What is Myopia Progression?

Does it seem like every year when you bring your kids in for their check-up their vision continues to
worsen? When will it stop changing? I get that question all the time! There is a normal amount of
changing year to year in our young kids but what happens if it is getting significantly worse each year?
Will little Johnny’s glasses end up looking like coke bottles? Is there something we can do to stop their
eyes from progressing so much? Today I would like to talk about ways to potentially slow down the
progression of nearsightedness in children.

The term is “myopia control”, myopia meaning nearsightedness or the inability to see clearly at a
distance. Myopia is very prevalent, affecting up to 40% of people by the age of 17! Myopia happens
because the eye grows too long or the cornea or the lens of the eye are too curved. Because of this,
images are focused in front of the retina instead of directly on it, causing vision to be blurry. Typically,
myopia starts in childhood and tends to taper out by early to mid-20s.

Myopia can cause some serious eye issues other than blurred vision. In most cases, lower levels of
myopia (below -3.00D) present little risk. If the level of myopia is worse than that, it could cause
significant loss of vision due to cataracts, glaucoma, or retinal detachment.

So- what causes myopia to get worse over time?

The main reason is that as we grow, the eye grows
longer as well which makes you more nearsighted. Genetics also plays a role. If the parents are
significantly nearsighted it is more likely that the child will go down the same path. Prolonged use of
digital devices has also been linked to myopia progression due to excessive stress on our focusing skills.
Is there a way we can prevent children from getting severely nearsighted and saving them from
potentially blinding diseases like glaucoma and retinal detachments? Potentially, yes! Myopia control
has been shown to decrease progression by up to 78%. We cannot reverse any nearsightedness that is
already present, but the goal is to keep it from getting worse.

What are our treatment options for myopia?

Low-dose atropine eye drops

These drops are used to widen the pupil. When used in children in small amounts for 2 to 3
years, the drops may slow myopia. We don’t know exactly how this works. One drop is instilled
into each eye daily.

Peripheral defocus contact lenses

These are multifocal contact lenses that has different areas of focus. Think of it like a bullseye.
The center has distance power while the outer ring defocuses or blurs the peripheral vision. This
is thought to slow eye growth and lessen myopia progression.

Orthokeratology (Ortho-K)

This is a type of contact lens that is worn at night that corrects blurry vision during the day. This
lens flattens the cornea while sleeping so that the next day vision is clear once the lenses are
removed. But this only works temporarily. Once you stop wearing the lenses, the cornea will go
back to its normal shape and the myopia returns. Still, ortho-K may provide some permanent
reduction in myopia progression.

Overall, the option that I use the most is the peripheral defocus contact lenses. Other important factors
you can do at home to help are making sure your kids spend more time outside! Also, limit screen time.

It is difficult in this day and age to do but this is a wonderful gift you can give your child to do all you can
to ensure that we slow the progression of myopia as much as possible.

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