What Is Progressive Myopia?

Nearsightedness or myopia is one of the most prevalent eye disorders worldwide and its incidence is increasing. In fact by 2050, myopia is projected to affect half of the world’s population!

Many children diagnosed with nearsightedness (myopia) experience a consistent worsening of their vision as they grow into adolescence. This condition can be so aggressive that for some, each time they take their child to the eye doctor for a vision checkup, their prescription gets higher.

This is called progressive myopia and can be a serious condition for many children now and in the future. Not only is there a financial burden and inconvenience associated with having to replace eyeglasses on a regular basis, but high myopia is a risk factor for many eye diseases later in life such as retinal detachment, early onset cataracts, glaucoma and macular degeneration.

What Causes Progressive Myopia?

Myopia is a refractive error that happens when the eye focuses incoming light in front of the retina, rather than directly on it, resulting in blurred distance vision. While an exact cause of progressive myopia is not known, most research indicates that a combination of environmental and genetic factors trigger the condition.

First of all, there is evidence that a family history of nearsightedness is a contributing factor. Additionally, spending a lot of time indoors may play a role in myopia development, as studies show that children who spend more time outside have less incidence of myopia. Lastly, near point stress, which can be caused from looking at a near object for an extended period of time, can prompt the eye to grow longer and result in myopia. Several eye doctors recommend following the 20-20-20 rule when using digital devices (stopping every 20 minutes to look 20 feet away for 20 seconds) to reduce near point stress caused by computer use.

What Can Be Done To Prevent or Treat Myopia?

There are several treatments that have been shown to slow the progression of myopia.

Orthokeratology (ortho-k):

Also known as corneal reshaping, this treatment uses rigid gas permeable contact lenses that are worn while the patient sleeps to reshape the cornea, which is the clear, front part of the eye. During the day, the patient is usually able to see clearly, glasses-free. In addition to allowing glasses-free vision during the day, this treatment has been shown to reduce the progression of myopia in many children.

Distance Center Multifocal Contact Lenses:

This treatment uses distance center (which means the area for seeing at a distance is in the center of the lens) multifocal soft contact lenses to provide clear vision and slow the progression of myopia. The lenses are worn as normal contact lenses during the day.

Atropine Drops:

Atropine drops are a daily-use prescription eye drop that has been shown to reduce myopia progression. It can be used alone or in combination with ortho-k or multifocal contact lenses.

Additional Myopia Treatments:

While these treatments are available in all of North America, some countries offer additional options that are approved for myopia control. For example, in Canada, Zeiss^TM MyoVision glasses that have an innovative lens curvature design are available to help reduce the rate of myopia progression. Additionally some doctors in Canada offer Coopervision MiSight^® lenses, which are 1-day contact lenses that are worn during the daytime. These contacts have a multifocal lens design with distance centre and near surround that is specifically designed for children.

Myopia & Your Child

If your child’s vision keeps getting worse, it’s more than an annoyance – it can be a serious risk factor for their eye health and vision in the future. The best strategy for myopia control depends on the child and the severity of the case, and requires consultation with an experienced eye doctor in order to determine the best solution. If your child wears glasses, make his or her vision a priority; schedule an eye exam to ensure stable vision and healthy eyes.

Healthy eyes and good vision are essential for your child’s growth and development. In fact, learning is 80% visual, which means a child’s success in school, athletics and many other aspects of life can be impacted by poor vision. Good vision goes beyond how far you can see, and also includes a number of other skills such as visual processing and eye movement abilities.

Often times vision deficiencies are at the root of learning problems and behavioral issues and may unfortunately go unchecked and misdiagnosed. Remember, if your child is having trouble in school, an eye exam and a pair of prescription glasses is a much easier solution than treating a learning disorder or ADHD; yet many people fail to check that first.

It is common for children to think that their vision deficiency is normal and therefore they often won’t report it to parents or teachers. That is why it is even more important to know what to look for. Here are some signs that your child may have a vision problem:

Vision Signs

• Squinting or blinking often
• Eye rubbing
• Tilting the head to the side
• Covering one eye
• One eye that turns out or in
• Reporting double vision
• Holding books or reading materials very close to the face

Behavioral Signs

• Complaining of headaches or eye fatigue
• Short attention span
• Difficulty reading
• Losing their place frequently when reading
• Avoiding reading or any activity that requires close work
• Problems with reading comprehension or recall
• Behavioral issues that stem from frustration and/or boredom
• Poor performance and achievement in school or athletics
• Working twice as hard to achieve minimal performance in school

Another issue is that many parents and teachers think that a school vision screening is sufficient to assess a child’s vision, so if that test comes back okay, they believe there is no vision problem. This however, is far from the case. A school vision test usually only assesses visual acuity for distance vision or how far a child can see. Even a child with 20/20 vision can have significant vision problems that prevent them from seeing, reading and processing visual information.

Every child of school age should have comprehensive eye and vision exams on a regular, yearly basis to assess their eye and vision health, and ensure that any issues are addressed as soon as possible. It’s also important to have an exam prior to entering kindergarten, as undetected lazy eye may be more complicated to treat past seven years of age.

Some of the issues the eye doctor may look for, in addition to good visual acuity, are the ability to focus, eye teaming and tracking, visual perception, hand-eye coordination, depth perception and peripheral vision. They will also assess the health of the eye and look for any underlying conditions that may be impairing vision. Depending on the problem the eye doctor may prescribe eyeglasses, contact lenses or vision therapy to correct the issue.

During the school years a child’s eyes and vision continue to develop and change so it is important to continually check in on your child’s vision. If you have a family history of vision problems, follow-ups are even more important. Progressive conditions like progressive myopia, strabismus (crossed eyes), amblyopia (lazy eye) or astigmatism can be treated and monitored for changes with early treatment so it’s important to seek a doctor’s diagnosis as soon as signs or symptoms are present.

Make sure that your child has the best possible chances for success in school and add a comprehensive eye exam to your back to school to-do list.

Many teens who wear glasses are eager to try out contact lenses for convenience, fashion or to just provide another option for vision correction. For teens who feel self-conscious in their glasses, contact lenses can be a way to improve self-esteem. Young athletes and swimmers find that contacts are an excellent option for sports, especially as younger kids are becoming involved in travel sports and club teams outside of school.

While contacts might appear to be the perfect solution for teens that need corrective eyewear, they are a convenience that comes with a lot of responsibility so it’s not a decision to take lightly. Improper use of contact lenses can cause severe discomfort, infections, irritation and, in the worst cases, eye damage or even permanent vision loss.

“With Privilege Comes Responsibility”

Contact lenses are a medical device and should always be treated as such. They should never be obtained without a valid contact lens prescription from an eye doctor, and always purchased from an authorized seller. Among other issues, poor fitting contact lenses bought from illegitimate sources have been known to cause micro-abrasions to the eyes that can increase the risk of eye infection and corneal ulcers in worst case scenarios.

Particularly when it comes to kids and teens, it is best to purchase contact lenses from an eye doctor as they possess the expertise to properly fit contact lenses based on the shape of the eye, the prescription, the lifestyle of the child and other factors that may influence the comfort, health and convenience of contact lens use.

There is some debate over the recommended age for kids to start considering contact lenses. While some experts will say the ideal age is between 11 and 14, there are many responsible children as young as 8 or even younger who have begun to successfully use them. When children are motivated and responsible, and parents are able to ensure follow-up to the daily regimen, earlier contact lens use can be a success. A good measure of whether your child is responsible enough to use contacts is whether they are able to keep their room clean, or maintain basic hygiene like brushing teeth regularly and effectively.

When you think your child might be ready, you should schedule an appointment with your eye doctor for a contact lens exam and fitting. The process will take a few visits to perform the exam, complete a training session on how to insert, remove and care for lenses, then to try out the lenses at home and finally reassess the comfort and fit of the contacts. You may try out a few varieties before you find the best fit.

What Kind of Contact Lens Is Best for My Teen?

The good news is that contact lens use has become easier than ever, with safety, health and convenience being more accessible as technology improves. There are a number of options including the material used to make the lenses (soft or rigid gas permeable), the replacement schedule (if disposable, how often you replace the pair – daily, weekly, biweekly or monthly) and the wear schedule (daily or extended overnight wear).

Single use, daily disposable lenses have become very popular, particularly with younger users, because they are easy to use, requiring no cleaning or storing, and therefore they reduce the risk of infection and misuse. You simply throw out the lenses at night and open a new one in the morning. Your eye doctor will be able to help you and your teen determine the best option.

Tips for Contact Lens Wearers

Following are some basic contact lens safety tips. If your teen is responsible enough to follow these guidelines, he or she may be ready for contact lens use:

1. Always follow the wearing schedule prescribed by your doctor.
2. Always wash your hands with soap before applying or removing contact lenses.
3. Never use any substance other than contact lens rinse or solution to clean contacts (even tap water is a no-no).
4. Never reuse contact lens solution
5. Follow the eye doctor’s advice about swimming or showering in your lenses
6. Always remove your lenses if they are bothering you or causing irritation.
7. Never sleep in your lenses unless they are extended wear.
8. Never use any contact lenses that were not acquired with a prescription at an authorized source. Never purchase cosmetic lenses without a prescription!

Contact lens use is an ongoing process. As a child grows, the lens fit may change as well, so it is important to have annual contact lens assessments. Plus, new technology is always being developed to improve comfort and quality of contact lenses.

Contact lenses are a wonderful invention but they must be used with proper care. Before you let your teen take the plunge into contact lens use, make sure you review the dangers and safety guidelines.

According to the Vision Council’s 2016 UV (Ultraviolet Radiation) Protection report, parents are more likely to wear sunglasses (56%) than their children (only 29%!). Yet children, who spend much more time outside, are typically exposed to three times the amount of sunlight and UV radiation that adults get. This early exposure can lead to serious eye damage and complications later in life.

Children’s Eyes are More Sensitive

Particularly when it comes to children under 10 years of age, a child’s eye is more vulnerable than an adult’s. This is because, in children, the human lens lets about 70% more UV into the eye than in an adult. Further, once the cells of the lens are damaged they cannot repair themselves so the damage continues to accumulate throughout life. While immediate danger may be minimal, early efforts toward eye protection can prevent problems in adulthood.

Children Have Greater Exposure to UV

At 20 years of age, the average person has received 80% of their life’s UV exposure. Children spend more time outdoors playing, participating in sports and even during recess at school. Since children have more transparent lenses in their eyes and more sensitive skin on their bodies, they are at great risk of experiencing adverse effects of overexposure to UV light. The effects of overexposure to UV light at a younger age may not show up until later in life, with higher risk of cataracts and age related macular degeneration. This is why it is critical to effectively protect our eyes from the sun.

UV exposure doesn’t just come from the sun. Sunlight reflected off of water, snow, sand and even pavement increases UV exposure and therefore wearing a wide-brimmed hat is often not enough to protect the eyes. Additionally, children are often looking upwards directly toward the sun at adults and objects that are taller than they are.

Children Need to Learn Good Habits

The immediate effects of sun damage, such as sunburns to the eye, often go unnoticed, especially by children. Therefore, unlike a serious and painful sunburn to the skin which can serve as a learned deterrent, the risks and results of eye damage are less obvious. Children need to be taught about the importance of wearing sunglasses. This starts with a good example set by parents who should wear sunglasses every time they go outside. Purchasing a good pair of properly protective sunglasses that are comfortable and fit your child, and encouraging their use and care are also essential.

Selecting Sunglasses for Kids

UV protection is available in some clear lenses as well as sunglasses. The choice can be confusing if you do not have some background information. Not all lenses are equal in terms of UV protection. For example cheaply made UV400 sunglasses have a spray-on coating that can wear off with cleaning and give you a false sense of security. Also lens distortion and poor frame quality of discount sunwear may cause eyestrain. Ophthalmic quality lenses that provide UV protection and crisp optics should be made to last with good warranties to back up problems that can occur.

There is a plethora of options for children’s sunglasses and a good pair doesn’t need to break the bank. The first and most important criterion is that the lenses block 100% of UVA and UVB rays. You may want to also consider impact resistant polycarbonate lenses for more durability. For smaller children, look for adjustable sunglasses or a pair that includes a strap to keep the glasses in place. Inviting your child to shop with you will help ensure that the glasses are comfortable, fit right and that the child will like them, which can definitely increase the likelihood of the child agreeing to wear them as needed.