At Eyeworks London lots of our younger patients are short sighted (or myopic), we are often asked if there is anything that can be done to prevent the myopia getting worse. The good news is that there are a growing number of options to manage the myopia and lots of ongoing research for more options in the future.
For a number of years Eyeworks London has offered MiSight contact lenses which can reduce myopia progression by an average of 59%. More recently in January 2021 HOYA have developed a new spectacle lens call MiYOSMART which gives similar efficacy but with the convenience of glasses. This is a really exciting development in the struggle against myopia; opening up treatment options to those who were not suitable for contact lenses.
During a routine eye test we will be able to give our younger patients an indication of the risk of developing myopia and discuss treatment options if necessary.
Myopia causes blur in the distance vision. The blur is caused by the image being focused too soon; in front of the retina rather than on the retina. The usual reason the focused light rays don't quite make it to the retina is that the eye is too long.
In some children as they grow the eyes will grow in length too. The elongation of the eyes will cause the myopia to progress. It follows then that myopia progresses more in late childhood and teenage years and therefore myopia management will be more effective in this age range.
What is myopia management?
Myopia management does not cure or reduce myopia, but aims to slow down the rate at which it gets worse. The eye grows rapidly until early adulthood, so myopia management will usually be continued until at least 17 years old. If myopia management is stopped before the eye has stopped growing, the myopia may start to get worse again.
Why does myopia matter?
There are two reasons why the amount of myopia matters. The first reason is obvious; the higher the myopia the more dependence on glasses or contact lenses. This can be inconvenient and expensive.
The second reason is that large amounts of myopia can affect the health of the eyes. The greater the myopia the longer the eye will be. A physically long eye creates tension on the structures of the eye. Consequently, a myopic eye is more at risk of retinal detachment and maculopathy. Studies have shown that a 1 dioptre increase in myopia will double the risk of maculopathy.
Risk of eye condition with myopia level
||Retinal Detachment||Myopia Maculopathy|
|-1.00 to -3.00
|-3.00 to -5.00
|-5.00 to -7.00
Therefore, every dioptre counts and intervening before the myopia progresses will be beneficial for the health of the eyes as well as reduce the dependence on glasses.
Who is at risk of myopia?
One myopic parent increases risk by three-fold, while two myopic parents means you are six times more likely to develop myopia.
East Asian descent is linked to myopia.
Less than 90 minutes outdoors per day increases risk.
Near Vision Efficiency
Children whose eyes tend to over converge and have a focusing lag when reading are more a risk of myopia. These two issues can be checked by the optometrist.
Age Appropriate Prescription
Children are born approximately +2.00 longsighted and as their eyes grow, they grow out of their longsightedness. Children with +0.50 or less at age 6-7 are at risk of developing myopia.
Myopia management options available at Eyeworks London
It is not fully understood but under-correction of the peripheral vision reduces the progression of myopia.
Hoya optical lens manufacturers have collaborated with Hong Kong Polytechnic to develop a lens called MiYOSMART. The lens has a peripheral defocus (to reduce myopia progression) while simultaneously providing clear vision. They have called this technology DIMS (Defocus Incorporated Multiple Segments).
The MiYOSMART lens was trialled in a 2 year study where participants had an average of a 60% reduction in myopia progression. The lens is a new non invasive myopia management solution. It is safe and convenient with the same look and experience as an ordinary spectacle lens.
MiSight contact lenses
Soft contact lenses have recently been developed especially for myopia management. These contact lenses have a dual focus like multifocal lenses that create a peripheral defocus. MiSight lenses from Coopervision reduce myopia progression on average 59%. Theses lenses are a daily disposable lens and are suitable for children as young as 8.
Alternative myopia management theories and practices
Under-correcting the prescription
There is a plausible rational that under-correcting the prescription reduces the eyes 'addiction' to glasses. The theory being the more prescription you give the more prescription the eyes will need in the future. However, 2 separate clinical trials in school aged children concluded that under-correction either had no influence on myopia progression or in one of the trials showed a small increase myopic progression.
Orthokeratology involves a hard contact lens worn overnight to reshape the cornea so that throughout the day clear lens free vision can be enjoyed. A by-product of this type of correction is that there is some peripheral defocus which helps to slow myopia progression. Studies have should that orthokeratology reduces the myopia between 32-63%. Eyeworks London does not currently offer this type of myopia management as similar results can be achieved with the MiSight soft daily disposable contact lenses.
Atropine eye drops have been used for many years to dilate the pupils. For reasons not understood atropine eye drops are very effective at slowing the progression of myopia. Because of unwanted side effects (light sensitivity, blurred reading vision ) the use of atropine eye drops are not yet licenced in the UK. However, this is likely to change in the next few years.
Simple at home considerations for myopia management
Time Spent Outdoors
Spending more that 90 minutes per day outside helps reduce the risk of myopia.
Being Mindful Of Close Work
There is an association with prolonged near work and myopia. It is not to say that reading and school work should be discouraged. Instead being mindful of regular breaks and minimising recreational screen time will helpful to limit myopia progression.
Making Myopia Management Routine
Myopia is such a common eye condition yet Myopia Management remains a speciality in Optometry. It is usually only offered in specialised clinics in specific appointment slots. We feel Myopia Management Consultations should be offered as part of a routine eye test - so no special appointments or extra charges apply. For an appointment please call 02075842697 or book online.