Myopia (short-sightedness) is the inability to see things clearly unless they’re relatively close to your eyes. Myopia control strategies include a range of specific treatments that help slow the progression of myopia and ocular axial elongation, and prevent associated complications later in life.
There is global evidence that exposure to outdoor light is key to reducing the myopia epidemic. According to Optometry Australia, children need to spend at least 90 minutes per day outside to help prevent myopia from developing and progressing. Sunlight helps dopamine release, which prevents axial growth of the eyeball.
The latest research on Light Exposure and Eye Growth in Childhood performed by QUT researchers, measured children’s eye growth via wristwatch light sensors to record light exposure and found that less than an hour of bright light exposure per day appears to predispose children to faster eye growth and, hence, the risk for myopia development. On the other hand, significantly slower eye growth was seen in the children who spent, on average, 120 minutes per day exposed to bright outdoor light levels.
Orthokeratology (also known as Ortho-K) is a clinical technique of corneal reshaping using specially designed rigid contact lenses. In modern Ortho-K, lenses are usually worn only during sleep and are removed first thing in the morning. During the night the contact lenses gently reshape the front surface of the eye, correcting the refractive error and allowing clear vision through all waking hours without the need for spectacles or contact lenses.
The most commonly accepted theory on how orthokeratology decreases axial elongation relies on the peripheral defocus created on the retina by the corneal changes made by the rigid lens. Research has shown that those at greatest risk for myopia progression were those whose peripheral refraction was hyperopic, or long-sighted.
A number of studies have since suggested that treatment approaches to myopia correction should address this peripheral refraction as a means of slowing further axial elongation.
Atropine sulphate is commonly used as eye drops to dilate the pupil and temporarily stop the lens from focusing. It is also used to treat an eye condition called amblyopia (lazy eyes) as well as other eye conditions like myopia.
The exact biochemical mechanism in how atropine slows myopia progression is not yet fully understood. Atropine has an effect on various structures within the eye, including the iris and the ciliary muscles that control focusing, but current research suggests atropine also acts to thicken the choroid, the middle layers of the eye’s structure, thereby helping to resist stretching and elongation that occurs with myopic eye growth.
Despite being used for myopia management for many years, significant controversy exists in both literature and clinical optometric practice regarding the optimal concentration of atropine. The LAMP study sheds light on this mystery by investigating the efficacy of 0.05%, 0.025% and 0.01% atropine for slowing myopia progression. This literature indicates that 0.01% concentration is 90% as effective as 1% atropine, with almost none of the common side-effects.
As concentrations of Atropine less than 1% are not commercially available in Australia, and therefore need to be compounded, it is possible to tailor an appropriate dosage for each patient depending on their family history, rate of progression and age.
Soft Contact Lenses
There are increasing options of soft contact lenses becoming available that have been proven to help minimise myopia progression. Ordinary single vision soft contact lenses and spectacles do not provide these myopia control benefits, and in fact, may even accelerate myopia progression.
- CooperVision Misight 1 Day
- SEED 1dayPure EDOF
- MYLO Custom Monthly Disposable
CooperVision MiSight 1 Day
CooperVision MiSight 1 Day with ActivControl Technology is a daily disposable soft contact lens specifically developed for childhood myopia.
The MiSight 1 Day is a concentric dual-focus or ‘multifocal’ lens design, which means it has a clear distance vision zone in the centre and peripheral treatment zones. In a way, this lens mimics the effect of orthokeratology lenses in reducing peripheral retinal defocus, a phenomenon linked to eye elongation and myopia progression. The special multifocal optics of the MiSight 1 Day lens refocuses peripheral light rays to reduce the signal for eye growth.
SEED 1dayPure EDOF
Japanese contact lens manufacturer SEED partnered with the Brien Holden Vision Institute of Sydney to bring this exciting lens to the market. It relies on the same concept of reducing peripheral retinal defocus to minimise myopia progression.
The lens interestingly is supplied with boxes of 32 per month ensuring your child has 2 extra lenses per month in case of loss or damage to a lens. The lens also has three levels of depth of focus. This means we can gradually increase the power of myopia control to allow your child to adapt to the lens. This proves useful in children that have struggled with other designs of myopia control contact lenses.
MYLO Custom Monthly Disposable
MYLO lenses are individually crafted and custom-made for each patient. The lens is specifically designed for Myopia Management using the Brien Holden Vision Institute patented Extended Depth of Focus technology.
The major advantage of MYLO contact lenses is the fact they are custom-made for the individual. Most disposable contact lenses are mass-produced meaning the lenses are all the same size. This assumes that you have an average eye with an average size and curve of the cornea. However, this is not always the case for everyone.
MYLO contact lenses allow us to take highly detailed three-dimensional scans of the cornea and produce a lens that is the optimal size and curve for your child’s eye. This improves lens comfort and lens stability which in turn improves visual performance. In short, a perfect fit and a perfect vision.