Myopia Management

Myopia or nearsightedness is characterized by blurry vision when viewing in the distance. Myopia is the most common visual condition worldwide, affecting an estimated 2.6 billion people in 2020. It is the leading cause of visual impairment in children and the prevalence of myopia is projected to nearly double to 5 billion people by 2050, impacting 50% of the world’s population. High myopia levels can lead to progressive vision loss and increased risk of developing retinal diseases, glaucoma, cataracts, and myopic maculopathy among others.

Risk factors for increased progression in myopia are, young age of onset, family history of myopia in at least one parent, those of East Asian ethnicity, and the daily time spent outdoors versus indoors. The earlier a person develops myopia in their life, the more likely they are to progress to a higher level. When one parent is myopic, children are up to three times more likely to become myopic and when both parents are myopic, the child will be up to six times more likely to develop myopia. Myopia is a multi-factorial condition that is linked to both genetics and environmental conditions.

Myopia Management is the utilization of research-based methods to slow the progression of myopia or nearsightedness. The latest studies in myopia management show significant benefits to patients, slowing their myopia progression by 50% or more. The two most effective methods include Orthokeratology specialty lenses and Low-Dose Atropine eye drops.

Ortho-K lenses are FDA approved for overnight wear and removed in the daytime. The highly sophisticated system uses a reverse geometry lens design to safely and effectively temporarily reshape the corneal curvature. This allows for clear functional vision throughout the day without the need for glasses or contact lenses, while simultaneously slowing the progression of myopia. The Ortho-K lenses are to be worn every night during sleep to maintain full effect of myopia management and to provide clear vision in the day when lenses are removed. This is a great way for children who are more active, play sports and enjoy recreational activities without needing to wear glasses or contacts.

Low-Dose Atropine is a very safe and effective therapeutic eyedrop that is specially formulated in a compounding pharmacy for the use in myopia management. The low-dose atropine is available in 0.01%, 0.025%, and 0.05% concentrations and will be selected by your doctor to best meet your child’s myopia needs. The bottled eyedrop is shipped directly to your home and to be kept refrigerated. The low-dose atropine is dosed one drop in each eye every night. In the daytime, eyeglasses or contact lenses will be needed for vision correction. The effectiveness of the low-dose atropine in reducing the progression of myopia will be monitored in-office throughout the myopia management program.

The figure above demonstrates an example of a patient with near zero (-0.50D) refractive error at age six and displays how their level of myopia can be reduced with a form of myopia management (green) compared to no myopia management (red). By age 17, the patient with management would be -4.00D instead of nearly -7.00D, benefitting by 3.00D less in prescription.