Innovative Treatments for Managing Progressive Myopia

May 30, 2024 | Dr. Elise Kramer | Comments are off for this post.

Myopia, commonly known as nearsightedness or shortsightedness, is a refractive error that causes blurred distance vision because light focuses in front of the retina rather than directly on it. This condition typically manifests in childhood and can rapidly worsen if left untreated.

The prevalence of myopia is increasing worldwide, affecting up to 90% of adults in some East Asian populations and over 33% in the United States. While genetics play a role, excessive use of digital devices and lack of outdoor time are major risk factors contributing to myopia in children.

Though glasses and contact lenses can correct refractive errors, they do not slow Myopia’s progression, leaving children at risk of developing severe ocular complications like retinal detachments, glaucoma, cataracts, and macular degeneration later in life.

There is a growing need for effective myopia management methods that can slow or halt myopia progression, especially in pediatric populations, to safeguard long-term vision health.

Patient review:
Dr. Kramer is great! Both my son and daughter are her patients and with progressive myopia. We moved this year but still decided to drive 3:30 hours to be seen by her at the Miami Contact Lens Institute.
~ Celina

What are Atropine Eye Drops, and How Do They Manage Myopia?

Atropine eye drops have emerged as an effective pharmaceutical treatment for slowing the progression of myopia in children. Atropine is a medication that temporarily relaxes the eye’s focusing mechanism and is thought to act on the receptors that regulate eye growth.

When administered as daily eye drops at low concentrations (typically 0.01% to 0.05%), atropine has demonstrated the ability to slow myopia progression by over 50%. The effectiveness appears to be dose-dependent, with higher concentrations providing greater myopia control but also increasing the risk of side effects.

Low-dose atropine eye drops are becoming a popular treatment option as they achieve meaningful myopia management with minimal side effects like light sensitivity and mild pupil dilation. Monitoring is required, as there can be an increased rate of myopia progression after stopping atropine treatment, known as a “rebound effect.”

How Does Orthokeratology Work to Manage Myopia?

Orthokeratology, or Ortho-K, is a vision correction method that uses custom-designed rigid gas-permeable contact lenses to temporarily reshape the cornea overnight. This reduces refractive error, allowing clear vision during the day without needing glasses or contact lenses.

Beyond correcting myopia, ortho-k has emerged as an effective treatment for slowing the progression of childhood myopia. Multiple studies have demonstrated that ortho-k can slow axial elongation (lengthening of the eye) by 30-60%

The benefits of ortho-k include freedom from daytime glasses and contacts, high quality vision, and significant slowing of myopia progression if treatment is initiated at a young age. Potential risks include infection from improper lens handling and the need for strict adherence to lens insertion/removal and cleaning.

Can Multifocal Contact Lenses Manage Myopia?

Multifocal contact lenses have emerged as another viable option for controlling myopia progression. These specialty lenses have alternating zones of differing powers – the center corrects for distance vision while the surrounding zones create slightly blurred vision.

This simultaneous correction and introduction of controlled peripheral defocus is thought to reduce the visual signals that drive axial elongation. Multifocal soft contact lenses like MiSight can slow myopia progression by around 30-50% on average compared to regular single-vision lenses.

A significant advantage of this approach is that it provides clear vision at all distances while actively working to limit future increases in myopia. The disadvantages include higher costs, the need for proper fitting, and some patients experiencing visual distortions or reduced contrast when first adapting to the multifocal lenses.

Can Altering Lifestyle and Environmental Factors Affect Myopia?

While genetics play a role in myopia development, research has shown that environmental factors and visual habits can significantly influence the onset and progression of childhood myopia. Two key risk factors are excessive screen time and lack of outdoor activity.

The Role of Screen Time

Prolonged screen usage has been shown to put additional focusing demands on the eyes, which may disrupt normal eye development in children.

While complete avoidance is impossible, it’s important to implement strategies to manage screen exposure. These strategies include:

Following the 20-20-20 rule: Every 20 minutes, look 20 feet away for 20 seconds to allow the eyes to relax
Ensuring proper viewing distances of at least 20-30 cm from screens
Setting reasonable screen time limits and enforcing regular breaks

The Importance of Outdoor Time

Increased time spent outdoors has been associated with a lower risk of developing myopia and slower progression rates. The underlying reasons are still being researched, but factors like higher light intensity outdoors, greater distance viewing demands, and increased vitamin D exposure may all play a role.

By being mindful of visual habits and adopting a more balanced lifestyle, parents can help reduce their child’s risk of developing high myopia and its vision-threatening complications later in life.

Protecting Young Eyes and Preserving Sight

Myopia is a growing global concern, but innovative treatments like low-dose atropine eye drops, orthokeratology lenses, and multifocal contact lenses offer hope for slowing its progression and protecting vision.

Encouraging lifestyle changes can help reduce environmental risk factors that may be driving myopic progression. Early myopia management is crucial for preventing vision-threatening complications later in life.

With continued research and increased awareness, the future looks bright for controlling the myopia epidemic and preserving visual potential in younger generations.