Nearsighted Treatments
New Treatments for Nearsighted Children
What is "nearsightedness" (myopia)?
Nearsightedness is the inability to see distance objects clearly. It is usually treated with glasses, contact lenses, or, in adults, corrective laser surgery.
What causes nearsightedness?
Nearsightedness is caused by an abnormality in the shape of the eye. In an eye with perfect vision, the cornea and lens focus light through the pupil to form a clear image on the retina. In nearsightedness, the eye is larger, so the cornea and lens focus the image in front of the retina. The light that reaches the retina is no longer in focus, causing distant objects to be blurry.
National Eye Institute, National Institutes of Health
Why does nearsightedness need to be controlled?
Corrective lenses do not address the full impact and progressive nature of the vision problem. Glasses, for example, introduce some visual distortion, making objects smaller and harder to see. This distortion can cause abnormal behaviors like face turns or squinting to improve vision. These behaviors can lead to eye strain and headaches.
Nearsightedness has also been shown to cause anxiety and decreased self-esteem in children, particularly in adolescents who already have concerns about self-image. Finally, nearsightedness worsens over time as the child grows. Higher levels of nearsightedness significantly increase the risk of serious eye problems like glaucoma, cataract, and retinal detachment that can lead to partial or complete vision loss.
Why does nearsightedness get worse over time?
The mismatch between the cornea, lens, and retina worsens through simple growth of the eye, resulting in stronger glass or contact lens prescriptions every year. The deterioration of vision accelerates when a child has excessive near visual activity because the eyes adapt to see more clearly where they are used the most.
Excessive screen time is not the only problem. Research suggests that > 2 hours of homework/reading causes more nearsighted progression than similar time spent on electronic devices. As the nearsightedness gets worse, the visual distortion caused by the corrective glasses gets worse. If the nearsightedness increases too much, the risk of serious eye health problems becomes much higher. Additionally, too much nearsightedness may cause the child to no longer be a good candidate for corrective laser surgery as an adult.
What can be done to reduce nearsightedness?
Nearsightedness can be stabilized and even reversed in some children using three main techniques that are supported by years of clinical research:
1. Behavior Modification - more time spent outdoors in the sun and less time spent indoors focused up close on the tablet, phone, book, or computer.
2. Special Glasses/Contact Lenses - specially designed multifocal glasses or contact lenses produce clear images on both the central and peripheral retina, reducing nearsighted progression because more nearsightedness is not required to clear the image for the peripheral retina. These lenses are different from standard glasses and contact lenses that only provide clear vision for the central retina but leave the peripheral retina blurry. An exciting new product is the CooperVision MiSight® soft daily contact lens for children, the first and only FDA-approved contact lens that slows the progression of nearsightedness. Email Special Services at South Bay Family Eye to see if your child might benefit from this new contact lens.
3. Medication - atropine eye drops have been shown to slow and even reverse nearsightedness in children by stabilizing the shape of the eye. Atropine 1% eye drops are FDA-approved to treat a lazy eye and inflammation inside the eye and dilute atropine 0.01% and 0.02% eye drops are in the final stage to become FDA-approved to treat nearsightedness. Email Special Services at South Bay Family Eye to see if your child might benefit from dilute atropine eye drops.
> Dr. Clark discusses atropine treatment and the importance of early intervention in Review of Myopia Management. Read the article here.