The Importance of Starting Myopia Management Early

Myopia management is a branch of pediatric optometry dedicated to decreasing the progression of myopia (nearsightedness) in children.

When a child becomes myopic, the condition often progresses (worsens) every few months.

When a child becomes myopic at an early age, their myopia tends to progress quickly, leading to higher levels of myopia. The higher myopia, the higher the risk of developing sight-threatening diseases later in life. This is why your child should begin myopia management as soon as possible.

Myopia Control is About Protecting Eye Health

Myopia in children may appear to require nothing more than a pair of glasses to correct blurred vision.

However, as the eye elongates, it stretches the retina, the light-sensitive layer lining the back of the eye. Eventually, this excessive stretching renders the eye more prone to tears, inflammation, the formation of new, weak blood vessels and scarring.

This, in turn, raises the risk of cataracts, glaucoma, retinal detachment and myopic maculopathy — damage to the central retinal area.

When Should Myopia Management Start?

Parents are at times reluctant to start myopia management early as they may believe their child is too young. Does it really matter whether a child has a stronger or weaker prescription if they have to wear glasses anyway?

Actually, it does matter.

The earlier a child becomes myopic, the faster the rate at which their prescription will continue to worsen. Therefore, starting myopia management early, when the myopia is still mild, will have the biggest impact on slowing myopia progression.

Myopia management should begin in children as young as 8 years old.

What is Myopia Management?

Myopia management is an evidence-based program that uses a variety of options to help stop or slow the progression of myopia. Each treatment option for myopia has different advantages and levels of efficacy.

If you’re worried about your child’s myopia, book an assessment to determine whether they can benefit from myopia management. Speak with Dr. Andrea Kozma and Dr. Stephanie Britton, who will advise you on the [best] treatment options for your child’s vision and lifestyle.

Our practice serves patients from Georgetown, Limehouse, Acton, and Halton Hills, Ontario and surrounding communities.

The Connection Between Near Work And Myopia

The steady rise of myopia (nearsightedness) in children around the globe may be alarming—but does it really come as a surprise?

Nowadays, children are spending more time engaging in near work through the use of digital devices and computers, which experts believe, is the driving force behind the myopia pandemic.

Fortunately, with myopia management, even a child that spends most of the time focusing on near objects can mitigate their risk of developing future eye problems.

Below, we’ll explain what myopia is, how near work contributes to the onset and progression of myopia and why parents should act now to protect their children’s vision for the future.

What Is Myopia?

Myopia occurs when light entering the eye is focused in front of the retina instead of directly on the retina’s surface. This could be due to the eyeball being too long or the focusing power too high.

Myopia worsens when the eye grows longer, causing the retina to stretch and strain. This makes the eye prone to serious diseases like macular degeneration, glaucoma, retinal detachment and diabetic retinopathy later in life.

Several factors may contribute to myopia’s onset and progression, including genetics, ethnicity, not spending enough time outdoors and near work.

What’s Considered Near Work?

Near work is defined as any activity that requires focusing on objects within arm’s reach from the eyes: 16-20 in./40-50 cm or closer. Examples include, but aren’t limited to:

• Reading, especially with focused concentration
• Writing
• Screen use (tablet, computer, smartphone, etc.)
• Watching TV or video games from a close distance
• Playing certain musical instruments (for example, looking at piano keys or reading sheet music)

How Does Near Work Contribute to Myopia?

Numerous studies have assessed the relationship between near work and myopia. A systematic review of 27 such studies found a 2% increased chance of developing myopia with every diopter-hour of near work time per week.

A diopter-hour is a term used in research to measure the time spent on near work and how it relates to myopia. For example, one diopter-hour spent reading is given more weight than multiple hours spent staring at a computer screen at an intermediate distance.

Additional research indicates that taking regular breaks while doing near work may have a positive effect on myopia. Children who engaged in continuous and focused reading had higher levels of myopia than groups of children who took frequent breaks, even if they read for the same amount of time overall.

According to several studies, children who play outdoors in the sunshine have a reduced risk of myopia and myopia progression. In fact, researchers are now investigating whether looking at faraway objects like a moving ball plays a role.

That said, it’s important to note that near work isn’t the only myopia risk factor.

How Myopia Management Can Help

This information isn’t meant to scare parents into removing digital devices from the home, but rather to encourage a balanced lifestyle for the whole family.

Myopia management can significantly reduce your child’s risk of developing serious eye disease later in life, so why wait? The earlier they start, the greater their chance of success. At Giddens Optometry, we provide the latest in myopia control to offer the best possible outcome for our young patients. Myopia treatments include multifocal contact lenses, orthokeratology (ortho-k) and atropine eye drops.

During your child’s myopia consultation, we’ll ask about your child’s lifestyle to determine which treatment option best suits them. We encourage our patients to be honest when it comes to how much time they spend engaged in near work, as it gives us a better understanding of their visual needs.

Myopia management is suitable for children aged 8-12 with any level of myopia, or those who are at risk of becoming nearsighted (if both parents are shortsighted, for example).

To schedule your child’s myopia consultation, contact Giddens Optometry today!

Our practice serves patients from Georgetown, Limehouse, Acton, and Halton Hills, Ontario and surrounding communities.

Dry Eye And Myopia Management

All parents considering myopia management for their children want to know that the treatments are safe, comfortable and effective. One particular concern is whether myopia treatments could affect their child’s dry eye syndrome.

Can a child with dry eye symptoms still be a candidate for each of the myopia management treatments? Is there a chance the myopia treatments could worsen a child’s dry eye symptoms? Or perhaps improve them?

There is much to consider, and your optometrist will carefully treat each case on an individual basis.

Below, we’ll explain what dry eye syndrome (DES) is and how it may relate to myopia management.

A Brief Overview of Dry Eye Syndrome

DES is a chronic lack of ocular hydration due to insufficient tears or an imbalance in the components that make up the tears (oil, mucus and water).

Certain health conditions, medications, weather conditions, aging, allergies, nutritional deficiencies, and excessive screen time can all contribute to the onset and severity of DES.

Common signs and symptoms of DES include:

• Red, irritated eyes
• Watery eyes
• Stinging or burning eyes
• Grittiness
• Blurred vision
• Light sensitivity
• Stringy mucus around the eyes
• Frequent eye rubbing

DES can be successfully treated in a number of ways, including artificial tears, medicated eye drops, nutritional supplements and by implementing proper eyelid hygiene, like cleaning the eyelids and regions adjacent to the eyes daily. Your eye doctor will prescribe the treatment that targets the underlying cause of your condition.

What Puts Children and Teens at Risk of Developing DES?

Although children have a lower risk of developing DES than adults, they can still suffer from its painful and irritating symptoms. Some experts believe that dry eye syndrome is underdiagnosed in children because they may lack the verbal skills to describe their discomfort.

Risk factors for a child/adolescent developing DES are:

• Allergies
• Certain medications (acne medication, antidepressants, anti-anxiety medications, antihistamines)
• Certain health conditions (blepharitis, herpes simplex viruses, evaporative eye disease, certain neurological disorders, diabetes, inflammatory conditions)
• Excessive screen time (people blink less when staring at a screen
• Nutritional deficiencies

If any of the above factors relate to your child, discuss them with your child’s optometrist before deciding on a particular myopia management treatment.

Myopia Management Options and DES

Multifocal Contact Lenses

These lenses are worn during the day and are usually discarded every night. Children naturally produce more oil in their tears and have a higher tear volume, making contact lenses more comfortable to wear and reducing the risk of DES symptoms.

Some research suggests that children with ocular allergies can actually benefit from wearing contact lenses, as the lens creates a barrier between the eye’s surface and airborne allergens.

However, children with seasonal allergies who regularly take antihistamines may be prone to DES due to the anticholinergic effects of the medicine that inhibit lacrimal gland functioning and reduce the child’s tear volume.

If children experience mild discomfort with daytime lens wear, they may find relief using lubricating eye drops.

Ortho-K Lenses

Ortho-k lenses (also called ‘orthokeratology’), are rigid gas-permeable contact lenses that are worn overnight during sleep. These lenses gently and safely change the shape of the cornea, so children don’t need to wear glasses or contacts during the day. They are removed in the morning and leave the child with crisp and clear vision.

Ortho-k is a fine choice for children who can’t wear daytime lenses due to allergies, DES, or other eye irritations. They are also great for children and teens who participate in sports and other physical activities since no daytime eyewear is required.

Atropine Eye Drops

These medicated eye drops are placed into the eyes once per day and have been shown to effectively slow childhood myopia progression.

Atropine eye drops usually contain preservatives that can cause eye irritation and dryness. However, the low-dose atropine drops prescribed to children have no clinically significant effect on the eyes with regards to DES.

If Your Child Has Myopia, We Can Help!

The bottom line is that even a child with sensitive eyes or DES can still benefit from myopia management treatments. Your optometrist will guide you on what options are the safest, most comfortable and convenient for you and your child.

If your child has myopia or is at risk of developing it, don’t wait until it’s too late. Halt their myopia now, and they’ll thank you later.

To schedule your child’s myopia consultation, call Giddens Optometry today!

Our practice serves patients from Georgetown, Limehouse, Acton, and Halton Hills, Ontario and surrounding communities.

Why You Should Care About Myopia

Myopia is one of the most widespread vision problems in the world today, and the numbers are growing. Particularly troubling is that it is being diagnosed earlier in school children and rising in severity.

If you have a young child, we recommend regular eye exams because the condition is known to progress rapidly throughout childhood, causing significant risk to your child’s eye health in the long term.

Visit Dr. Andrea Kozma and Dr. Stephanie Britton at Giddens Optometry to learn more about myopia and myopia management.

1 in 3 Children Have Myopia

Statistics show an alarming increase in myopia (nearsightedness) among children—25% in the past 40 years alone. Today, myopia affects 40% of the population, and by the year 2050, half of the world’s population is expected to be myopic.

More than 50% of parents are unaware that myopia increases the risk of developing severe eye diseases such as glaucoma or retinal detachment later in life.

Many researchers believe that increased use of digital devices and reduced time spent outdoors are among the causes.

Myopia Increases the Risk of Severe Eye Diseases

Myopia progresses rapidly during childhood. As the level of myopia increases, so does the risk of sight-threatening retinal damage, such as glaucoma, cataract, retinal detachment and myopic macular degeneration (maculopathy). Early treatment through myopia management can slow down or even stop the progression.

The level of myopia a child has is directly correlated to their risk of eye disease — the higher the myopia, the greater the risk.

Higher Risks With High Myopia

Glaucoma. Research shows that people with moderate or high myopia have a 50% higher risk of developing glaucoma.

Cataract. The rate of cataract surgery in people with high myopia is 17% higher than in patients with moderate myopia.

Retinal Detachment. A child between -0.75D and -3.00 is more than 3 times more likely to develop retinal detachment in the future. That number triples for individuals with high myopia (-5.00 and above).

The risk of myopic macula disease is also influenced by the level of a child’s nearsightedness. Children under -5.00 have just a 0.42% of developing this serious eye condition, but anything above -5.00 the risk level leaps to 25.3%.

Is Your Child at Risk?

Fill out our Myopia Assessment Quiz to find out.

What Is Myopia?

Myopia, also known as nearsightedness or shortsightedness, causes blurry distance vision, while near vision remains clear. This refractive error is often hereditary and develops in early childhood. If left untreated, it progresses rapidly until early adulthood. High levels of myopia can lead to serious vision impairment. It is the most common vision problem in the world today.

What Does a Myopic Eye Look Like?

In a healthy eye, light passes through the eye lens and comes into focus directly on the retina, located at the back of the eye. In a myopic eye, the eyeball is too long, and therefore the image comes into focus in front of the retina.

Should Your Child Wear Prescription Glasses?

Glasses enable your child to see clearly. However, they do not reduce peripheral hyperopia, which is considered to be the main reason why the eyeball grows longer and myopia progresses.

By the time your child reaches adulthood, he or she may be at risk of severe eye disease due to the high level of myopia. Myopia management, on the other hand, slows down or even stops the progression. The prescription is kept low, and so is the risk.

Facts About Myopia Management

There is published evidence that

• Low-dose atropine has been effective in reducing the progression of myopia.
• Special contact lenses that reduce peripheral hyperopia can slow the progression of myopia.
• Orthokeratology treatment can decelerate myopia progression.

Myopia Management in Ontario for Your Child

Contact Giddens Optometry if the assessment above has shown that your child is at risk of developing myopia, or you feel the need for reassurance regarding your child’s vision. We will conduct an eye exam and offer methods of myopia management, proven to slow down myopia progression effectively.

Our practice serves patients from Georgetown, Limehouse, Acton, and Halton Hills, Ontario and surrounding communities.

Resources:

• Optometrists Network: Myopia Management for Children
• https://www.aoa.org/newsroom/myopia-rates-on-the-rise-syvm
• https://www.healio.com/…/increase-in-myopia-will-lead-to-rise-in-retinal-conditions
• https://onlinelibrary.wiley.com/doi/abs/10.1111/opo.12455
• https://www.nature.com/news/the-myopia-boom-1.17120
• https://www.who.int/blindness/causes/MyopiaReportforWeb.pdf
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688422/?report=classic

Is Childhood Myopia (Nearsightedness) Dangerous?

Myopia (nearsightedness) progression in children is more than just a rapidly changing prescription. Medical research now indicates that myopia progression in children can actually be dangerous. As a child quickly develops and myopia rapidly progresses, the child is at risk of developing serious sight-threatening eye diseases later in life. Namely, retinal detachment, macular degeneration, glaucoma and cataracts. The faster the progression, and the younger the child, the greater the risk.

To thwart any of these sight-robbing conditions, Giddens Optometry offers evidence-based treatment to prevent the onset or reduce the progression of myopia in our pediatric patients. Our staff works closely with each family and provides personalized treatment programs based on the child’s unique needs.

What Is the Connection Between Myopia and Eye Disease?

Cataracts and Myopia

A child with medium to high myopia is 5 times more likely to develop cataracts in his or her lifetime. Cataracts occur when the lens of the eye clouds rendering it difficult or even impossible to see.

Glaucoma and Myopia

Rates of glaucoma increase dramatically in children with myopia. A child with medium to high myopia is 5 times more likely to develop glaucoma — the leading cause of blindness in the United States and Canada. This condition develops when ocular fluid build-up places pressure on the eye, causing irreversible damage to the optic nerve.

Retinal Detachment

Recent research has shown that medium-to-high myopia significantly increases the risk of developing retinal detachment. Retinal detachment is a condition where the retina detaches from the layers beneath it, causing field vision loss, light flashes, floaters and in severe cases — total loss of sight. A child with mild myopia (-4D to -7D) is 21 times more likely to develop retinal detachment, whereas a child with high myopia (-7D and higher) is 44 times more likely to develop this serious condition.

Myopic Macular Degeneration

Myopia is caused by the elongation of the eyeball. When myopia is extremely high, it can cause the retina to stretch, leading tears to form in the macula and bleeding to occur in the areas beneath the retina. This can result in irreversible vision loss and even blindness.

What To Do About Myopia Progression?

One of the best things you can do to slow your child’s myopia progression is to ensure that he or she undergo routine annual eye exams. It’s important that Dr. Andrea Kozma and Dr. Stephanie Britton monitor the rate at which the myopia is progressing. If your child’s vision is rapidly deteriorating, we can offer various myopia management measures to slow the progression and enable your child to experience a more mild form of myopia than he or she would have otherwise had without treatment.

What is Myopia Management?

Myopia management refers to different techniques to slow the progression of myopia in children and teens. These treatment options reduce the stress and fatigue which are ultimately responsible for deforming the cornea and therefore causing myopia. This, in turn, slows or even stops the development and progression of myopia. Giddens Optometry currently offers several different customized and evidence-based treatment options for effective myopia management.

What Are the Treatment Options for Myopia?

Certain treatments in the form of eye drops, contact lenses or glasses, can help slow down a child’s myopia vision deterioration.

The treatments offered at our practice include:

• Atropine eye drops
• Orthokeratology (“ortho-k”)
• Multifocal contact lenses
• Multifocal glasses

Over a period of 6-12 months, patients are carefully monitored and reviewed to assess the efficacy of the chosen treatment modality.

For more information, or to learn how to get your child started with myopia management, get in touch with Giddens Optometry, and our staff will be happy to answer any questions you may have.

Our practice serves patients from Georgetown, Limehouse, Acton, and Halton Hills, Ontario and surrounding communities.