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Myopia Control in Children

What is Myopia? Why Should I be Concerned?

In order to see clearly, light that enters the eye must focus on the retina.

In myopia, light focuses in front of the retina due to the elongated eye. This causes blurry vision in the distance. Myopia as known as “nearsightedness”, is not only a refractive error, but it is a chronic, progressive eye disease characterized by eye elongation and increased risk of eye diseases: cataracts, glaucoma, retinal detachment and myopic macular degeneration.

Axial Length: The length of your eyeball is measured using biometry. It is an accurate way to monitor myopia progression. A longer eyeball has a higher risk for myopia progression, and a higher risk for myopic disease. The risk for eye disease increases exponentially for an eye length of >26.00mm. In the past the importance of eye health has been overlooked due to lack of technology.

Although higher levels of myopia are associated with greater risk of developing eye disease, it is imperative to know that any amount degree of myopia increases the risk of vision threatening conditions that could lead to blindness in a lifetime.

67 Percent For every one diopter of increased myopia, the risk for developing myopic macular degeneration or loss of vision by 67%. If you’re under -3.00 myopia, the risk is 20x and this risk is 40x if the myopia is greater than -6.00 myopia.

What is myopia control & why have I never heard about it?

Myopia control includes a group of treatment methods backed by Science to slow down the progression of myopia. There is no current method that can completely stop the progression as of yet, but the goal is to flatten the risk curve.

In years past, the only treatment offered to a progressing myopia was to prescribe stronger glasses or contact lenses to allow them to see well, and the eye was allowed to progress until it plateaued once growth was complete, typically in the mid to late teen years

The past decade has seen an abundance of research, studies and treatment options emerge that are effective and evidence based. Having multiple effective, evidence-based treatment options has allowed eye doctors to confidently prescribe myopia control options and tailor a treatment approach to each child’s individual lifestyle. More treatment options involving pharmaceuticals, glasses and contact lenses are currently in development and the future of myopia control is very promising!

What puts your child at risk?

1. UNSTABLE BINOCULAR VISION

An unstable binocular vision is a risk factor for early onset of myopia and myopia progression. Your binocular vision can be examined by booking a binocular vision appointment with Dr. Pink Sidhu and Associates.

2. MYOPIC PARENTS33percent tangerine. CB1198675309 . TTW

There is a 33% chance that a child will develop myopia if one PARENT IS MYOPIC.

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The number jumps to 50% if both are myopic.

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3. INCREASED SCREEN TIME

There is a link between increased screen time and reduced outdoor time.

School-aged children who spend 7+ hours per week or more using computers or mobile video games TRIPLE THEIR RISK for myopia.

Current Myopia Control Options

Ortho K

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Ortho-K +

Ortho K is a method used for decades where a customized hard lens is worn overnight to change the corneal shape. It serves as a night time brace. It allows for corneal reshaping to allow for daytime freedom from glasses or contacts. This requires an initial fitting and frequent appointments to allow for a customized brace to be created for you in the first month. It is the most rewarding option because it offers daytime freedom from glasses or contacts. Parents love this for their young or independent children. Our Ortho-K Fitting Program equates to approximately just over $5 a day in the first year, and just over $2 a day in subsequent years. Please see us back for Axial Length Biometry and Corneal Topography.
*Corneal Topography: Computerized corneal curvature mapping measures over 15,000 points if the cornea to identify surface shape. This information is used in the fit and design of AOK Eye Braces for maximum correction & optimal myopia control.

Learn more about Ortho-K.

glasses

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Specialty Eyeglasses and Contact Lenses +

Spectacle lenses or contact lenses may be the right choice for you and your family. It is a non-invasive, safe, and effective option for younger children. Hoyas Miyosmart lenses, DIMS technology has been proven to slow down 60% of myopic progression.

Learn more about DIMS technology.

Read this article on a study on the efficacy of DIMS

Read this study on “A comparative study of orthokeratology and low‑dose atropine for the treatment of anisomyopia in children”.

Hoya

Myopia Child with cape

Millions of children across Canada are poised to benefit from a breakthrough therapy that addresses the fast-growing issue of myopia (nearsightedness), which is projected to negatively affect more than 50 percent of the world’s population by 20502. CooperVision MiSight® 1 day contact lenses are now available for fitting by our Eye Care Professionals. It is the world’s first one-day soft contact lens clinically proven to substantially slow the progression of myopia in children. They look and feel like ordinary one day soft contact lenses, but they have a very different optical design called ActivControl™ Technology. Our Optometrists have been trained and educated to offer this unique contact lens solution.

Contacts

MiSight 1 day contact lenses were studied over three years in children as young as age eight MiSight® 1 day has been shown to reduce myopia progression by more than half versus a single-vision one-day lens1,4. Over three years, children wearing MiSight® 1 day had 59 percent less myopia progression and 52 percent less axial elongation on average than those wearing a single-vision one-day lens1. The innovative contact lens is designed for children who have a myopia prescription from -0.25 to -6.00. Its ActivControl® Technology addresses both axial elongation and refractive error4. MiSight 1 day contact lenses are child-friendly and fit their active lifestyles, the lens is designed for children’s ease of use and parental peace of mind. In a multi-center study, 100 percent of children who had never worn contact lenses before found MiSight® 1 day easy to remove after one month of wear4. After a single month of wear, 85 percent of children said the lenses were easy to insert4. Children were found to have not changed their daily activities, and their wearing experiences were similar to those of children wearing a single-vision lens1. Children as young as age eight and new to contact lenses reported ease of handling‡. 90% of children said they preferred wearing their MiSight 1 day contact lenses over wearing their spectacles.* ≥ 98% reported seeing well while playing outdoors.* 90% of children reported seeing well while doing schoolwork, reading, watching TV, and playing video games.‡ Children agreed that MiSight 1 day gave them clear vision at a variety of distances during every day activites. Parents in the same study also had a highly positive response, noting their children could mostly manage their lens wear independently. Prior to dispensing contact lenses, less than half of the parents were extremely at ease with their child wearing contact lenses, but this increased significantly to 79 percent after just one month and remained high through the two-year mark4. After their children had worn MiSight® 1 day contact lenses for three years, 100 percent of parents rated their children “happy” with the overall experience1,5 References: 1. Chamberlain P, back A, Lazon P, et al. 3 year effectiveness of a dual-focus 1 day soft contact lens for myopia control. Presented at the 40th British Contact Lens Association Clinical Conference and Exhibition; 10 June 2017; Liverpool, United Kingdom. 2.Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036-1042. 3. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prof Retin Eye Res. 2012;31(6):622-660. 4. Data on file, Coopervision. 5. Tiderman JW, Snabel MC, Tedja MS, et al. Assocation of axial length with risk of uncorrectable visual impairment for Europeans with myopia. JAMA Ophthalmol. 2016;134(12):1355-1363.

*Over a three-year period of studying MiSight® 1 day contact lenses in children 8-15 years; 1 week through 3 year visits. †As reported by parents. After 1 month of wear 100% of the children found the lens easy to remove and 85% of who have never worn contact lenses before find the lenses easy to insert. ‡ From one-week through three-year visits.

Cooper (1)

Check out this article on how to use low-dose atropine to slow myopic progression in kids

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Vision Therapy/Vision Training +

VT aims to equip the child with skills to better handle the increased modern day demands and visual stress at near. In turn, it helps slow down the onset of myopia. It was thought earlier, that only high amounts of myopia were a risk for early eye diseases, but it is now known that no amount of myopia is safe.

Vision therapy is helpful to all patients, but it is especially beneficial for emergent/pre-myopes and early myopes because it helps strengthen near vision skills. Myopia is a symptom and an adaptation to an overloaded or fragile near visual system due to modern day activities ( increased screen time, excessive near tasks and limited outdoor time). Function alters structure. VT helps delay the process for those who are transitioning from an “as if” myopic visual system, and adapting to an “is“ myopic visual system.

Atropine

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Atropine Use +

Low-dose atropine eye drops are another form of myopia control for children, recommended by Dr. Pink Sidhu and Associates. These drops are administered to your child on a daily basis to reduce eye strain and slow the progression of myopia. The drops temporarily reduce the eye’s ability to focus at near, relaxing the eyes and controlling myopia. This is a prescription item and dispensed at a compounding pharmacy.

*Remember:
  1. Each option considers your child’s refractive error, axial length, binocular vision status ,
    individual lifestyle and physical limitations.
  2. To receive the full benefit of any treatment plan an ensure eye health, you must adhere to a recommended lens care and wear schedules, and return for timely progress evaluations (not covered by OHIP).
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