Orthokeratology (Orthok) / Atropine / Myopia Control
What is Myopia?
Myopia is a condition when your eyes do not focus light correctly so that distant objects are blurry while close objects appear clear. It is a problem of the eyeball growing too quickly and too long for its optical power. It is also referred to as “near-sighted” or “short-sighted”. Research has helped us to better understand the factors that cause eye elongation in children—and new clinical technologies allow us to harness these insights to slow myopia progression in developing eyes. Comparing the myopia results of the 1971-1972 National Health and Nutrition Examination Survey to the same study three decades later (1999-2004), findings indicate that the prevalence of myopia in Americans between 12 and 54 years of age increased from 25.0% to 41.6% (P < 0.001). This growth of myopia in the US is just part of a worldwide trend toward increasing myopia prevalence.
Why is myopia control important?
First, there are enormous social and personal costs to myopia. In addition, myopia, especially high myopia, is associated with increased risk of retinal detachments, myopic degeneration, glaucoma, and other serious morbidities. Around the world, the incidence of myopia is increasing. In addition, the average age for developing myopia is also decreasing.
What causes myopia?
Once thought of as solely a product of genes, it is now clear that environmental factors and the individual’s behavior also contribute to myopia progression. Activities such as reading, computer, and phone use have been associated with the development of myopia.
Studies suggest that myopic progression is typically faster in children due to their faster rate of eye growth. This often leads to higher levels of myopia resulting in the need for stronger glasses and more long-term eye health problems. There also seems to be a correlation between Asian ancestry and faster progression and higher levels of myopia. Anyone with myopic parents will also have a higher risk for developing myopia. Research suggest that mid-peripheral retinal defocus may be one stimulus that triggers myopia progression.
If your child already wears glasses, you can do something to slow down or stop their vision from worsening.
Why should I choose Alta Eye Care?
Both Dr. Chen and Dr. Lee are board certified M.D.'s, each with more than a decade of experience in this area. Our myopia control program not only offers the latest in myopia control therapy, but with the use of our specialty equipment and technology, we can precisely measure your child's eye axial length and corneal curvature before treatment, and track changes thereafter. These results are used to determine an optimum management strategy, which may include prescribing medication eyedrops or the fitting of specialty contact lenses and glasses shown in recent research to be effective in controlling myopia progression.
Can You Really Slow or Stop Myopia (Nearsightedness)?
Yes! Most people can slow down or sometimes even stop their eyes from becoming more myopic (nearsighted or shortsighted). While there is no cure, you can most likely improve how your eyes are changing. The key is to catch the development of myopia as early as possible. In order to do this, your child needs an eye exam every year starting at age five.
What can I do right now?
Spend more time outdoors. We don't know why exactly - it may be the sun or brighter light levels, it may be focusing on distant objects or some other factor. The fact we have for now is that outdoor time helps more than a little. Children should strive to be outdoors at least two hours a day. Children who were outdoors at least this long did not progress as quickly. Participation in sports or other strenuous activities is not necessarily protective since indoor sports such as basketball do not give the same protection. Decreasing screen time and avoiding eye strain are also important.
Currently, the most effective way to slow down or stop the progression of myopia is with either Ortho-k or Atropine.
If you are interested in doing more and want a consultation for myopia control for your child, please call and schedule an appointment to see if and how myopia control may benefit your child. The goal is to start treatment as early as possible, since we still do not have any treatment available to reverse myopia.
What is Orthokeratology (Ortho-k)?
Ortho-k is a hard lens that is worn during sleep at night. The hard lens act as a mold to reshape the cornea so that you can see clearly during the daytime without having to wear glasses or contact lenses. Ortho-k can be worn in both children and adults. It is a great option for myopic kids to slow-down or stop their myopic progression. In adults, who want a more active lifestyle, Ortho-k is an excellent alternative to glasses, soft contact lenses, LASIK or other refractive surgeries.
Is Ortho-k safe?
Ortho-k has been around since the 1960s. Over the years, the design and material of the lenses used have continued to evolve and improve. Currently, research show that ortho-k is a safe treatment option for correcting vision and myopia control. As with any contact lens wear, there is a small risk of eye infection. This can be reduced by properly cleaning and wearing the lenses as instructed.
Atropine eyedrops
The concentration of Atropine eyedrops used for myopia control can vary from 0.01% to 1%. Most studies show a dose dependent effect on myopia control. While the stronger concentration seems to be more effective in slowing down the progression of myopia, it can also cause more side effects. Lower concentrations of Atropine in the range of 0.01%-0.05% have been shown to have minimal effects on the pupil and vision. However, every child is different. Our goal is to find and use the lowest concentration of Atropine that will slow down their eye growth.
Side effects can include increased light sensitivity, enlarged pupils, and difficulty reading. In children who experience these side effects, glasses that turn color when outdoor, as well as, wearing progressive lens glasses can help.
Which is best Ortho-k or Atropine?
Dr. Lee and Dr. Chen will be able to offer the best guide as to which myopia control option is best for your child. This will depend on a number of factors, including level of myopia, age, level of maturity, eyeball axial length and corneal shape. In some children, Ortho-k may be combined with the use of Atropine. This has been shown in some studies to be even more effective.