Myopia Control

Myopia is also known as short-sightedness. Near objects are clear but objects viewed in the distance are blurry. This is usually because the eye has grown too long to focus correctly. Myopia is increasing worldwide at a rate which can’t be explained by genetics alone. In 2010 28% of the global population was myopic. By 2050 this is predicted to be 50%.

Why does Myopia Matter?

For most short-sighted people the main problem is inconvenience. Being dependent on spectacles or contact lenses can limit activities and be frustrating. However, highly myopic eyes are at a greater risk of developing some serious eye conditions. A person who has a myopic prescription of -6.00 has a 16x risk of developing retinal detachment and a 40x risk of getting myopic maculopathy. If the myopia is in the region of -3.25 the risk drops to 10x in each case. If we can stop myopia developing beyond -1.25 those risks drop to just 2x in each case.

You are more likely to develop short-sightedness if your parents are short-sighted. If one parent is short-sighted their child is 3x more likely to become myopic. If both parents are myopic then their child is 7x more likely to also be short-sighted.

The younger the child is when they are first found to be short-sighted, the higher the myopia is likely to be come.

The link below helps understand how myopia generally progresses.

Myopia Prevention

Research has shown that more time spent outdoors as a child helps prevent myopia. The exact reasons why this is the case are not yet fully understood and much work continues in this area to property understand the protective mechanisms outside life provides, whether it be sunlight, UV exposure, vitamin D levels or more limited exposure to screen technology. It doesn’t matter if the time outdoors is spent sitting around or playing sports, it’s just that time outside seems to be a positive in slowing myopic change.
Time spent outdoors cannot however reverse myopia once it has developed.

Myopia Control

There is currently no cure for short-sightedness. Laser surgery in adulthood doesn’t change the length of the eye, just the front surface curvature, so doesn’t change the risk of conditions associated with myopia. Various methods of complex spectacle correction such as bifocals or multifocal lenses have been shown to slow myopic progression rates to some degree but contact lenses are most likely to provide the best slowing of myopic eye elongation. Under correction of myopia has been shown to actually promote eye growth.

The aim of myopia control is to slow the progression of myopia as much as possible. It is highly unlikely that we can stop myopic change altogether. The response to myopia control treatments varies significantly between individuals but we hope to try and reduce myopic change by around 50% . So, if a child is predicted to be say -6.00 by adult hood our hope would be to stop this becoming more than about -3.00. There are, however, no guarantees that this can be achieved.

Research into myopia has shown that the light going to the periphery of the retina is responsible for eye growth or the lack of it. As normal contact lenses don’t change the way the light hits the peripheral retina these aren’t effective at controlling the growth of length of the eye. Specialised myopia control contact lenses, whether they be daily disposable soft contact lenses or Orthokeratology overnight rigid gas permeable lenses, are designed to blur the light hitting the peripheral retina.

At Specs of Kensington we offer 2 types of lenses for myopia control:

Orthokeratology (Ortho-k or Overnight Vision Correction) for Myopia Control.

Extensive research worldwide has shown orthokeratology has one of the greatest effect on the slowing of myopia progression. It is thought that the effect on myopia control may be greatest with orthokeratology because the reshaping of the front of the eye is combined with the refocusing of the light that reaches the peripheral retina. The effect is not guaranteed, as results vary for individual children, but it has never been shown to make children more short-sighted.

Ortho-K lenses are rigid gas permeable contact lenses, made of very high oxygen permeable materials of a type which have been shown to be generally safe over many years of wear. All lens wear is done overnight so the lenses are not worn out of the house, which means less worry about lost lenses or spectacles. Also, daytime is free of specs and or contact lens wear so children can take part in all activities and sports without having to worry about their vision or lens loss.

Who Is Suitable for Ortho-K?

We use a variety of Ortho K lenses and may be able to fit people with up to the following degrees of short-sightedness and astigmatism:

  • A spherical spectacle prescription of up to -8.00 D
  • Astigmatism of up to -2.50D

Orthokeratology lenses are worn overnight to gently reshape the front of the eye so that the lenses can be removed in the morning and give crisp, natural vision all day.

Ortho-K at Specs of Kensington

As well as being experts in all types of contact lens fitting, our Optometrists have attended extensive training programmes in Ortho-k fitting. We will be pleased to advise on suitability and our Ortho-K fitting programmes include the necessary ongoing professional care.

MiSight Daily Disposable soft contact lenses.

MiSight lenses are a newer approach to myopia control. First developed in 2009 and launched in Hong Kong, early results were promising and now longitudinal studies are showing good results. (Myopia in Eastern populations is at higher levels than in the West – 47% in 2010 – projected to rise to 65% by 2050).

After 3 years children wearing MiSight lenses had 59% less myopia on average than the control group and 52% less growth in the axial length of the eye.

Our goal to try and achieve the best results, is to treat early. Myopia at any level, once established, will not reduce. Once the eye has grown, it cannot ‘ungrow’.

Contact Lens wear in general.

You should be aware that anyone who wears contact lenses, of any type, is at a slightly greater risk of eye infection. Nevertheless, the advantages of contact lens use, irrespective of any myopia control considerations, has been shown to be significant for young people in terms of self-image and convenience, for instance when playing sport. Modern contact lens materials and modalities of wear have significantly reduced the complication rates and risks of lens wear.

Ortho-K Versus MiSight

Ortho-K

Pros

Longer establish proof of efficacy

Freedom from contact lens wear in the day

Appropriate with low levels of astigmatism

Cons

Time to gain lens tolerance

Overnight wear may raise the risk of eye infection compared to daily wear.

MiSight

Pros

Easy adaptation

Cons

Peripheral vision ghosting

Not suitable for those with significant astigmatism

Myopia Control
Our Patient Charter

References:

  1. Chamberlain P, at al. Clinical evaluation of a dual focus myopia control 1 day soft Contact lens. 3 years results. BCLA meeting June 2017.
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