In this article, Deven Lakhani, Myopia Focus contributor and Director at Hammond Opticians explores the different options available for slowing down myopia's progression. Additionally, he discusses the associated risks and provides guidance on how to make well-informed decisions. Our aim is to help parents navigate this topic with a better understanding and choose the most suitable approach for their child's specific needs.
If your child has myopia, also known as nearsightedness or shortsightedness, you may have heard about myopia management. Myopia management is a treatment program that aims to slow down the progression of myopia and reduce the risk of developing eye diseases in the future. But what are the side effects or risks of myopia management for children? And how can you weigh them against the benefits?
What is myopia and why is it a problem?
Myopia is a common eye condition that affects millions of children and adults worldwide. It occurs when the eye grows too long or the cornea and/or eye lens are too curved, relative to the length of the eyeball. This causes distant objects to appear blurry, while near objects remain clear.
Myopia usually starts in childhood and tends to get worse until the eye stops growing, around 20 years of age. Myopia may also develop in adulthood due to environmental factors or health problems. Myopia is often hereditary, so if you or your partner have myopia, your child is more likely to have it too.
Myopia can be easily corrected with glasses or contact lenses, but it can also pose serious risks to your child's eye health. Higher levels of myopia are associated with higher chances of developing vision-threatening eye diseases later in life, such as:
Myopic macular degeneration: a deterioration of the central part of the retina that affects detailed vision.
Glaucoma: a condition that damages the optic nerve and can lead to blindness.
Cataracts: a clouding of the eye lens that affects vision quality and clarity.
Retinal detachment: a separation of the retina from the back of the eye that can cause permanent vision loss.
These eye diseases can cause significant impairment and reduce your child's quality of life. Therefore, it is important to prevent or slow down the progression of myopia as much as possible.
What are the options for myopia management?
In the below video, Deven shares his personal journey of living with myopia from a young age and highlights the thrilling prospects that exist for eyecare professionals like himself to assist others in managing and regulating this ever-growing condition.
There are several options for myopia management that have been shown to be effective in reducing the rate of myopia progression by 30 to 80 percent compared to conventional optical correction. These include:
Orthokeratology: a type of contact lens that reshapes the cornea overnight to temporarily correct myopia and reduce eye growth.
Multifocal contact lenses: a type of contact lens that provides different focal points for near and far vision to reduce eye strain and eye growth.
Atropine eye drops: a type of medication that relaxes the eye muscles and inhibits eye growth.
DIMS and HAL spectacles lenses: these are specially designed glasses that have treatment zones which have been clinically proven to slow down the progression of myopia.
Lifestyle changes that are simple to do and completely free:
Encourage your child to limit close visual tasks to no more than 30 minutes at a time
Ensure that all reading and near visual tasks are held more than 30 cm away
Outdoor time: spending more time outdoors exposes the eyes to natural light and reduces near-vision stress
The best option for your child depends on several factors, such as their age, level of myopia, rate of progression, lifestyle, preferences, and budget. You should consult with your eye doctor to discuss the pros and cons of each option and make an informed decision based on your child's individual needs and goals.
What are the side effects or risks of myopia management?
While myopia management has many benefits for your child's vision and eye health, it also has some potential side effects or risks that you should be aware of. These are generally mild and rare, but they may include:
Discomfort and irritation: some children may experience discomfort when wearing contact lenses or using eye drops.
Dryness: some children may experience dryness in their eyes when wearing contact lenses or using eye drops, especially if they regularly stare at smartphones (also one of the major causative factors in myopia development and progression).
Infection or inflammation: some children may develop an infection in their eyes when wearing contact lenses or using eye drops, though some studies have shown that young children are more compliant at looking after contact lenses.
Allergic reaction: some children may have an allergic reaction to contact lenses or eye drops(particularly if a child has hay fever or similar conditions).
Corneal abrasion: some children may scratch their cornea when wearing contact lenses or using eye drops. This is rare. Very occasionally, this may lead to a corneal ulcer. However, research has shown that adults and teenagers tend to be less compliant with contact lens care compared to young children.
Reduced contrast sensitivity: some children may have difficulty seeing subtle differences in brightness when wearing multifocal contact lenses. This may also occur with Orthokeratology night lenses, particularly in dark conditions.
Reduced peripheral vision: some children may have difficulty seeing objects at the edges of their vision when wearing multifocal contact lenses and spectacles.
Rebound effect: some children may experience a rebound effect where their myopia progresses faster after stopping treatment. This is particularly prominent when low dose Atropine therapy is stopped suddenly, rather than gradually tailed off.
Reduced effectiveness over time: a recent Cochrane review at City University showed many therapies were only effective over the first 18-24 months.
To minimise these side effects or risks, you should follow your eye doctor's instructions carefully and use your chosen intervention as prescribed. You should also monitor your child's vision and eye health regularly and report any changes or problems to your eye doctor as soon as possible. You should also attend all scheduled follow-up visits with your eye doctor to check your child's progress and adjust their treatment if needed.
How can you make an informed decision?
Myopia management is a personal choice that involves weighing the benefits and risks of each option. You should consider your child's current and future vision needs, as well as their comfort and preferences. You should also consider your budget and insurance coverage.
You should talk to your optometrist about all your options and ask any questions you have. Your eye care professional will provide you with honest and evidence-based information and advice. You should also do your own research and seek a second opinion if you wish. To find a myopia specialist near you, check out our website tool.
Ultimately, you should make an informed decision that is best for your child's vision and eye health.
If you're a parent whose child has been diagnosed with myopia or if they are struggling with their distance vision, we hope you found MyopiaFocus helpful. Please join our community or sign our petition to get the government and NHS to recognise myopia as an ocular disease/severe ocular condition and fund myopia management for children.