If your child has myopia (nearsightedness), you’re probably wondering if there is a cure…
For years, eye care professionals and researchers have been asking the same question. Today you are lucky because there is a good news. A number of recent studies suggest that it may at least be possible to control myopia by slowing its progression during childhood and adolescence.
What does myopia control consist of?
Although there is no absolute cure for myopia, doctors can now offer a number of treatments that slow its progression.
These treatments can induce changes in the structure and focus of the eye to reduce the stress and fatigue associated with the development and progression of myopia.
Why should you be interested in myopia control? Because slowing the progression of nearsightedness can prevent your child from developing high levels of nearsightedness that require thick corrective glasses, which have been associated with serious eye problems years later, such as early development of cataracts or even retinal detachment.
Currently, there are four types of treatment that have proven to be effective for myopia control:
1 – Atropine eye drops
2 – Multifocal contact lenses
3 – Orthokeratology (ortho-k)
4 – Multifocal glasses
Here is a summary of each of these treatments and recent research on myopia control:
Atropine eye drops
For many years, atropine eye drops have been used for the control of myopia with effective short-term results. However, the use of these drops also has some drawbacks.
Topical atropine is a medication used to dilate the pupil, as well as to temporarily paralyze accommodation and completely relax the focusing mechanism of the eyes.
Atropine is not used for routine dilated eye examinations because its actions are long-lasting and may take up to a week or more to wear off. The effect of dilating drops, those used by the eye doctor during the eye exam, usually wears off within a couple of hours.
Currently, atropine is often used to reduce eye pain associated with certain types of uveitis.
Since research indicates that myopia in children may be linked to accommodative effort, researchers have considered using atropine to deactivate the eye’s focusing mechanism to control myopia.
And the results of studies of atropine eye drops to control myopia progression have been impressive-at least during the first year of treatment. Four short-term studies published between 1989 and 2010 concluded that atropine produced an average 81% reduction in myopia progression in myopic children.
However, additional research has shown that the myopia-controlling effect of atropine does not continue after the first year of treatment, and that short-term atropine use cannot significantly control myopia in the long term.
Interestingly, one study found that when atropine drops were discontinued for myopia control after two years of use, children who were using drops with the lowest concentration of atropine (0.01%) had more sustained myopia control than those children who were treated with higher concentration atropine drops (0.1% to 0.5%). They also had less progression of “rebound” myopia one year after treatment.
In addition, many eye specialists are reluctant to prescribe atropine for children because the long-term effects of consistent use of the medication are unknown.
Other drawbacks of atropine treatment include discomfort and light sensitivity due to prolonged pupil dilation, blurred near vision, and the added expense of the bifocals or progressive lenses that children need during treatment in order to read clearly, since their ability to focus up close is impaired.
Orthokeratology is a technique in which specially designed gas permeable contact lenses are worn during sleeping hours at night to temporarily correct nearsightedness and other vision problems so that glasses and contact lenses are not needed during waking hours.
Some eye doctors use ortho-k lenses (another name for orthokeratology) to control the progression of nearsightedness in children. Evidence suggests that nearsighted children who have undergone orthokeratology for several years reach adulthood with less myopia compared to children who wear glasses or regular contact lenses during the years conducive to myopia progression.
Many eye care professionals refer to these lenses as “corneal shaping lenses” or “corneal refractive therapy (CRT),” rather than ortho-k lenses, although the lens design is similar.
In 2011, researchers in Japan presented a study that evaluated the effect of ortho-k lenses on eyeball elongation in children, which is a factor associated with myopia progression.
A total of 92 myopic children completed the two-year study: 42 wore ortho-k lenses at night and 50 wore conventional glasses during the day. The average age of the children participating in the research was about 12 years at the start of the study, and the children in both groups had essentially the same pre-existing amount of myopia (-2.57 D) and the same axial (front-to-back) eyeball length (24.7 mm).
At the end of the study, the children in the spectacle-wearing group had a significantly greater increase in average axial eye length compared to the children wearing the ortho-k contact lenses. The study authors concluded that orthokeratology at night suppressed the lengthening of the eyes of the children in this study, and that the study suggests that ortho-k lenses may slow the progression of myopia compared to wearing glasses.
In 2012, the same researchers published the results of a similar five-year study of 43 myopic children, which showed that wearing ortho-k contact lenses at night suppresses axial elongation of the eye compared to wearing conventional glasses for myopia correction.
Also in 2012, researchers in Spain published data from a study that revealed that children ages 6 to 12 years old with -0.75 D to -4.00 D myopia who wore ortho-k contact lenses for two years had less myopia progression and reduced axial elongation of the eyes compared to children of the same age who wore glasses for myopia correction.
Early detection of myopia
The best way to take advantage of methods to control nearsightedness is early detection.
Even if your child does not complain of vision problems , it is important to do a routine eye exam before your son is going to enter school.
Early childhood eye exams are especially important if you or your spouse are nearsighted or if your other older children have nearsightedness or other vision problems.
Can eye exercises cure myopia?
No doubt you have seen or heard advertisements on television and the Internet claiming that eye exercises can reverse nearsightedness and correct eyesight “naturally” without surgery or glasses.
Some of these eye exercise programs recommend that you consult with your eye doctor for a prescription for glasses that intentionally under-corrects nearsightedness by wearing them all the time as a supportive treatment for performing the exercises. The claim is that the exercises and under-correction of myopia will reduce nearsightedness, so you will need less vision correction as time goes on.
It is worth noting that research has shown that myopia under-correction is ineffective in slowing the progression of myopia and, in fact, may increase the risk of it getting worse. Also, intentional under-correction of nearsightedness causes blurred distance vision, which can put your child at a disadvantage in the classroom or in sports, and affect his or her safety.