Nearsightedness – Myopia
Frequently Asked Questions
What is nearsightedness/ myopia?
Nearsightedness is when vision is blurry in the distance and usually clear up close. Fortunately, glasses and contacts can provide the proper power to allow someone to again see clearly in the distance.
Who is at risk to develop it?
Myopia equally affects both males and females. The risk of developing myopia increases if one or both parents are myopic. However, more and more children are developing myopia even without a family history of the condition. We are also seeing the condition develop sooner in life for many children. The younger the child is when first showing signs of myopia, the worse their myopia will likely become. The higher the myopia, the greater the risk for developing other eye conditions such as early onset cataracts, glaucoma, retinal detachments and myopic maculopathy.
What causes myopia?
While the cause of myopia is still somewhat unknown, the leading theory deals with how light focuses on the back of the eye. In myopic eyes, light entering straight into the eyes becomes focused in front of the eye while light entering to the sides gets focused behind the retina. This disparity may be the driving force to cause the eyeball to elongate. If the eye continues to elongate, the myopia continues to increase. Multiple treatment options using this theory have successfully shown to slow down and even halt in the progression of myopia.
How to prevent myopia?
Yearly eye exams are crucial in preventing the development of myopia. The sooner it is found, the easier it is to manage. While an increase in screen time (such as phones, tablets and computers) and near work is often thought to be causing the condition, studies have shown other factors to be involved. In fact, research has shown that children who play outside are less likely to develop myopia. However, once a child starts to develop myopia, playtime outdoors is not enough to prevent the progression. Fortunately, we have more methods to help slow the progression and help manage the disease.
Myopia Management Options
There are several great options to slow or halt myopia progression!
- Orthokeratology: Also known as Ortho-k for short, is the use of a specially designed hard contact lens that reshapes the front of the eye to provide clear vision. These lenses are put in at bedtime, slept with overnight similar to a retainer, and then removed in the morning and cleaned for the next use. Ortho-k lenses must be custom fitted and evaluated in office, which is not covered by vision insurance, as they are an off-label preventative treatment. Learn more >
- Atropine: Atropine is an ophthalmic medication that is typically used to dilate the pupil. Recent studies have shown that a very low dose (0.01% to 0.05%) of this dilating drop used nightly can reduce myopia progression with few side effects, including but rarely, light sensitivity and blurry vision at near. While the exact mechanism is not fully understood, it is thought that this low-dose of atropine prevents myopia progression by binding to certain growth receptors in the eyes and blocking stimulation that causes progression. Low-dose atropine is currently being used off-label and is not covered by insurance. The medication must be purchased from a compounding pharmacy.
One study compared the effectiveness of ortho-k against low-dose atropine in reducing childhood myopia progression. This study concluded that these two myopia progression treatments produced roughly the same results. Children who received one of these treatments had roughly half of the progression that would be expected over two years in an untreated patient.
Additionally there are soft contact lens options for those that would prefer to wear contacts during the day.
- Mi-Sight Contact Lenses: Mi-Sight is the first FDA approved soft daily contact lens to help manage the progression of myopia. These lenses are to be worn for at least 10 hours a day and your child will put in a fresh daily lens every morning.
- Multifocal Soft Contact Lenses: There are other brands of multifocal soft contacts that have been shown in studies to delay myopia progression but unlike Mi-Sight, these lenses have not gone through rigorous FDA approval for this therapy specifically. These options may be discussed by your child’s doctor if Mi-Sight lenses do not fit properly during the fitting stage.