In 2009, Rose Optometrists opened the first clinic in New Zealand devoted to managing myopia. Other terms that are used interchangebly for myopia management clinics are myopia control clinics. The purpos of this clinic was to use evidence based methods in order to slow the rate of progression of shortsightedness in children. The options that we employ within our clinic range but broadly are spectacles (bifocal and progressive designs) , contact lenses (bifocal, multifocal and dual focus designs), corneal reshaping lenses (also known as Shift lenses) or Orthokeratology and drug therapy (Atropine eye drops of varying concentrations).
What is Myopia?
Nearsightedness, or myopia, as it is medically termed, is a vision condition in which close objects are seen clearly, but objects further away appear blurred. Nearsightedness occurs if the eyeball is too long. As a result, the light entering the eye isn’t focused correctly and distant objects look blurred. In most patients the cause of the blur is because the length of the eye grows. It is the most common visual complaint amongst children and young adults.
It has been long understood that genetics and environment play a role but the mechanism of myopia progression has now had some clarification in research conducted internationally. It is recommended that anyone progressing with their short sightedness (or changing glasses regularly) should now be referred on to OR managed with myopia control. Our clinic was the first to be setup in late 2009 in New Zealand. It has been shown that where the light focuses in the periphery (side) of the retina has a strong influence on the progression of myopia. This affects the thickness of the choroid (the part of the retina that contains blood vessels and nourishes the eye to help with sight) by increasing its thickness when utilising methods such as Orthokeratology (Shift lenses) and MiSight soft contact lenses. Atropine is also used and this prevents the thinning of the choroid. In some cases it is recommended that combination therapy is used.
- What can be done?
Since there is now a greater understanding of the mechanism of myopia progression, researchers have been looking at options for altering this peripheral focus in an attempt to develop options to control (slow) myopia progression. This research has lead to the following three options currently being available for myopia control:
Orthokeratology (Shift lenses) uses individually custom designed corneal molds/retainers worn during sleep. Along with Atropine it is regarded as a gold standard treatment option for controlling myopia. They reversibly reshape the cornea (front of the eye) to correct myopia, so no visual correction is required during the day. Due to the reshaping effect on the cornea, they recreate the ideal optical properties required for myopia control. This is currently the one of the best options for myopia control. Some studies show a 50-90% slowing in the progression of myopia.
- Soft Contact Lenses
These disposable soft multifocal contact lenses have been shown to give a similar amount of myopia control as orthokeratology. As with standard disposable contact lenses they are worn during waking hours. They do not correct myopia like orthokeratology. These lenses have the ability to reduce progression by 59%.
- Spectacle Lenses
Spectacle lenses designed in Australia have been specifically designed to reduce myopia progression. The effect on myopia progression is not as large as the previous options but these lenses have been shown to reduce myopia progression by 30% in some groups.
If you would like to discuss your options for myopia control further please contact one of our friendly team at Visique Rose optometrists. We would be happy to discuss the pros and cons of each method on an individual basis as each patient may suit a different option.
It is important to realise that to get the greatest benefit myopia control, treatment should be continued until the eye stops growing altogether (often in the early twenties). After that time myopia control options may no longer be required as the eye naturally stabilises.
Atropine is also regarded as a gold standard option along with orthokeratology (Shift lenses). Atropine is a topical drop that has been shown to be effective at halting myopia from progressing in normal strengths, this is typically 1%, however it comes with side effects, these can include blurring, dilated pupils and stinging of vision.
There is currently a growing amount of research to test whether lower (safer) concentrations also are effective in controlling myopia. Your optometrist may be best to discuss the use of this medication in myopia control. This medication is instilled nightly and must be made by a compounding pharmacy. It is available via your prescription from your therapeutically qualified optometrist.
Thanks to the latest scientific research we now have several options available to us as outlined above. We would be happy to discuss the pros and cons of each method on an individual basis as each patient may suit a different option. Book a suitability appointment now on 07 8473195.
All myopia control options carry an associated cost that is higher than standard contact lenses or spectacles. It is important to realise that to get the greatest benefit myopia control treatment should be continued until the eye stops growing altogether (often in the early twenties). After that time myopia control options may no longer be required as the eye naturally stabilises. For more information on myopia control we recommend:
Dr Richard Anderson’s website: www.myopiaprevention.org
Paul and Kate Gifford’s website: www.mykidsvision.org
Nick Dash and Pascal Blaser’s website: www.myopia.care
Rose Optometrists Myopia Control Video: Stopmyopia
Practitioners requiring help
If you are an optometrist, ophthalmologist or specialist with an interest in myopia and would like assistance in the management of your patient or would like to request time in our clinic then please feel free to contact us through the general enquiries form under “contact us”.