Myopia Control
Myopia, also known as nearsightedness, is the most common refractive disorder worldwide. In fact, it has been predicted that myopia prevalence will increase to affect 50% of the worldwide population by the year 2050 or 4.8 billion people, and both the incidence and severity are increasing. The incidence of myopia does affect different ethnicity and geographical locations differently, affecting approximately 85% of the urban population in East Asia and 44% in the United States. It is characterized by excessive eye lengthening, or axial elongation, which causes light from distant objects to focus in front of the retina.
Myopia is a multifactorial disorder based on interactions between environmental and genetic risk factors, and it generally develops during childhood; myopia progression gradually stabilizes after adolescence for most individuals. Environmental factors that play an important role in the development of myopia in children include the amount of time spent outdoors, near work, prolonged intense education, and urbanization, so, not surprisingly, the prevalence in myopia is much lower in underdeveloped areas of the world such as rural Nepal where it only affects 4% of the population. Retinal detachment, macular degeneration, foveoschisis, early-onset glaucoma, cataract are all conditions shown to have an increased risk of comorbidity with myopia, and retinal detachment and macular choroidal neovascularization incidence increases with higher levels of myopia.
Unfortunately, despite much research, the underlying mechanisms of myopia development are not well understood. Consequently, there is no established way to prevent the onset of myopia or halt or reverse progression. However, current myopia control treatment strategies aim at delaying onset or slowing progression. These strategies include increased time spent outdoors and decreased near work duration, pharmacological interventions (such as atropine 0.01% eye drops), and optical strategies (such as soft multifocal contact lenses and orthokeratology). Orthokeratology and certain soft multifocal contact lenses are both thought to provide myopic blur to the retina, which is thought to act as a cue to slow eye elongation. Both of these methods of myopia control have shown an approximate 50% slowing of myopia progression in controlled studies. Atropine 1.0% eye drops provides the best myopia control, but the effects on focusing and pupillary dilation limit its utility for myopia control. However, low-concentration atropine eye drops, such as atropine 0.01% eye drops, have been shown to provide effective myopia control with far fewer side effects than 1.0% atropine.
Please ask our eye doctors about myopia control for your child, particularly if one or both parents have moderate to high myopia.
Please ask our eye doctors about myopia control for your child, particularly if one or both parents have moderate to high myopia.
Sources:
1. https://journals.lww.com/claojournal/Abstract/publishahead/Biological_Mechanisms_of_Atropine_Control_of.99080.aspx
2. Prog Retin Eye Res. 2012 Nov;31(6):622-60. doi: 10.1016/j.preteyeres.2012.06.004. Epub 2012 Jul 4.
1. https://journals.lww.com/claojournal/Abstract/publishahead/Biological_Mechanisms_of_Atropine_Control_of.99080.aspx
2. Prog Retin Eye Res. 2012 Nov;31(6):622-60. doi: 10.1016/j.preteyeres.2012.06.004. Epub 2012 Jul 4.