Ortho-K & Myopia Control Markham | Berczy Eyecare

Myopia Control In Markham Ontario

What is Myopia?

Myopia is blurry long-distance vision, often called ‘short-sightedness’ or ‘near-sightedness’. A person with myopia can typically see clearly up close – when reading a book or looking at a laptop screen – but words and objects look fuzzy on a whiteboard, on television, across the room,when looking outdoors or when driving.

Why is myopia a concern?

The rate of myopia is growing across the world, increasing from 22% of the world’s population in 2000 to 33% in 2020 – half of the world’s population expected to be myopic by 2050. 1 Most myopia is caused by the eye length growing too quickly in childhood. The eyes are meant to grow from birth until the early teens and then cease, but in myopia the eyes grow too much and/or continue growing into the teenage years. Once a child becomes myopic, their vision typically deteriorates every 6-12 months, requiring a stronger and stronger prescription. Most myopic children tend to stabilize by the late teens and early 20’s. 2 Excessive eye growth raises concern because even small amounts of stretching can lead to increased likelihood of vision threatening eye diseases in later life, such as myopic macular degeneration, retinal detachment, and cataract. 3,4

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Why manage myopia in children?

Myopia progresses fastest in younger children, especially those under age 10. 5 This means that the most important opportunity to slow eye growth is when children are younger. Myopia management aims to apply specific treatments to slow the excessive eye growth to a lesser rate. Experts agree that myopia management should be commenced for all children under age 12, 6 and typically continue into the late teens. 7

The short-term benefit of slowing myopia progression is that a child’s prescription will change less quickly, giving them clearer vision for longer between eye examinations. The long-term benefit is reducing the lifetime risk of eye disease and vision impairment. This risk increases as myopia does 3 with the good news being that reducing the final level of myopia by only 1 dioptre reduces the lifetime risk of myopic macular degeneration by 40% and the risk of vision impairment by 20%. 8

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Treatments for slowing myopia progression

Standard, single-focus long distance spectacles or contact lenses do not slow down the progression of childhood myopia. 8 Instead, specific types of spectacles, contact lenses and eye drops called atropine have been proven to slow myopia progression in children. 6

The best option for your child will depend on their current prescription and other vision and eye health factors determined in their eye examination. Your eye care practitioner will discuss the options with you to determine the best option. Treatment options vary across the world due to availability, supply and regulatory reasons. It is important to note that no treatment can promise the ability to stop myopia progression in children, only to slow it down.

Contact lenses

Standard single-focus contact lenses do not slow the worsening of childhood myopia but specific designs do. These specific designs can both correct the blurred vision of myopia and work to slow down myopia progression. The options include soft myopia controlling contact lenses and orthokeratology.

Risks and safety

Contact lens wear increases the risk of eye infection compared to wearing spectacles, with the risks being:

1 per 1,000 wearers per year for reusable soft contact lenses or overnight orthokeratology lenses 9,10

1 per 5,000 wearers per year for daily disposable soft contact lenses 9

With proper hygiene and maintenance procedures, this risk can be well managed – especially by avoiding any contact of water with contact lenses or accessories. 11 Other side effects of contact lenses to control myopia can be temporary adaptation to the different experience of vision, which typically resolves in 1-2 weeks.

Benefits

There are many benefits to children wearing contact lenses:

1. Wearing contact lenses improves children’s self confidence in school and sport, and their satisfaction with their vision – as much as it does for teens 12

2. Children aged 8-12 years appear to be safer contact lens wearers than teens and adults, with a lower risk of eye infection 13

3. Children only take 15 minutes more to learn how to handle contact lenses than teens 14

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Orthokeratology contact lenses are worn overnight and removed upon waking, such that no spectacles or contact lenses are required for clear vision during the day. They can require more appointments for fitting than other types of myopia control treatment. Adaptation to the lens-on- eye feeling can take 1-2 weeks but shouldn’t affect sleep. 17 There are significant benefits for water sports and active lifestyles, and since the contact lenses are only worn at home there is low risk of them being lost or broken during wear.

Soft myopia controlling contact lenses are worn during waking hours. They may be daily disposable, or reusable for up to a month. They typically require more appointments for fitting than spectacles but less than orthokeratology. Adaptation to the lens-on-eye feeling typically occurs in a few days. There are benefits in safety with daily disposables being the safest modality, and the number of lenses retained meaning loss or breakage is less of a practical issue.

Treatments

(Click a treatment to see how it works)

1. Ortho Keratology (Ortho-K) Lenses

Ortho-K lenses are specialized rigid gas permeable contacts worn overnight. They gently reshape the cornea while you sleep, providing clear vision throughout the day without the need for glasses, while helping to slow the elongation of the eye.

2. Soft Myopia Control Contact Lenses

These multifocal daytime lenses utilize a "dual-focus" design. They provide clear distance vision in the center while creating peripheral defocus, which sends a signal to the brain to slow down the eye's growth rate.

3. Low-dose Atropine Eye Drops

Daily drops formulated at very low concentrations (typically 0.01% to 0.05%). This treatment is highly effective at slowing myopia progression by targeting chemical receptors in the eye that control axial length growth.

4. Myopia Control Spectacles

Advanced spectacle lenses, such as those using D.I.M.S. or H.A.L.T. technology, look like regular glasses but feature hundreds of tiny "segments" that manage light focus on the retina to curb nearsightedness.

⚠️ Medication Safety: Atropine drops must be stored securely. While safe for eye application, ingestion can be dangerous for young children. [Ref 16]

Spectacles

Standard single-focus spectacles do not slow the worsening of childhood myopia but specific designs do. Myopia controlling spectacles can both correct the blurred vision of myopia and work to slow down myopia progression. They are safe to wear and adaptation is typically easy, with the only side effects being related to the limitations spectacles pose for sport and active lifestyles.

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