Myopia Management

Myopia Management is a way to slow down the development of Myopia (Short-sightedness) in the growing child. Myopia is when you can see close up but the distance is hazy.

Why do we want to limit children’s myopia?

High myopes (over -6.00 Dsph) have a higher risk of detached retinas, glaucoma and cataracts  as their eyes age.

History

Earl Smith 111 in the USA wanted to know why children’s eyes grew too long so they went (short-sighted ) myopic. He did some research on Rhesus monkeys and discovered that it is where the peripheral (at the side) light focuses that drives the eye to grow.

Geoff Walline in the USA experimented with defocus contact lenses on children to slow eye growth. The light defocus is moved to fool the eye into thinking it has grown, when it hasn’t.

Paul Chamberlain (et.al) started clinical trials at Coopervision with Misight contact lenses. These contact lenses are now clinically proven to hold the eye growth down by nearly 2/3rds.

This means that with the use of Misight contact lenses the adult might only be -3.oo Dsph instead of -9.00 Dsph with no treatment, or -1.00 instead of -3.00.

 

Measuring Children's Eye Growth

Our Topcon axial length machine

We will be measuring all the children who might grow to go myopic (those of +0.75 Dsph or less). This is free during the eye examination and may be requested by parents who want to see how  much their childs’ eyes grow.

normal eye length

Approximately 23mm is the normal length of a perfect eye

If the eye grows longer that 23mm then distance is blurred.

Hoya MyoSmart spectacle lenses

Last year in February 2021 we started using MyoSmart

We fit Misight contact lenses from age 7 but there are younger children who are myopic. In fact the younger you become myopic the higher the adult prescription as you have more eye growth ahead.

MyoSmart spectacle lenses can  slow myopia progression by 59% and axial progression by 60% over two years and may be easier for some children to manage. The lenses contain tiny defocus segments surrounding the clear central zone. MyoSmart was developed at Hong Kong Polytechnic University.

They are useful before age 7 years and for when the child is not wearing their contact lenses

Atropine eye drop treatment is not licenced for Myopia treatment in the UK. We would use this in the future but only if very low doses worked on slowing myopia. The high doses have side effects and the children wear hats, sunglasses and reading glasses as their pupils are dilated. The biggest research study in the Netherlands.