Why is it important to manage myopia progression in children?

Myopia, also known as short sightedness or near sightedness, is an increasingly common condition that affects children’s sight. There can be many causes of myopia, such as family history or genetics, spending too much time focusing on close objects as a child, not spending enough time outdoors, etc.

Myopia can progress rapidly in children if it is not managed well, and every 1 diopter increase in myopia increases risk of myopic maculopathy by 67% – there is no “safe” level of myopia. As seen in the table below, myopia increases the risks of eye diseases such as cataracts, glaucoma, retinal detachment, and myopic maculopathy.

Some other risk factors (non-exhaustive) include diabetes, high blood pressure, family history of eye disease, or taking prescription medications which may affect the eyes.

Do take comprehensive eye exams to check your child’s eyes or your and detect eye diseases such as cataracts and glaucoma. You should also maintain healthy habits such as relaxing your eyes and eating healthy to get sufficient vitamins for your eyes and body.

What are some ways to slow down myopia progression?

EyedropsEyeglassesContact Lenses
What is it and how can it manage myopia progression?Atropine eyedrops, with differing doses available depending on the child’s needsIt slows down the progression of myopia in about 50% to 60% of children for low-dose atropine 0.01%, and 20% to 30% of children may require higher dose atropine (0.125% / 1%).Bifocal lenses: top half corrects for long distance and the bottom half corrects for reading vision, research has shown that it can slow down myopia progression  Myopia control lenses of differing designs: special lenses designed to help control myopia progression more effectively than the typical bifocal and progressive designsHard contact lenses, also known as Orthokeratology or OrthoK lenses which are worn to sleep; it flattens the central area of the cornea to restore clear vision and the mid-peripheral area is steepened to control myopia progression
Soft contact lenses: multifocal lenses can help slow down myopia progression. These lenses are clinically effective for myopia progression control.
AdvantagesThese eye drops can help to complement the eyeglasses that your child uses.Eyeglasses are usually more cost-effective than contact lenses. No infection risks involved as kids are not required to touch their eyes or put lenses into their eyes.Hard contact lenses: no need to wear anything during the day to see well, parents are able to supervise closelySoft contact lenses: lowest infection risk for daily disposables, minimal lifestyle limitations such as need for sufficient sleep
LimitationsChildren on 1% atropine eye drop treatment often require photochromatic or sunglasses with UV filters, and a progressive or reading additions in their glasses. Other possible side effects are often mild and temporary e.g. glare, dry eyes, eye allergy. Eyeglasses may be inconvenient when leading an active lifestyle, or some kids may find eyeglasses uncomfortableBifocal lenses: obvious line in the middleMyopia control lenses: pricier than normal single vision or bifocal lensesHard contact lenses: need to have sufficient amount of sleep every night, need to ensure hygieneSoft contact lenses: daily disposables may cost more

References:

  1. https://www.snec.com.sg/patient-care/specialties-and-services/clinics-centres/myopia-centre/Patient-Care
  2. https://pubmed.ncbi.nlm.nih.gov/24435660/
  3. https://www.singhealth.com.sg/news/patient-care/childhood-myopia-use-of-atropine-eye-drops