Myopia

Myopic eye

Most babies are born longsighted (hyperopic). Their eyeball grows to almost adult size by the time they are around 8 or 9 years old and as this growth occurs they become less longsighted. When the eyeball has grown more than it should it causes blurry vision in the distance. This is called myopia.

Image description

In a 'typical eye' the light enters and vision focusses when it meets the retina.

In a 'myopic eye' the light enters and it is focussed before it meets the retina because the retina is further away from the front of the eye due to the eyeball being longer.

Myopia is a common, progressive condition. Glasses and contact lenses can make the vision clearer but certain lenses can have the added benefit of slowing the progression of myopia. High levels of myopia can lead to substantial vision loss and increases the risk of retinal detachment and myopic maculopathy. Even lower levels of myopia are associated with an increased prevalence of glaucoma and cataracts.¹ High myopia requires stronger, thicker prescription lenses.

Myopia is becoming more common in children and adults around the world. It’s been estimated that half the world population will be myopic by 2050.²

What causes myopia?

• Spending longer periods of time on near tasks such as using iPads or reading.
• Less time outdoors in natural light or looking at further distances.
• Myopia can be hereditary, and it’s more common when one or both parents are myopic.³

Signs to look out for include:

• headaches
• tired eyes
• squinting
• distance vision becoming blurry or
• your child might be struggling at school

Sometimes there aren’t any obvious symptoms, so regular eye tests, especially for children, are important to detect changes in the eye and vision.

When should a child have their first eye test?

Speaking with Kylie Sprumont, an experienced optometrist in myopia treatment at Health Partners Optical, “If a child appears to be squinting, moving closer to objects to see more clearly, is getting headaches, seeming to have trouble with their coordination or complaining of blurred vision they should have an eye test”, says Kylie.

“If the child has a family history of myopia they should start having their eye tests at least a couple of years before the parents or family member started needing glasses. Even if a child has no family history of vision problems and do not seem to have any trouble with their vision, just before starting school is a good time to have their first eye test”.

How can myopia progress?

Myopia can progress in a number of different ways. For some the changes are very slight, others more pronounced over a shorter period of time. Key reasons for progression include:

• delay in diagnosing and treating young children
• children not having regular eye checks
• wearing glasses or contact lenses that do not slow the progression of myopia such as single vision lenses
• spending less than 90 minutes outdoors per day

Options to manage myopia

There are ways to slow the progression of myopia, and to manage the condition into adulthood. Treatment options are discussed with patients on a case by case basis. Consider:

• Spending more time outdoors. Spending 90 minutes or more outdoors can reduce the risk of developing myopia⁴.
• Taking regular breaks from near vision activity such as reading and screen time. After spending 20 minutes on a screen, spend 20 seconds looking at an object 20 feet away (this is called the 20-20-20 rule).
• Regular eye tests to understand what is happening with the eyes.

“Thanks to years of research it is now possible to slow the progression of myopia though lifestyle changes, special myopia control spectacle lenses or contact lenses and therapeutic management with eye drops”, Kylie explains.

Myopia Treatment and Monitoring

At Health Partners Optical, our optometrists are experienced and trained in the treatment and management of myopia. They will talk you through management options available and tailor treatment strategies to ensure the best approach is undertaken for each individual.

1. Eye Exam – undergoing regular eye tests is the first step to detect or confirm changes in your current prescription.
2. Corneal Topography Scan – A Topographer is a computer assisted diagnostic scanning device that creates a three-dimensional map of the surface curvature of the cornea. Topography takes measurements to benchmark and show whether the treatment selected is working. This mapping will also will assist in deciding if you are a suitable candidate for the Ortho-K treatment. This equipment is centrally located at our Adelaide Pirie Street store, so all referral appointments for topography scans will take place here.
3. Axial length measurements – to monitor the progression of the myopia by measuring the length of the eyeball. This is a non-invasive measurement that can also be done at the Adelaide Pirie Street store.
4. Discuss the options – treatment plans are tailored based on the desired outcome, patient need and budget. Our experienced optometrists will explore the most suitable intervention and treatment options available for your individual circumstance and make an appropriate recommendation.

Corneal Topography Machine

Treatment options include:

1. Ortho-K or overnight contact lenses

• Orthokeratology contacts (also known as ‘Ortho-K’ or ‘dream contacts’) are worn overnight, and have shown to slow down progressive myopia by gently correcting the shape of the eyeball while you sleep.
• Ortho-K contact lenses are custom made which is why the process to receive the lenses can take a little longer. Once the contact lenses are made our optometrists will ensure the customised fit is correct and comfortable.
• Find out more information on Ortho-K

2. Myopia Control spectacle lenses

• Special lenses with unique optic designs that help to reduce the progression.
• Progressive lenses especially designed for children who might struggle with contact lenses.

3. Myopia Control soft contact lenses

• Specially designed soft multifocal/dual focal contact lenses that are worn during the day to help reduce the progression of myopia. Available in disposable contact lens types.

4. Pharmaceutical treatment

• Once a day, low dose Atropine eye drops can be prescribed in conjunction with corrective glasses. Glare and sensitivity to sun can be side effects.

1 Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res; 2012;31(6):622-660

2 Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016 May;123(5):1036-42. doi: 10.1016/j.ophtha.2016.01.006. Epub 2016 Feb 11. PMID: 26875007.

3 Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci. 2019 Feb 28;60(3):M184-M203. doi: 10.1167/iovs.18-25977. PMID: 30817832.

4 Xiong S, Sankaridurg P, Naduvilath T, Zang J, Zou H, Zhu J, Lv M, He X, Xu X. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review. Acta Ophthalmol. 2017 Sep;95(6):551-566. doi: 10.1111/aos.13403. Epub 2017 Mar 2. PMID: 28251836; PMCID: PMC5599950.

5 Lim LT, Gong Y, Ah-Kee EY, Xiao G, Zhang X. Impact of parental history of myopia on the development of myopia in mainland China school-aged children. Opthalmology and Eye Disease. 2014; 6:31-5 NOTE: from Child Myopia brochure p3