What is Myopia?
Myopia (or nearsightedness) is the inability to see distant objects clearly. Nearsighted individuals see better near than far. Myopia is often the result of an elongated eye, or longer axial length on average, that inaccurately focuses light in front of, rather than, on the retina. The retina is the photographic film at the back of the eye. So why is myopia a problem, besides having to wear vision correction? Higher levels of myopia are associated with a higher risk of eye disease. Longer eyes are more susceptible to the following diseases that can cause vision loss:
The optics of myopia are seen below. Distant objects such as street signs or presentation boards are blurred.
What are the risk factors for myopia?
Parental myopia, myopic siblings, Asian ancestry, myopia that appears before the age of 7, rigorous academic pursuits (high near visual demands) particularly at younger ages, and limited outdoor activity all can be used to predict myopia and its progression to high myopia. Patients with high degrees of myopia experience a poorer quality of life than those with low to moderate myopia. Refractive surgery can also be affected, with outcomes generally better in patients with lower prescriptions. Myopia control therapy can help change the future of your child’s myopia progression and significantly reduce the risk of future visual impairment.
Take this 1-minute survey to determine your child’s risk factors for myopia development and progression.
Myopia Control Therapy
- has the potential to reduce the incidence of myopic maculopathy by 40%
- retinal detachment by 23%
- open-angle glaucoma by 16%
- and the risk of visual impairment by as much as 24%
We must measure what we are trying to control.
The axial length of the eye refers to how long the eye is, from the front of the cornea to the back of the retina. In children with rapidly progressing myopia, axial length will increase faster than the normal rate. This information not only helps determine the progression rate, but also helps indicate the potential cause of the prescription increase, as well as the risks and therefore treatment approach to controlling eye growth and myopic progression.
Atropine Eye Drops
These are compounded eye drops are taken once nightly (not covered by Ontario Drug Benefit or most private insurance). They have shown excellent (60% and above) success at slowing myopia and axial lengthening. Side effects such as light sensitivity and difficulty focusing at near must be monitored. These are the same medications we use to perform dilated eye exams but at a fraction of the dosage.
Soft Contact Lenses
Multifocal lenses with a center-distance design are another option in the effort to control myopia progression. They are a cost-effective approach while providing spectacle-free vision throughout the day.
Abiliti™ 1-Day lenses are a new option of daily wear, single-use, disposable lenses that have the potential to slow the progression of myopia and are specifically designed for children who are 7 to 12 years old at the start of treatment. ACUVUE® They are made from a water-loving (hydrophilic) material that has the ability to absorb water, making the lenses soft and flexible. The lenses are tinted to make them easier to see and also contain a special ingredient (UV Blocker) to protect the patient’s eyes from ultraviolet (UV) radiation. The lenses are intended for daily disposable wear and should be discarded upon removal. There is no cleaning or disinfection required because new contact lenses are used for each wear.
D.I.M.S. Spectacle Lenses – MiyoSmart
This spectacle lens type is made up of a central clear optical zone for correcting myopia, with an outer band of defocus that acts to control myopia progression. The lens makes use of the natural eye adjustment known as “emmetropization”, where the eyeball shapes to receive focused images as it does for normal vision. The D.I.M.S. lens design, called MiyoSmart, distributed in Canada through select eye care professionals, was found to have the following statistically significant outcomes:
– slows myopia progression on average by 59%
– Slows axial eye growth on average by 60%
– completely halted myopic progression in over 20% of study participants
Below is an image of the D.I.M.S. lens for Myopia Control. Each of the small segments seen in the periphery of the lens adds +3.50 diopters of power to create a myopic defocus, that is, the image lands in front of the peripheral retina, which helps to slow the elongation of the eye. This can be observed when looking at the lens from an angle and appears as a honeycomb pattern on the lens. These lenses have equal adaptation and acceptance to standard single-vision lenses, with the benefit of slowing myopia progression in children.
Hard contact lenses are worn at night to reversibly shape the cornea to reduce both eye lengthening and myopic progression, while mostly eliminating daytime dependence on visual aids. Learn more by watching the video below.
Specifically, Paragon CRT lenses are a non-surgical solution to nearsightedness or myopia. CRT lenses are worn overnight and work to gently correct the curvature of the cornea while you sleep. In the morning, simply remove the lenses and enjoy spectacle freedom with your enhanced vision.
Our Commitment – Safeguarding Vision
Myopia Control Therapy is an investment in your child’s future eye health and well-being. With increased screen time at the expense of outdoor activities, myopia is growing at epidemic proportions. By 2050, half the world’s population, or 5 billion people, will be myopic. Many treatment options exist that have been found to diminish the eye’s axial lengthening and the corresponding myopia progression. After conducting a thorough eye health and vision assessment, Dr. Sciberras will determine the modalities best suited for successful compliance and myopia control. At times, more than one viable option exists, and the decision will be made after deliberate consultation between the doctor and parents.
We are committed to providing you with the best value in eye care and vision correction. We strive to provide all patients with clear, comfortable vision with the best lens technology and the most convenient modality for your child. We have an obligation to make the science and research available to you to ensure long-term eye health for your child.
Early intervention through regular eye exams and myopia control therapy is the best way to maintain healthy eyes and safeguard their vision.
To learn more about this topic, and to calculate your child’s future myopia based on their specific risk factors, visit www.MyKidsVision.org
Another useful site is called www.myopia.care
Sign up for the Myopia App – this ingenious digital device app measures how closely the device is being held and darkens the screen if it’s held too close, revealing the screen again when it’s held back at the ideal distance or further. Developed by a partnership of scientists and optometrists, early research on this app has shown it effectively modifies screen time behavior, making a dramatically positive difference in the demand placed on the eyes.
To learn more about children’s vision and its importance to learning, click here.
What about Astigmatism?
Astigmatism can accompany nearsightedness. It is the result of an eye that is shaped like a football. It causes light to be focused at two distances within the eye, instead of one. The light must be focused on the retina to have clear vision. Astigmatism can cause blurred vision at near and far distances. This can result in headaches, eyestrain, and squinting. Astigmatism can be corrected with either glasses or contact lenses.
Regular Eye Exams are Important
Vision is a gift and should never be taken for granted. Dr. Sciberras can detect eye disease in the absence of symptoms and can determine risk factors for future eye disease. Some of the symptoms your child may display in the presence of myopia includes frequent eye rubbing, squinting, sitting closer than normal for reading and viewing tasks, turning their head to the side, complaints of tired eyes, or inability to recognize signs or faces from a distance.
Recommended Screen Time
- 0-2 years of age should have no screen time. Watching a screen at a young age can limit time for active play and learning, reduce opportunities for language development and inhibit their attention skills.
- Children aged 2-5 years should have a maximum of 1 hour per day. Infants, toddlers and pre-schoolers should not be inactive or sedentary for more than one hour at a time, except for sleeping. In this age group, excessive screen time is associated with less outdoor, creative and active play time; poorer language skill development; poor social skills and an increased risk of obesity.
- Children of school age (5-17 years) should be limited to 2 hours of recreational screen time per day. When using screen-based electronics, positive social interaction and experiences are encouraged. Sleep is also so important in this age group. Children aged 5-13 years should have an uninterrupted 9 to 11 hours of sleep per night and 8 to 10 hours per night for those aged 14–17 years. Consistent bed and wake-up times are very helpful, as are restricting screen time 2 hours before bed and removing screens from the bedroom where possible.
- Apply the 20-20 Rule: take a break from reading or screen time every 20 minutes for 20 seconds, looking at something far away (eg. 20 feet). He or she should look across at something distant to relax the focusing muscles in the eyes before commencing near viewing. This can be managed as a break between book chapters, Netflix episodes for preteens and teens, or timers set for younger children. Recent evidence suggests the 20-20 rule is not a hard and fast rule, but should highlight the need for reducing screen time, and taking frequent near-task breaks.
Book your child’s eye exam here. Your vision matters to us.