Myopia Management in Children

*Sponsored Blog by Simon Falk Eyecare

Myopia (short sightedness) is on the increase. It effects 1.45 billion people worldwide, which is 27% of the world’s population. Studies from around the world show a dramatic increase of Myopia in children in the last 20 years. Indeed, it is predicted to double again in the next 20 years.

This might appear good news for Opticians, contact lens suppliers and Laser Eye providers, but it is infact a danger for Myopic adults and associated eyecare in years to come.

Myopic adults are at more risk of future eye problems such as Glaucoma, Retinal Detachment and Myopic Macular Degeneration.

The challenge for Optometrists, is to find out why we are seeing such a large increase in myopia and to find ways of slowing or halting its progress.

Over the last 5 years or so, there have been encouraging signs that we now have treatments available. These live under the banner of myopia management.  It is now known a number of factors that seem to influence the speed at which a prescription will change.

Research shows;

• It is important for a child to spend time outdoors. It is recommended to spend 90 minutes outside each day, being sun smart and 60 minutes being active. The benefits of UV cannot be underestimated.
• Trying to reduce the amount of screen time to less than 2 hours after school and not to sit for too long. The constant use of smart phones, ipads and computers seems to be having an effect.
• It is important to take regular breaks from reading and screen
• Try to follow the elbow rule, which means keeping the forearm distance between eyes and the book.
• It is most important for children to have regular eye examinations to catch myopia at its earliest development.

So how do we achieve the aim to slow or possibly halt myopia progression?

There are generally 3 methods that Optometrists agree are having the best effect.

1. Orthokeratology – This is a reshaping of the front window of the eye (cornea), by wearing a hard contact lens overnight. This gentle moulding means in the morning, the lenses are removed, and the child does not need spectacles during the day.
2. Multifocal Soft Daily Disposable Lenses – A soft lens is worn for the majority of the time and is showing very promising results in reducing how the eye lengthens. It is this growth in the eye which is the primary cause of myopia.
3. Specialist Spectacle Lenses – Hoya have introduced the first myopia management lens called MiYo Smart. An innovative design that again seems to stop the eyes from elongating.

When I qualified, it was frowned upon to fit young children with contact lenses, but actually 8–12-year-olds appear to be safer contact lens wearers than teens and adults with a lower risk of infection. So contact lenses in either format, is a safe method of providing correction. They give children greater self-confidence, make sport, drama and other pastimes much easier than when wearing spectacles. Indeed, imagine the freedom a child has, having removed their overnight lenses and being free of eyewear all day. A complete joy.

So whilst all these methods are exciting and very promising, we must proceed with realistic expectation and caution. It would be unreasonable to think that myopia management will completely stop ALL progression. However, all studies are showing it does reduce the degree of myopia during development. This means when adulthood is reached and stabilization takes place, that adult will have a considerably lower amount of myopia.

The World health organisation adopted in 2015 the definition of High Myopia to be;

“A person who needs greater than or equal to -5D of correction”

The risk of disease increases with the degree of myopia, as seen in the chart below. Those with High Myopia compared to those with low to moderate myopia are at much higher risk of glaucoma, retinal detachment and myopic macular degeneration.

 This is a growing concern for Optometrists; particularly if as predicted myopia doubles in the next 20 years, the prevalence of the above conditions dramatically increases.

If you or any member of family would like further information, please contact myself or Julie Clarkson at myopiamanagement@simonfalk.co.uk

Simon Falk

Simon Falk Eyecare

www.falkleeds.co.uk