MYOPIA MANAGEMENT
What is Myopia?
Myopia is blurry long-distance vision, often called “short-sighted’’ or “near-sighted”. A person with myopia can see up close – when reading a book or looking at a phone – but words and objects look fuzzy on a blackboard, on television, or when driving. But a pair of glasses isn’t the whole story.
Myopia in kids tends to progress or get worse throughout childhood, and higher levels of myopia are associated with higher eye disease risks in adulthood.
If your child already wears glasses, you can do something to stop their vision from worsening. If they don’t, you can assess their risk of developing myopia.
- Myopia occurs when the eyeball grows too quickly in childhood or starts growing again in adulthood
- Childhood-onset myopia is most commonly caused by the eyes growing too quickly or continuing to grow after age 10-12 when eye growth should normally cease. Genetics, environment, and the individual’s characteristics can all contribute to this excess growth
- In younger children, myopia progresses more quickly because their eyes are growing at a faster rate, leading to higher levels of myopia, stronger glasses, and more eye health risks
- Adult onset myopia usually occurs as an adaptation to fatigued eye-focusing muscles due to a significant increase in close work, such as university studies
Myopia FAQ
Myopia is becoming more common in children around the world – the prevalence among 12-year-olds doubled between 2005 and 2011. The average age for developing myopia is reducing – younger onset means faster and more eye growth, which increases the likelihood of high myopia and higher risk of eye diseases such as the following:
- Retinal detachment – the light-sensitive ‘film’ lining the back of the eye pulls away from its base, causing distorted vision or blindness depending on its location
- Myopic macular degeneration – loss of central vision clarity, like having a thick smudge permanently in the middle of your vision
- Glaucoma – increased pressure in the eye which damages peripheral vision, called the ‘sneak thief of sight’ as very few people who have it notice its symptoms until it is very advanced
- Cataract – a cloudy window in the middle of the eye, like looking through a foggy windshield
- Spending more time on close work has been linked to the development of myopia, such as reading, playing computer games, drawing, or using smartphones and tablets
- Electronic handheld devices are easy for toddlers to use resulting in increased exposure to close work at a younger age
- Myopia can be hereditary, and a person’s ethnicity and family background can increase the risk
- A person with one short-sighted parent has three times the risk of developing myopia – or six times the risk if both parents are short-sighted
- Some studies show that children are more likely to be short-sighted if their parents finished high school or went to university
- Under or over-corrected vision (incorrect glasses, or having no glasses when they are needed) has been shown to promote the onset and accelerate the progression of myopia
- Catching early signs of myopia before it fully develops can help slow the onset and progression
- Children should not spend more than three hours a day – in addition to school time – on close work such as reading, homework or screen-time
- When using a computer, ensure it is properly positioned to avoid eye strain and take breaks every 20 minutes by looking across the room for 20 seconds
- Smartphones are popular for children and teenagers’ texting, social media, reading, and games – but too much screen time is linked to myopia, can cause dry eyes, and increase the risk of eye damage and diseases in adulthood similar to UV damage
- The blue-white bright light from tablets and phones can damage long-term eye health and affect sleep – while there are no guidelines yet on how much to limit a child’s overall time spent on screens, these devices should be avoided by children and adults for three hours before bedtime
- Outdoor sports and play of at least 90 minutes a day can reduce the risk of myopia – looking at your tablet or phone when you’re outside doesn’t count!
- There is evidence to suggest that exposure to outdoor light is beneficial in slowing the onset and progression of myopia – but UV protection is still important so wear sunglasses and a hat
How We Manage Progressive Myopia
Although myopia cannot be cured entirely, we can manage and limit its effects. At Tarr Eye & Vision Center, our experienced doctor follows the latest evidence-based myopia management treatment options. An initial consultation visit is recommended with both parents and the patient. A detailed discussion is conducted, it includes risk factor identification, the examination process, selection of treatment strategies and guidelines for ongoing management.
Call 865-475-6565 or email TarrEyecare@gmail.com if you are interested in scheduling a consultation visit for your child.
Our treatment options include:
Orthokeratology – Special contact lenses are worn while sleeping gently reshaping the cornea to allow uncorrected 20/20 daytime vision. The concept is similar to orthodontics for teeth but is only used while sleeping.
Eye Drops – Daily use of eye drops containing atropine has been found to slow myopia progression in our youngest patients but is not considered a cure.
Contact lenses – The FDA recently approved a daily soft contact lens used to slow myopia progression. Ideally, a child begins wearing these lenses at age 6-8.
Specialty Eyeglasses – Patients with eye-muscle balance challenges, especially young children not suited for contact lenses or eye drops, may benefit from bifocal or multifocal eyeglasses.
Vision therapy – Exercises to stimulate eye muscles and eye-to-brain communication may be prescribed for treating progressive myopia. The exercises may include visual aids and computer-assisted activities.
High myopia affects the quality of life and may contribute to more severe sight-threatening complications in life, including retinal detachment, myopic maculopathy, glaucoma, and cataracts. Myopia management provides the opportunity for clear vision and the potential to slow the progression of myopia.
Schedule an annual eye exam for your child and set them up for success in school, sports, and life.
Call or text Tarr Eye & Vision Center at (865) 475-6565.
LINKS TO RESEARCH
- International Myopia Institute (IMI) White Papers and Clinical Research Summaries
- Link to download the IMI White Papers book
- BHVI20190211_IMI_White-Papers-Book-1.pdf Daytime MiSight® 1-Day Contact Lens (CooperVision)
- CRT® and CRT Dual-Axis® Ortho-K lenses (CooperVision Specialty EyeCare)
- Overnight Low Dose Prescription Atropine Eye Drops
- Three-Year Clinical Trial of Low-Concentration Atropine for Myopia Progression Study: Continued Versus Washout - Phase 3 Report (2021):
- Atropine for Myopia Progression (LAMP) Study phase 2 report (2020):
- Efficacy and Adverse Effects of Atropine in Childhood Myopia-A Meta-analysis (2017):
- ATOM2 Study (2013):
- ATOM1 Study (2012):
- American Academy of Pediatrics: Media and Children
- World Health Organization (2019): Guidelines on physical activity, sedentary behavior and sleep for children under 5 years of age.
- Prevention of Progression in Myopia: A Systematic Review
- Benefits of contact lens wear for children and teens
- Stabilizing myopia by accelerating reshaping technique (SMART)-study three year outcomes and overview
