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Thursday, November 1, 2012

Controlling Myopia Progression

Is your child near-sighted (or myopic)?  Chances are, their prescription is only going to increase as they grow!  Myopia progression is something that I discuss with worried parents daily.  Many parents have high prescriptions themselves, and would love to save their child from the difficulties involved with highly myopic prescriptions. Unfortunately trying to prevent this from happening is a difficult battle.

On average, myopia progresses by 0.50D every single year in a growing child.  That means if your child is a -1.00D myope at age 6, they will be wearing a -6.00D by age 16!  Myopia is a condition that results from the curvature of the eye and the length of the eyeball.  Often, as we go through normal growth and puberty changes, that length can increase, inducing more myopia.  Eventually, these changes will slow down, and normally stop progressing by our 20s.  But in this critical time period, a prescription can develop that permanently changes that individual's lifestyle forever.

How do we prevent myopia progression?

That's a question scientists still don't have complete answers to.  Today's best research suggests that 3 options are giving the best results in slowing myopic progression:

Atropine:  Warning--it burns when it
is inserted into the eye!
1) Atropine 
      -this involves daily insertion of a potent dilating drop, and having to wear bifocals to read
2) Corneal Reshaping with specialty hard contact lenses
3) Soft multifocal contact lenses
      -the premise is the cause reduced near strain and peripheral blur, giving a negative feedback signal to the eye's myopia development process 

None of these options are easy.  Atropine is an eye drop that causes the pupil to dilate and the accommodative muscles in the eye to lose the ability to focus.  As a side effect, the child will need to wear bifocals in order to see to read.  They may experience headaches, and will complain of intense burning when the drop goes in.  Great for kids, right?
Corneal reshaping is performed by wearing rigid (hard) contact lenses overnight, almost like a retainer that molds the eye into a different shape.  Believe it or not, it's not as uncomfortable as it sounds.
The third option involves soft contact lenses, which is another extra addition to the child's daily routine, for cleaning and caring for these lenses.

Even with these techniques, myopia will likely still progress.  Studies have shown that the rate of progression with these options can be reduced anywhere from 30-50% however, which can make a real difference in your child's final prescription.  If you are interested in any of these options, talk to your doctor to see if your child would be a candidate!

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