural integrity of the eye and thereby reduce its elongation. Some side-effects of atropine include blurred near vision, less accommodation (focusing ability at near distances), and pupil dilation resulting in light sensitivity. However, these effects can be minimized by changing the dose based on any symptoms your child may have.
This treatment is recommended for children who are too young or unable to wear contact lenses and is often used in conjunction with some of the treatments above. There are no long term studies on the potential negative effects of this treatment but eye doctors have been using this treatment for many years with great success.
These eye drops must be obtained from compounding pharmacies. Eligibility for insurance coverage varies with providers but the cost is generally less than $100 a month.
The Myopia Control Academy – only at Mission Eye Care
We will enroll your child in this structured program to best ensure their success. This includes regular office visits and measurements using specialized instruments to monitor your child’s myopia. Accurate measurements including cycloplegic refraction, corneal topography and axial eye length are all critical to truly monitor all aspects of progression. Your Optometrist will make recommendations depending on the baseline date obtained, genetic and lifestyle risk factors, and the goals of treatment.
You will also get an annual report card with graphs showing the results of treatment relative to what they would have been without treatment. We want you to be as pleased with the outcomes as we are!
How often should I have my child’s eyes checked?
The Alberta Association of Optometrists recommends the first eye exam for children at six months of age, then again when the child is two years old, and every year after the age of four. Eye examinations are covered under Alberta Health Care until age 19. You can read more on this, as well as the current recommendations on screen time for kids here.
For additional information, talk to one of our Optometrists at your next appointment and if you like, you can do some of your own research on the sites below: