Myopia Management

What is myopia, and why do we need to manage it?

Myopia, or nearsightedness, occurs when the eyeball grows too long and light focuses in front of the retina, resulting in blurry vision at a distance.

Myopia can lead to serious eye conditions like retinal detachment and glaucoma if not managed early. Standard glasses don’t slow its progression—and may even worsen it. Myopia management options like orthokeratology, multifocal contacts, and atropine drops help slow progression and reduce long-term risks. Early detection and treatment are key to protecting your child’s vision.

Risk of Eye Problems with Higher Myopia Levels

level of myopia chart

Myopia symptoms in children include:

  • Squinting when looking at distant objects
  • Difficulty seeing the whiteboard at school
  • Sitting very close to the TV
  • Struggling with activities requiring hand-eye coordination

Risk factors for myopia:

  • Genetics: a child has a 25% chance of becoming myopic if one parent is myopic and a 50% chance if both parents are myopic.
  • Increase in near work especially if the reading distance is 25cm or less.
  • More time indoors. Children who spend more time outside are less likely to be myopic.

Myopia Management Options

Orthokeratology

Orthokeratology treatment involves the overnight wear of customized rigid contact lenses that gently reshape the surface of the eye while sleeping.

This allows freedom from contact lenses and glasses during the day and is ideal for active kids who may otherwise be limited by eyeglasses during sports and other activities. It has also been shown in many studies to be one of the most effective methods to slow the progression of myopia.

These lenses can last up to 2 years and have a proven safety record when used under doctor supervised care along with good hygiene practices.

Soft Multifocal Contact Lenses

Specially designed soft contact lenses are worn during the day and removed at bedtime. These lenses have been proven in long term studies to slow down eye elongation (and therefore myopia) through a method known as peripheral defocus.

These lenses are available in daily disposables for those without astigmatism, and also monthly disposable for those with more complex prescriptions.

Atropine Eye Drops

This treatment is often prescribed for children who are either too young or unable to wear contact lenses. However, it is most effective when used in conjunction with other treatments to further reduce myopia progression.

Recent studies show that 0.01 to 0.05% atropine decreases progression of myopia by 50-87%. It appears to act by thickening the layer of the eye just under the retina called the choroid. This may increase the structural integrity of the eye and thereby reduce its elongation.

These drops are made at compounding pharmacies and generally dispensed in supplies of 1 to 3 months. Some children will have light sensitivity or difficulty focusing at near, in which case the concentration is adjusted to reduce or eliminate these effects.