Understanding myopia control

Short-sightedness, also known as myopia, is a very common visual disability that afflicts many adults and children. In this article, a consultant ophthalmologist show myopia control techniques and approaches can hinder the progression of myopia.

What is myopia?

Myopia, simply explained, is when objects farther away are more difficult to see, appearing as blurry and indistinct. Common everyday activities such as driving, cooking, watching films, and reading can become strenuous and difficult. Structurally, myopia is caused by an eyeball that is elongated (becoming ovoid), which alters the way that light is focused by the lens and cornea towards the retina, hitting a point in front of the retina instead of directly onto it.

This structural aberration can be due to a variety of health conditions or developmental circumstances. Many people are born with myopia which worsens over time, or it can occur later in life as an adult. Most patients are diagnosed around 10 years of age, and typically progression halts at around their mid-twenties.

Myopia is not typically a cause for concern, but there is the possibility of unaddressed myopia leading to serious ocular conditions like glaucoma, retinal detachment, and maculopathy.

How is myopia treated?

To accommodate for the reduced visual acuity of myopia, many patients wear graded contact lenses or glasses to correct their vision in their day-to-day lives, but this can actually contribute to the worsening of myopia due to overreliance on seeing aids.

Surgical intervention can ‘correct’ myopic vision, and not every patient is suitable, willing, or able to afford to undergo treatment.

What is myopia control?

Myopia control refers to approaches and methods that are employed to slow down the progression of myopia, particularly in paediatric patients as their eyes are the most malleable.

Myopia control may not restore 20/20 vison, but it can help to preventing and reduce the risk of serious conditions later in life. Patients and their parents will also benefit from a more stable prescription, eliminating the need for frequent lens upgrades.

Myopia control will employ techniques such as:

• Myopia control glasses and contacts, which function similarly to typical graded contacts and glasses by aiding vision at a distance, but are specially designed to slow the elongation of the eyeballs by adopting bifocal technology by utilising the top section of the lenses for distance focus, and the bottom for near focus. The technology of myopia control contact lenses and glasses is new and is still been developed, but results are promising.
• Orthokeratology (ortho-k), which are harder contact lenses that are donned at night during sleep. They temporarily reshape the eyeball, by flattening the centre of the cornea to manipulate how light enters during the day, during which the lenses are not worn. These are best suited for children between 8 and 15 years old.
• Low-dose atropine drops, which were originally used for pupil dilation in eye examinations, but it has been discovered that low doses of about 0.01% daily can stop further elongation. It is recommended for children between 6 and 12 years old. This is a new field of research that also has promising results.

Further management can be achieved by encouraging more time spent outdoors, ideally two hours daily. It is thought that the exposure to natural sunlight and visual stimulation from various distances can strengthen the eyes.

As much as possible, reduce the use of digital screens, especially in environments with low light, and have frequent breaks. Even reading physical texts can be detrimental if in the dark and held too close to the face.