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The M word.

Myopia control, myopia progression, near-sightedness

“Is it because they’re on the computer too much?” Is the number one question I hear from parents about why their child’s eyes continue to become more nearsighted. I suppose it is true, excessive near work will cause a child’s eyes to become more nearsighted, or myopic. However what I end up explaining to parents is as their child’s eyes continue to grow, their myopia will continue to progress. I find myself having to reassure parents for the rest of the exam that their days of worry that their child eyeglasses will look like “coke bottles” will come to an end sooner rather than later.

However the truth is when you look at the risk of retinal issues that come with myopia, I guess parents have a legitimate concern. Compared to eyes with no vision issues, those with 1 to 3 diopters of myopia have a 3 times higher risk of retinal detachments. Nine times higher if you have 3-5 diopers and 21 times higher if you have 5 to 7 diopters of myopia(1). Forty four times higher risk if… well I think you get it.

“What should be done about it doctor?” Well I try to look on the bright side and tell parents that their child must be a good reader since it likely was from all that reading on that ipad! After that joke fails to break the ice… I think most doctors look to update the prescription with a new pair of specs and then book that yearly eye exam on the way out. I am guilty (and still) of doing this as well. But what parents really want to know is what they can do to stop its progression. The chances of children decreasing their screen time is as likely as their parents giving up their cell phones.

So when there is a serious concern about the rate of myopic progression, what deserves a conversation are contact lenses that help slow down its progress. The traditional device used are hard contact lenses worn overnight called Ortho-keratology. This is when the parents stop me cause it’s already inconceivable to them that they would let their child wear uncomfortable contact lenses… but now you want them to be worn while they sleep?? “I will just take the prescription doctor.” However, I find myself extending the conversation to include a new contact lens that is not only more comfortable, but worn during the day. What’s better is instead of teaching a child how to care for the contact lens, all the child has to do is discard it at the end of the day. Oh.. and I forgot the most important part…. It’s a lens that’s proven to reduce the progression of myopia.

In a 3 year study done on 144 myopic children aged 8-12 years from Singapore, Canada, Portugal and England, a dual focus contact lens, called MiSight 1-day, was able to slow the progression of myopia in almost 70 percent of children verses a regular, single focus contact lens after just 12 months of wear(2). At the 3 year mark, there was a decrease in myopic progression in 60 percent of children in the study(2). This is promising news for parents. Furthermore, if parents are still worried about contact lens wear in a child, I am always quick to note that I don’t put an age limit on starting contact lens wear. I have a responsibility limit on those wanting to get into contacts. More often than not, I find the responsible child, when taught properly, tend to take better care and wear their lenses than some adults.

Children need their electronic devices whether parents like it or not. It’s becoming a large part of their academic curriculum and nightly school work. So all of us (parents, children and eye care professionals) need to take part in the battle against the progression of myopia. The MiSight

1-day contact lens is our latest weapon that should be embraced by many parents wanting to take a proactive approach to managing their child’s nearsightedness.

To a healthy visual field,

Dr. Michael Yee, Optometrist

(1) Flitcof DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012; 31: 622-60. Summary from Gifford K. mivision.issue114.July 16

(2) Chamberlain P, Logan N, Jones D, Gonzalez-Meijome J, Saw S-M, Young G. Clinical evaluation of a dual-focus myopia control 1 day soft contact lens: 3-year results. Presented at: British Contact Lens Association Clinical Conference, Liverpool, England

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