BMN Blog

OCT 23
Controlling Myopia Progression

What is myopia?

 

Myopia is a condition that results in distant objects appearing blurry to a patient when not being corrected with glasses or contact lenses.1 Myopic blur typically results from the eye being too long for its optical focusing components (cornea and crystalline lens), which causes distant objects to be in focus in front of the retina (back of the eye) instead on the retina, a requirement for the eye to be able to see clearly.1 About one third of Americans have myopia, and its prevalence is likely increasing because of factors associated with living in a developed country (e.g., decreased time outdoors).2-5 With that said, the scientific community only has a vague understanding of how genetics and the environment influence the development and progression of myopia.1 While myopia’s visual affects can be a costly nuisance and strain on the health care system,6 myopia also places the affected individuals at a greater risk for developing vision-threatening conditions like cataracts, retinal detachments, and glaucoma.1 Once present, myopia cannot be cured; therefore, preventing it or even reducing the amount of myopia that a patient develops is an upmost priority for the scientific community.7

 

What are the options for controlling myopia progression?

 

The scientific community currently lacks the ability to prevent or predict who will become myopic, though there are three methods with scientific backing that have the potential to decrease the progression of myopia by 50 to 60 percent.8-10

 

  1. Orthokeratology Contact Lenses

 

Orthokeratology contact lenses are hard contact lenses that are primarily worn during sleep and are removed in the morning.8 Orthokeratology contact lenses work by temporarily reshaping the cornea so that a person with myopia can see clearly without correction.11,12 Orthokeratology contact lenses may also slow the progression of myopia by beneficially bending light as it enters the eye, so that when light reaches the peripheral part of the back of the eye, it is in focus in front of the back of the eye instead of in back of the eye, which is the case when wearing single vision glasses or contact lenses.7

 

  1. Soft Bifocal Contact Lenses

 

Soft bifocal contact lenses are devices that were developed for treating presbyopia (decreased ability to see at near with age).13 Soft bifocal contact lenses are also thought to slow myopia progression in a similar manner as orthokeratology contact lenses.7

 

  1. 0.01% Atropine

 

Atropine eye drops have been historically used during ophthalmic examination to dilate pupils, which allows for better views of the back of the eye for detecting ocular pathology and for treating amblyopia (lazy eye).14 Atropine eye drops have also been used to treat myopia progression.7 The scientific community currently lacks a mechanics understanding of how 0.01% atropine slows the progression of myopia, though atropine is currently thought to be the most effective of the three myopia control methods used in practice.10,15

 

Who should be treated for myopia progression?

 

While none of the above myopia control methods have been U.S. Food and Drug Administration approved for preventing myopia progression,7 all three of the above methods have shown scientific promise,8-10 and there is a growing consensus within the vision community that the above treatments have the ability to slow myopia progression.7 New myopic patients (first pair of glasses) and patients who are younger will likely benefit the most from myopia control interventions because their eyes will likely grow more than older patients who already have high myopia, though any myopic patient at risk for progression (patients less than 25-years-old) may still benefit from starting a myopia control intervention.16 All three myopia control methods are generally considered safe, even in children as young as 6-years-old.10,15,17,18 In fact, children and teens are able to wear their contact lenses for a similar amount of time each day, and both groups feel that contact lenses improved their social acceptance, appearance, ability to play sports, and overall satisfaction with their vision correction.19,20 While there is no scientific data on how long a patient should undergo myopia control therapy, the general consensus is that patients should be treated until their eyes are done growing, which is when patients are in their mid-teens or even older.16

Myopia, or nearsightedness, cannot be cured once present. However, there are ways to slow the effect of myopia over time. At UAB Eye Care, three treatment methods are offered for controlling myopia progression at the Myopia Control Clinic. Learn more about this clinic by calling 205-975-2020.

 

Dr. Andrew Pucker is an assistant professor at the UAB School of Optometry, which operates UAB Eye Care. The Myopia Control Clinic at UAB Eye Care is now accepting patients. Learn more by calling 205-975-2020.

 

References

 

  1. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31(6):622-660.
  2. Vitale S, Ellwein L, Cotch MF, Ferris FL, 3rd, Sperduto R. Prevalence of refractive error in the United States, 1999-2004. Arch Ophthalmol. 2008;126(8):1111-1119.
  3. Vitale S, Sperduto RD, Ferris FL, 3rd. Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Arch Ophthalmol. 2009;127(12):1632-1639.
  4. Jones LA, Sinnott LT, Mutti DO, Mitchell GL, Moeschberger ML, Zadnik K. Parental history of myopia, sports and outdoor activities, and future myopia. Invest Ophthalmol Vis Sci. 2007;48(8):3524-3532.
  5. Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. 2008;115(8):1279-1285.
  6. Vitale S, Cotch MF, Sperduto R, Ellwein L. Costs of refractive correction of distance vision impairment in the United States, 1999-2002. Ophthalmology. 2006;113(12):2163-2170.
  7. Walline JJ. Myopia Control: A Review. Eye Contact Lens. 2016;42(1):3-8.
  8. Walline JJ, Jones LA, Sinnott LT. Corneal reshaping and myopia progression. Br J Ophthalmol. 2009;93(9):1181-1185.
  9. Walline JJ, Greiner KL, McVey ME, Jones-Jordan LA. Multifocal contact lens myopia control. Optom Vis Sci. 2013;90(11):1207-1214.
  10. Chia A, Chua WH, Cheung YB, et al. Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2). Ophthalmology. 2012;119(2):347-354.
  11. Koffler BH, Sears JJ. Myopia control in children through refractive therapy gas permeable contact lenses: is it for real? Am J Ophthalmol. 2013;156(6):1076-1081 e1071.
  12. Choo JD, Holden BA. The prevention of myopia with contact lenses. Eye Contact Lens. 2007;33(6 Pt 2):371-372; discussion 382.
  13. Remington LA. Clinical anatomy of the visual system. 2nd ed. St. Louis: Butterworth-Heinemann; 2005.
  14. Repka MX, Kraker RT, Holmes JM, et al. Atropine vs patching for treatment of moderate amblyopia: follow-up at 15 years of age of a randomized clinical trial. JAMA Ophthalmol. 2014;132(7):799-805.
  15. Chia A, Chua WH, Wen L, Fong A, Goon YY, Tan D. Atropine for the treatment of childhood myopia: changes after stopping atropine 0.01%, 0.1% and 0.5%. Am J Ophthalmol. 2014;157(2):451-457 e451.
  16. Group C. Myopia stabilization and associated factors among participants in the Correction of Myopia Evaluation Trial (COMET). Invest Ophthalmol Vis Sci. 2013;54(13):7871-7884.
  17. Chia A, Lu QS, Tan D. Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2: Myopia Control with Atropine 0.01% Eyedrops. Ophthalmology. 2016;123(2):391-399.
  18. Walline JJ, Lorenz KO, Nichols JJ. Long-term contact lens wear of children and teens. Eye Contact Lens. 2013;39(4):283-289.
  19. Walline JJ, Gaume A, Jones LA, et al. Benefits of contact lens wear for children and teens. Eye Contact Lens. 2007;33(6 Pt 1):317-321.
  20. Walline JJ, Jones LA, Sinnott L, et al. Randomized trial of the effect of contact lens wear on self-perception in children. Optom Vis Sci. 2009;86(3):222-232.

 

Bookmark and Share

Comments


Post a Comment

Please login to post a comment.

Search

Categories

Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: