Myopia is a progressive condition but progression can be controlled if detected early enough. A cure has not been discovered but there are several ways to improve your vision if you have this eye condition. And the good news is research shows that there are ways to manage the onset and progression of myopia. Clinical trials involving children with myopia show it is feasible to diminish the progression for a better visual outcome.
Ways to correct your vision if you are short-sighted include:
- Wearing glasses – The most common treatment for myopia is corrective eyewear. While glasses correct vision and relieve symptoms when worn, they do not cure your myopia. Depending on the amount of myopia, you may only need to wear glasses for certain activities, like watching a movie or driving a car but if you are very short-sighted, you may need to wear them all the time. Generally, a single-vision lens is prescribed to provide clear vision at all distances but people aged over 40, or children and adults whose myopia is due to the stress of near-vision work, may need a bifocal or progressive addition lens. These multifocal lenses provide different powers or strengths throughout the lens to allow for clear vision in the distance and up close.
- Contact lenses are worn directly on the eye. You can wear soft contact lenses which are like glasses and correct vision and relieve symptoms while worn. For some individuals, contact lenses offer clearer vision and a wider field of view than eyeglasses.
Ways to slow the progression of myopia in children (otherwise known as ‘myopia control’):
- Some soft daily disposable contact lenses are designed to slow the progression of myopia in children. The single-use, disposable contact lenses correct the vision and may slow myopia progression in children. There are several of these soft myopia-control contact lenses available in the Australian market. It is best to speak to your optometrist to see which brand best fits and suits your child.
- Ortho-keratology contact lenses (known as ‘Ortho-K’) are only worn in bed at night while sleeping. In this nonsurgical procedure, you wear specially designed rigid ‘hard’ contact lenses to gradually reshape the curvature of your cornea, the window of the eye. The lenses place pressure on the cornea to flatten it which changes how light entering the eye is focused. You wear the contact lenses for limited periods, such as overnight, then remove them. People with mild myopia may be able to temporarily obtain clear vision for most of their daily activities. Research shows that starting ortho-k for children at a young age halves the risk of rapid progression in those whose myopia is progressing fast. This study found that the ideal age is six to less-than-nine years for children to start wearing overnight ortho-k contact lenses to control myopia. It further showed that older children, including adolescents, can also benefit from ortho-k significantly reducing myopia progression, if they showed rapid progression before treatment. There is now growing evidence of the effectiveness of ortho-k for myopia control in children. Not all optometrists prescribe ortho-k lenses but if your optometrist does not, they can refer you to one who does.
- Atropine eye-drops – Low concentration Atropine eye drops have been shown to slow progression of myopia in children and their use is gaining popularity. There are different formulations and many trials are ongoing. This may be a good myopia-control option for those children who cannot wear contact lenses. However there are pros and cons with using Atropine. It is important to speak with your optometrist.
- Having laser surgery – a laser beam is used to change the shape of your cornea. Laser procedures such as LASIK (laser in situ keratomileusis) or PRK (photorefractive keratectomy) are possible treatment options for myopia in adults. The beam reshapes the cornea by removing a small amount of eye tissue. In PRK, a thin layer of tissue is removed from the surface of the cornea in order to change its shape and refocus light entering the eye. LASIK removes tissue from the inner layers of the cornea. These techniques are performed by an eye surgeon (ophthalmologist).
- Other refractive surgery procedures. People who are highly short-sighted or whose corneas are too thin for laser procedures may be able to have myopia surgically corrected. A doctor may be able to implant small lenses with the desired optical correction in their eyes. The implant can be placed just in front of the natural lens (phakic intraocular lens implant), or can replace the natural lens (clear lens extraction with intraocular lens implantation). These techniques are performed by an eye surgeon (ophthalmologist).
The key message is we don’t have to sit back and watch our children’s vision get worse every year as there are things we can do about it. Optometrists can see signs of children who are heading towards becoming myopic even before they are myopic and alert parents to interventions including increased outdoor time. Changes are often quite subtle in myopia early on and parents don’t readily pick up if a child has reduced vision, so children should have eye examinations with an optometrist when pre-schoolers, before starting school, in middle school, before starting high school and more regularly if symptoms appear.
Atropine eye-drops are gaining popularity as a treatment to slow myopia progression.
