myopia

Why is myopia a problem?

The prevalence of short-sightedness (or myopia) has rapidly increased globally in recent decades. This is a public health concern because short-sightedness, especially at high levels, has been shown to be associated with increased risk of certain vision-threatening eye diseases, such as glaucoma and retinal detachment. This is why it is so important for us to prevent myopia progression and protect your future eye health.

 

Current management options shown to slow down the progression of myopia include multifocal glasses, multifocal contact lenses, orthokeratology lenses and low dose atropine eyedrops.

Orthokeratology

  • What is it?

    Orthokeratology (often known as Ortho-K) is a non-surgical procedure which removes the need to wear glasses or contact lenses during the day. Instead, custom designed lenses are worn at night while sleeping, gently changing the shape of the front of your eye, to allow clear natural vision after the lenses are removed the following morning.

  • How does it work?

    When somebody cannot see clearly, it may be because the eye is too long (short-sightedness), too short (long-sightedness) or the surface of the eye is irregular in shape (astigmatism). This means that images cannot focus properly on the back of the eye, which is needed for clear vision. Normally this is fixed by using glasses or contact lenses, but with ortho-K lenses we refocus images by changing the shape of the front surface of the eye.

  • What are the benefits?

    Not only have studies shown that ortho-K lens wear helps to control myopia progression, but they are also a great option for anybody wanting freedom from glasses or contact lenses. For example, you may have a very active lifestyle, and/or contact lenses may cause your eyes to feel dry and uncomfortable.

  • Is it safe?

    Ortho-K lenses are safe and the procedure is completely reversible. This makes it a great option for those who may be interested in corrective laser eye surgery, but are hesitant as surgery is not reversible. A trial will also be performed, which is a great way to experience what it’s like before you decide.

Atropine

  • Atropine eyedrops have also been shown to be effective in preventing myopia progression.
  • A research trial called the ATOM study (Atropine for the Treatment of Myopia) showed that amongst 400 children aged 6-12, low-dose 0.01% atropine eyedrops halved the progression of myopia over a period of 5 years.

As the eyeball grows longer, the amount of myopia increases and distance vision worsens. Atropine slows myopia progression by slowing the growth of the eyeball. Although the exact mechanism is unknown, atropine is believed to work by blocking some receptors in the eye, which in turn inhibits one or more biochemical steps along the pathway of eyeball growth.

Atropine treatment simply involves the application of low-dose 0.01% atropine eye drops, 1 drop in each eye before sleep each night. This would be more convenient than other myopia control options like multifocal contact lenses or ortho-K lenses, which require the learning of insertion and removal, and adherence to hygiene procedures. This would be particularly beneficial for young children.

At such a low dosage, 0.01% atropine has been shown to be very well tolerated with no known serious adverse effects. Some mild documented side effects include increase in pupil size, possibly causing glare; and loss of focusing muscle ability (accommodation). However, research trial subjects reported no impact on their overall quality of life with use of the medication, with no change or loss in distance and near vision. These side effects did go away upon stopping atropine, and have been deemed clinically insignificant.

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