Myopia Management

Myopia, also known as nearsightedness, is a condition that typically begins in childhood due to the elongation of the eye. Individuals with myopia experience blurry vision at a distance but may be able to see clearly up close, depending on their refractive error. The causes of myopia are multifactorial, involving genetics, lifestyle, and environmental factors. Signs of myopia can include squinting, holding objects close to the face, and experiencing difficulties in school performance.

By 2050, the incidence of myopia is expected to increase, potentially affecting around half of the world's population. High myopia can lead to serious ocular conditions that may result in vision loss, such as cataracts, glaucoma, retinal detachment, and myopic macular degeneration. However, managing the progression of myopia can help reduce the risk of these complications. Patients with myopia are closely monitored by assessing changes in refractive error and axial length of the eye. Currently, there are three main methods available to manage myopia and minimize eye elongation. The optimal treatment will vary based on each patient’s individual needs.
 

1. Hard Contact lens

Orthokeratology lenses, also known as hard contact lenses, are worn overnight for 7-8 hours to temporarily reshape the cornea to signal the eye to prevent further elongation. When the patient wakes up, they can see clearly throughout the day without glasses, as the lenses have corrected their vision. However, the effect diminishes by the end of the day, so the lenses need to be worn each night to maintain vision correction. Currently, orthokeratology is effective for correcting up to approximately 6.00 diopters of myopia and 1.50 diopters of astigmatism. Insertion and removal of hard contact lenses will be taught in office and monitored appropriately.
 

2. Soft Multifocal Contact Lenses

Soft multifocal contact lenses for myopia management feature concentric rings where the central portion of the lens corrects the patient’s refractive error, while the peripheral rings have added plus power to help slow the elongation of the eye. This approach is particularly beneficial for patients with higher levels of astigmatism. There are various brands of contact lenses designed for myopia control, and the insertion and removal of these lenses will be taught in the office and monitored appropriately.
 

3. Low Dose Atropine Eye Drops

Low-dose atropine eye drops, administered once daily in each eye, are an effective treatment for reducing eye elongation with minimal to no side effects due to their low concentration. This option is particularly useful for patients who may not yet be ready for contact lenses or can be used as an adjunct therapy alongside contact lenses.