Myopia Management

Myopia

Myopia1 is a long-term, progressive eye disease characterized by excess eye elongation, associated sight-threatening risks and blurry distance vision.

INCREASING GLOBAL EPIDEMIC

  • Prevalence of myopia has almost doubled over the last 20 years2

  • By the year 2050, more than 50% of the world’s population is anticipated to be myopic2

MYOPIA RISK FACTORS

The following are found to be risk factors for myopia and its progression:

  • Early age onset of myopia3

  • Refractive error4

  • Minimal time outdoors (<2 hrs/day)5

  • Significant near work or short working distance6,7

  • Myopic parents8


ASSOCIATED RISKS OF MYOPIA

Myopia is associated with a higher risk of developing:

  • Myopic macular degeneration9

  • Retinal detachment10

  • Primary open-angle glaucoma11

  • Cataracts12

  • Staphyloma13


There is no safe level of myopia because any amount of myopia elevates the risk of sight-threatening complications.14,15
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Odds Ratio of Ocular Disease as a Function of Myopia Relative to Emmetropia Chart1

OUR GOAL

With various treatment options, we can now slow myopia progression (prescription increases) and reduce associated risks instead of just correcting the visual symptoms with glasses, contact lenses or laser vision correction. By creating mid-peripheral blur with light rays that focus in front of the retina, this down-regulates peripheral blur from light rays that focus behind the retina, the signal for eyeball elongation. Several myopia management treatment options have shown reduced eyeball elongation by more than 0.3 mm (~equivalent to 0.75 D) during 2-3 years of treatment.16–19


TREATMENT OPTIONS

Early intervention is essential; best if treatment is started before 12 years of age.


Lifestyle modifications

  • Reduce near activities7

  • Increase outdoor activity time (2+ hours/day)20,21,22


Corneal Reshaping Therapy (CRT), or orthokeratology, involves gas permeable contact lenses worn overnight and specifically designed to temporarily alter the shape of the cornea, reducing the need for corrective lenses during the day. Great option for athletics and water activities. Allows parental oversight because they are used at night.
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Soft Multifocal Contact Lenses (some designs) are useful in slowing myopic progression because they create peripheral myopic defocus in the retina. Great option for athletics and young patients23.
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Atropine Eye Drop Therapy incorporates the use of low concentration eye drops that relax the ciliary muscle of the eye and cause the pupil to dilate. Limited side effects of near blur and light sensitivity24. Must be used in conjunction with glasses or contact lenses. May be combined with other myopia management treatments25. Allows complete parental control.
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Myopia Control Spectacles are a safe and easy option for various prescriptions, however, optical designs and treatment efficacy vary greatly.
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