Myopia, or nearsightedness, is a refractive condition of the eye where light focuses in front of the retina. This results in poor vision that is worse for distance vision compared to near vision. Myopia results when the length of the eye, measured from the front of the cornea to the back of the retina, is elongated.
The prevalence of myopia is dramatically increasing worldwide. According to the National Eye Institute, “the prevalence of myopia, or nearsightedness, increased 66 percent in the United States between 1971-1972 and 1999-2004”. This increase is even more dramatic in some parts of the world and is quickly becoming an epidemic.
The functional implications of high degrees of myopia on everyday life are numerous. Increasing amounts of myopia can cause serious eye health complications in addition to vision difficulties, thicker eyeglass prescriptions, limited contact lens options and laser vision complications. Myopic patients develop higher risks of developing vision threatening eye conditions such as:
- Retinal tears and detachments- an ocular emergency that can lead to permanent vision loss if not treated immediately. Myopic patients over –8.00 diopters have 8 times the risk of developing a retinal tear or detachment.
- Glaucoma- a condition that causes damage to your optic nerve from increased pressure. Without treatment, glaucoma can cause total permanent blindness within a few years and is one of the leading causes of blindness in the United States today. Myopic patients over –6.00 diopters have 14 times the risk of developing glaucoma.
- Macular Degeneration- a condition caused by deterioration of the retina, specifically the macula, which is responsible for detailed and central vision. If left untreated, scarring and permanent damage may occur. Myopic patients over –8.00 diopters have 8 times the risk of developing macular degeneration.
The need to control the likelihood of developing myopia, especially high degrees of myopia is increasing and the doctors at Milpitas Optometric Group can help!
Myopia and the potential for health complications need to be addressed in early points of development. Every myopic child, student and young adult would benefit from myopia control strategies and therapies. When combined with lifestyle and visual hygiene changes, the rate of increase of myopia progression can be slowed significantly.
Lifestyle Changes for Myopic Patients
Recent studies indicate a higher percentage of children becoming myopic or nearsighted. These children are becoming myopic at earlier ages and reaching higher prescriptions before stabilizing. Much of this progression has been attributed to the use of digital devices. Slowing down myopia requires a huge commitment in lifestyle changes and the following steps can make a considerable difference in the health of you and your child:
- Increase your working distance- Hold reading materials such as books or tablets at waist level, or approximately 20” away. Avoid reading while lying on a couch or floor as working distances decrease in these positions. Computer monitors should be positioned at least arms length or 24” away to reduce eye fatigue.
- Reduce digital time- While convenient to give a child or toddler your phone or tablet to occupy their attention, digital devices pose significant long-term risks. These devices are typically held at 12” or closer, use font sizes that are significantly smaller than normal, emit damaging blue light, and can increase myopia progression, especially in young children with short arms. New studies show that as little as one hour a day on a digital device substantially increases the risk of myopia progression.
- Take a break- Staring at near distances for extended periods of time can cause myopia progression. Take a break from near work for 20 seconds, every 20 minutes and look at something in the distance (20/20 rule). This break should be a full 5 minutes or more for kids.
- Get outside- Outdoor “play” time is extremely important in maintaining normal visual function. Studies show that children need a minimum of 1½ hours a day of outdoor time. By playing outside, in natural light, a child increases their visual working distance and can prevent myopia progression before it starts.
- Blue Light Protection- The high energy blue light emanating from digital devices interferes with melatonin production affecting your sleep patterns, cause eye fatigue, and potentially can damage your retina. Avoid using digital devices 1-2 hours before bedtime for better and more restful sleep. Use blue light filters on your digital devices, and apps that reduce blue light at night. Glasses with blue light protection technology are now available for anyone using computers for work and are perfect for kids who use digital devices.
- Consider Myopia Control therapy- It is recommended to start myopia control therapies, such as Multifocal Contact Lens Therapy, Corneal Refractive Therapy or Atropine Drug Therapy, by age 7 or if the child is already myopic and progressing at a rapid rate.
Myopia Control Options:
Multifocal Contact Lens Therapy involves the use of specially designed multifocal contact lenses that limit the progression of myopia when compared to traditional single vision contact lenses or glasses. Multifocal contact lens therapy reduces the progression of myopia by focusing light in front of the peripheral retina a technique known as “peripheral hyperopic defocus”. These multifocal contact lenses inhibit the elongation growth of the eye which causes the progression of myopia. The effectiveness of multifocal therapeutic contact lenses is reported to reduce the rate of myopic progression by up to 50%.
Pricing*: Initial evaluation including follow up: up to $248, Contacts $340 to $600
Year two and beyond*: Evaulation $59.00 to $198, contact lenses $340 to $600
Pros: Least expensive optical therapy, May be covered by insurance and/or flexible spending
Cons: Age and hygiene of the patient may restrict contact lens use. Not as effective as other treatments for rapid progression, not available for patients with astigmatism
Corneal Refractive Therapy, or CRT, is the use of specialized “reverse geometry” gas permeable contact lenses while sleeping to improve vision to normal without the use of contact lenses or eyeglasses during the day. CRT lenses work by temporarily altering the curvature of the cornea. Results will vary based on wear time. The effectiveness of CRT is reported to reduce the rate of myopic progression by approx 50%.
Pricing: Initial evaluation including follow up and contact lenses: $1600
Year two and beyond: Evaluation: $99.00-$598, contact lenses: $450.00 per pair.
Pros: Overnight wear so parents can assist young children, May be covered by flex spending
Cons: Most expensive upfront cost. Not covered by insurance. Not as effective at higher powers, and may require supplemental glasses for end of day use or with myopia > -6.00.
Atropine Drug therapy is the use of a compounded concentration of the Atropine drop at night to relax the eye muscles associated with accomodation. Atropine drug therapy at the concentration rate of 0.01% has been shown to be effective in reducing side effects and reducing myopia progression. The effectiveness of Atropine drug therapy is reported to reduce the rate of myopic progression by approx 60%.
Pricing: Initial evaluation including all follow ups $499, drug cost approx $90/month
Year two and beyond: Evaluation and follow up $149, drug cost approx $90/month
Pros: Available for all levels of myopia and ages, Parents can assist young children
Cons: Not covered by insurance, drug availability limited to certain specialty pharmacies.
Is it time to consider Myopia Control for your child?
Call us at 408-606-2781 to schedule
a complimentary consultation for any one of these therapies.
*All prices quoted will be honored through December 31, 2018.