Pediatric Myopia Management

Understanding Progressive Myopia and Treatment Options for Parents:

Is your child’s glasses prescription getting stronger each year? Your child may be experiencing progressive myopia!

Myopia, also known as nearsightedness, is a common vision condition, in which you can see objects near to you clearly, but objects farther away are blurry.  Myopia is corrected with glasses or contact lenses. Myopia may develop gradually or rapidly, often worsening during childhood and adolescence. It tends to run in families.

Myopia is more common and increasing in prevalence more quickly than ever before. Extrapolating current trends, over half of the world’s population will be myopic by 2050, and one-tenth will have high myopia.1 Myopia progression, and particularly high myopia, is associated with the development of sight-threatening conditions including an increased risk of cataracts, retinal detachment and myopic macular degeneration.2

Risk Factors for Myopia:

Genetics: The genetic contribution to myopia is well-established. When both parents are myopic, a child has a significantly higher risk of myopia.

Lack of Outdoor Activity: Outdoor activity has been shown in multiple studies to slow down the progression of myopia.3

Increased Near Work:  Near work activities such as reading, studying (doing homework, writing), computer use/playing video games are associated with increasing myopia.4

 

Treatment Options:

Environmental  Increase time spent outdoors and decrease near work activities!

Pharmaceutical  The only drug proven to treat myopic progression is atropine. Low dose atropine has been well-studied in multiple randomized clinical trials. I am currently one of the principal investigators in the Phase 3 FDA trial for approval in the US. Side effects are rare and include pupil dilation, photophobia, and blurred near vision.5

Optical  A special contact lens has now been FDA approved for slowing the progression of myopia. The lens is called the MiSight lens. It is a single use, disposable, soft contact lens that is discarded at the end of each day. The safety and effectiveness of MiSight was studied in a three-year randomized, controlled clinical trial.6

Stopping the progression of myopia can save vision! Intervening can prevent future complications in your child’s eyes. Ask me about Myopia Management and schedule an appointment for an evaluation!

Monica Bratton, M.D. – Ophthalmologist 

Dr. Bratton is a pediatric eye surgeon who specializes in pediatric ophthalmology and both pediatric and adult strabismus. She provides vision care and eye specialist services for children with complex eye problems as well as adults with eye misalignment. She is a fellow with the American Academy of Ophthalmology, a member of the American Academy of Pediatric Ophthalmology and Strabismus, and is a member of the Association for Research in Vision and Ophthalmology. Dr. Bratton provides services in the Kennestone, Acworth,  and Towne Lake (Woodstock) locations. Read more about Dr. Bratton here.

 

 

References:

  1. Fricke TR, Jong M, Naidoo KS, Sankaridurg P, Naduvilath TJ, Ho SM, Wong TY, Resnikoff S. Global prevalence of visual impairment associated with myopic macular degeneration and temporal trends from 2000 through 2050: systematic review, meta-analysis and modelling. Br J Ophthalmol. 2018 Jul;102(7):855-862.
  2. Wong TY, Ferreira A, Hughes R, Carter G, Mitchell P. Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review. Am J Ophthalmol. 2014 Jan;157(1):9-25.e12.
  3. Wu et al.: Myopia prevention and outdoor light intensity in a school-based cluster randomized trial (Ophthalmology. 2018;125:1239-1250).
  4. Huang H-M, Chang DS-T, Wu P-C (2015) The Association between Near Work Activities and Myopia in Children—A Systematic Review and Meta-Analysis. PLoS ONE 10(10).
  5. Yam JC, Li FF, Zhang X, Tang SM, Yip BHK, Kam KW, Ko ST, Young AL, Tham CC, Chen LJ, Pang CP. Two-Year Clinical Trial of the Low-Concentration Atropine for Myopia Progression (LAMP) Study: Phase 2 Report. Ophthalmology. 2020 Jul;127(7):910-919.
  6. Chamberlain P, et al. A 3-year randomized clinical trial of MiSight® lenses for myopia control. Optom Vis Sci. 2019; 96(8):556-67

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