What is Myopia?
Myopia or Nearsightedness means that you can see objects close up but you can not see objects in the distance like a road sign or white board at school.
Myopia occurs when the eyeball is too long, relative to the focusing power of the cornea and lens of the eye. This causes light rays to focus at a point in front of the retina, rather than directly on its surface.
Myopia typically begins in childhood and you may have a higher risk if your parents are nearsighted. In most cases, nearsightedness stabilizes in early adulthood but sometimes it continues to progress with age.
What might contribute to Myopia?
Signs of Myopia
Genetics, parents who have myopia
Environment, factors include sunlight, vitamin D, dopamine levels, and time spent outdoors
Near Work, extended reading and use of electronic devices.
Fatigue when driving or playing sports
Long term effects of Myopia
Cataracts develop sooner
Greater risk of Glaucoma, which puts pressure on your optic nerve causing loss of vision.
Treatment for Myopia
Atropine Eye Drops
Atropine eye drops have been used for myopia control for many years. Studies have shown that Atropine has had some short-term result, though some long term effects are not known at this time.
Atropine is a medication used to dilate the pupil and completely relax the eyes' focusing mechanism. It is not used in a routine eye exam because its actions are long-lasting and can take a week or longer to wear off.
Research has suggested that myopia in children is due to focusing fatigue, by using Atropine to disable the eye's focusing mechanism it can control their myopia. From 1989 to 2010 there were 4 studies done which found that Atropine produced an average reduction of myopia progression of 81%. One study also found that when using the lowest concentration of Atropine .01%, patients had less "rebound effect" and were able to sustain control of their Myopia after two years of discontinuing the drug.
There are some drawbacks to using Atropine. Cost of the drug can be high depending on your Prescription Plan and Patients may need to purchase Bifocals or Multi-focal Contacts during treatment to be able to read clearly. There is also some side-effects when using Atropine. They include discomfort, light sensitivity, and blurred near vision. Many Eye Care Doctors are reluctant to prescribe Atropine because long-term side effects are not know at this time.
"Ortho-K"or Orthokeratology is the use of a specialty gas permeable contact lens that is worn during sleep at night. Patients who wear these lenses while they sleep can temporarily correct myopia and and other vision problems so glasses and contacts are not need during waking hours.
Eye Doctors use Ortho-k lenses in children to control myopia because evidence suggest that with several years of treatment they will be less myopic as adults. Many studies have been done with results showing that with continued treatment there was a reduction in Myopia.
Ortho k is a great option for Patients who don't want to wear Glasses or Contacts during the day, but there are some negatives to this treatment. This treatment is very expensive and very complex, patients will need to follow up with their eye doctor to make sure the lens is fitted properly. Patients may feel some discomfort wearing this lens as is the case with any contact lens. Patients must wear this lens as prescribed, rebound effect can happen if the lens is not worn consistently. Lastly, because this lens is for night time wear there is a risk of infection and inflammation so it is critical that Patients clean the lenses regularly and replace when needed.
Multi-focal Glasses and Contacts
Whether it is multi-focal glasses or contacts, these special lenses have different powers in different zones to correct presbyopia as well as nearsightedness or farsightedness. Studies have shown that using multi-focal correction can help control myopia. Studies have also shown that Multi-focal Contact work better than Bifocal eyeglass lenses at controlling myopia.
For patients who go the route of Bifocal lenses, cost is the only mitigating factor. Patients will have the cost of the specialty lenses which may have to be changed every 6 months during the treatment.
Multi-focal contacts do take some patience. Along with fit there may need to be some "tweaking" needed to make sure patients get the best possible vision. Also when wearing contacts there is always a risk of discomfort throughout the day, infection from improper cleaning and wear cycle, and inflammation. Multi-focal contacts come in a range of costs depending on wearing cycle, and will need to be checked regularly.