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Posted on 08-31-2015
Last month we discussed myopia in children and the potential for serious damage to vision. This month we’ll discuss Ortho-K, which has been shown to significantly slow or even completely arrest the progression of the disease.
Remember, in myopia, the eye physically grows longer and stresses the retina. There is no cure, no medical technology that can “un-grow” it. Treatment can save the eyes from associated glaucoma, cataracts and retinal detachment. Eyeglasses and standard contact lenses are not treatment; they only compensate by correcting vision.
Myopia will commonly increase 3/4 of a diopter or more per year. Serious pathologies can begin to set in even before the myopia is considered pathological, at 6 diopters of correction.
Proper treatment, though, will actually slow and often completely arrest the abnormal growing. This is what prevents future pathologies. The eye will likely never get to the stage of pathology with proper treatment.
There are three types of non-surgical treatment that have been shown to significantly reduce or even halt myopia progression:
Atropine eyedrops are FDA approved, but not for myopia, so their use would be off-label.
A child using atropine drops would have to wear sunglasses outdoors and reading glasses for near work. We often use highly diluted atropine to minimize side effects while still gaining significant myopia control.
If for some reason the other methods aren’t suitable, Atropine is a viable option for controlling myopia.
Bi- or Monofocal contact lenses slow myopic progression in addition to correcting vision. They can be used by children as well as adults and are designed to be worn daily, like any other contact lens. Like regular contacts, they would have to be cleaned or replaced daily, but again, these can do a good job of protecting your child’s eyes.
Ortho-K (seen in the image below) gently reshapes the cornea to correct vision in such a way as to reduce and often stop the progression of myopia. Lenses are worn only at night, while sleeping, and provide clear vision all the next day.
Dr. Jackman recommends Ortho-K as the preferred treatment for most children. Since 2002, she has fitted many patients with success, including children in her own family. For Ortho-K wearers, these lenses not only save eyesight but improve quality of life immensely.
Especially for children, who are too young for Lasik, Ortho-K is an ideal solution. Application and hygiene can be monitored by parents, who don’t have to worry about lost contacts or scratches from flying dirt in the playground. Children can enjoy the best of childhood free of glasses or contacts during the day.
Additionally, for young athletes, Ortho-K can make a tremendous difference. For instance, often swimmers will wear their contacts in the pool, even though it’s dangerous due to the risk of bacteria and other pathogens contaminating the lens as it is worn on the eye. Ortho-K can significantly reduce this danger, while also eliminating risks associated with impaired vision should the contact lens(es) fall out during sports activity.
The biggest risk, like that with any contact lens, is infection, which has been extremely rare. The vast majority of cases occurred a decade ago in Asia, from using tap water.
And, if desired, Ortho-K can be stopped at any time with no harm or permanent changes to the eye.
As we said earlier, it’s important to take your child for their first eye exam at the age of six months. Even if there are no apparent problems, we want to catch any eye disorders early.
Myopia is commonly noticed in school-age children. The earlier it begins or the faster it progresses, the more likelihood for later pathologies. And, the later you start treatment, the more difficult and expensive it will be. Conversely, the sooner it is recognized, the simpler the treatment and better the outcome.
If myopia is present and your provider only offers to correct vision with glasses or contacts, find one who’s familiar with myopia treatments.
And, get your kids outdoors. Early and often. If they’re glued to a screen most of the day, they’re setting themselves up for increasing myopia. They need to be outside daily, getting light exposure and using their eyes for distance viewing.
We don't know yet whether outdoor light slows the progression of existing myopia, but studies show that outdoor light is critical to preventing the onset of myopia in children.
Whatever you do, don’t tell them to stop reading. As we said last month in Part 1, that theory of myopia has been debunked.
You can protect your child from potentially sight-threatening complications of myopia and other eye disease by beginning their eye exams in infancy and maintaining regular checkups.
In the meantime, educate yourself as much as you can, especially if both parents are myopic, one parent is highly myopic or the child already has myopia.
There is an excellent, non-profit site with information about the above treatments and more. Myopia Prevention and Control covers what we’ve discussed in much greater detail - in plain English for the layperson - as well as providing links to scientific papers.
For testimonials and FAQs you can go to Ortho-K Doctors. An excellent article in Nature magazine will tell you all about the severity of the myopia problem in Asia. And, if you have 33 seconds, don't miss this video below of a young lady who, after five years of increasing prescriptions, says having Ortho-K "was like living in a new world."
That’s it. Call or visit Jackman Optometry, 714-543-2022, to make an appointment or get more information on the various treatments for myopia control. We look forward to helping you protect your child’s vision for years to come!
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