Myopia (Nearsightedness)

Myopia, or nearsightedness, is one of the most common childhood vision problems which now can be successfully treated.

What is Myopia?

Myopia, also known as nearsightedness, is a condition in which distant objects appear to be blurry. The main reason for blurry vision is related to the eye growing too long from front to back. This causes the light to come into focus in front of the retina rather than on the retina, causing blur.

Myopia most commonly develops during childhood years and progresses until late teenage years. Ongoing research has discovered the earlier the onset of myopia, the worse it gets. The level of myopia the child has is directly correlated to their risk of eye disease development. The higher the myopia, the greater the risks of developing sight-threatening eye diseases later in life that can lead to permanent vision loss and even blindness.
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The prevalence of myopia is increasing globally at an alarming rate, with more than half of the world’s population expected to have myopia by 2050. For decades, we thought of myopia as an inconvenience of blurry vision and ever-thickening glasses, but now, we know it is a disease that needs our attention and intervention.

Image illustrating the underlying physiology of myopia and comparing a myopic eye to a normal eye.

Factors that Contribute to Myopia Onset and Progression

Genetics: Family history of myopia

With one myopic parent, the risk of developing myopia is roughly 30%. When both parents are myopic, there is a 50% chance that the child will develop myopia. When neither of the parents are myopic, the child still has a 25% chance of developing myopia

Age of Myopia onset

The younger the child is when they start to show signs of myopia, the faster they will progress and the worse they will end up. Monitoring at an early age (even starting at 3 or 4 years old) for the potential development of myopia can have a tremendous benefit in slowing the onset and progression of this disease.

Lack of outdoor time

Scientific evidence shows that lack of outdoor time, and the amount of light the child is exposed to, may be contributing to the onset of myopia in children. Spending at least 2 hours per day outdoors has a protective benefit of reducing the risks of developing myopia.

Increased screen time

School-aged children who spend 7+ hours per week on computer screens and other digital devices triple their risk of myopia development and progression. Minimizing screen time as much as possible is one other factor we can control to minimize the risks of myopia.

What are the Risks of Myopia?

Blurry distance vision, which is a symptom of myopia, can certainly affect a child’s ability to see in school or perform in sports. More importantly, myopia carries a risk of sight threatening diseases later in life due to the compromise of eye health as a result of the eye growing too long. Having myopia significantly raises the risk of visual impairment and even blindness.

Myopic Maculopathy

Myopic maculopathy is similar to age-related macular degeneration (often found in older individuals) which affects central vision. When the central part of the retina, called the macula, is compromised due to the eye growing too long,it weakens this delicate tissue. Once myopic maculopathy develops, it will cause vision loss which is irreversible. For every diopter increase in myopia, the risk of developing myopic maculopathy, or loss of vision, is increased by 67%.

Retinal Detachment

Retinal detachment is another devastating eye disease that is more prevalent in the myopic patient population. With the increase in amount of myopia, there is an exponential increase in the risks for developing a retinal detachment. The excessive eye elongation jeopardizes the delicate structure of the inside lining of the eye called the retina. Compromised retina can lead to retinal breaks or detachments which may cause vision loss or blindness.

Open Angle Glaucoma

Glaucoma is one of the leading causes of irreversible blindness in the adult population and there is an increased risk of developing this eye disease in myopes. In glaucoma, the compromised optic nerve interrupts the transfer of information to the brain. It is called a “silent thief of sight” because it slowly degrades vision starting in the periphery without any symptoms. If not diagnosed or treated in time, it may lead to blindness.

Cataracts

Cataracts are a normal aging change of the eye. When cataracts develop, individuals are no longer able to focus when looking at near. Eventually, cataracts cause image blur and degradation which is when surgery is needed to replace the cataract with a clear lens implant. Myopes tend to develop these cataracts prematurely (even as early as in their 30s) and, therefore, are at an increased risk of needing cataract surgery at a much younger age.

Eye Disease Risks Associated with Increasing Myopia Compared to No Myopia

Source: 1 Blue Mountain Eye Study, Vongphanit et al., 2002
2 Ogawa & Tanaka, 1988

What is Myopia Management?

Myopia management is a treatment program aimed to control or slow down the progression of myopia in children. Separate from glasses that only improve the symptom of myopia (blurry distance vision), treatment options for Myopia Management include prescription atropine drops, custom designed contact lenses worn during sleep or daily contact lenses.

​​​​​​​Our doctors are at the forefront of myopia management through our partnership with TreeHouse Eyes, the country’s leading pediatric myopia management service. For twenty years, our doctors have been passionate about improving myopia management outcomes and the quality of our patient’s lives. A consultation with our doctors will determine the best myopia treatment for your child. Learn more about our myopia management services.

Treatment Outcomes & Patient Successes

“Dr. Spokas prescribed Ortho-k lenses for my son when he was 10 years old to correct his vision and for myopia control. Now 7 years later he has decided to switch to daily soft contact lenses. Amazingly his vision had not worsened at all in the past 7 years. The Ortho-k lenses halted the progression of his myopia and his soft lenses are a fairly mild prescription. If he had not worn the Ortho-k lenses for those years, his myopia surely would have progressed. I would recommend the Ortho-k treatment to anyone who is a candidate and Clarendon Vision for their top-notch staff.”

“Dr. Spokas is very kind, intelligent and knowledgeable doctor, especially in orthokeratology for myopia control. My son has been under her care for many years. She has not only controlled his myopia but gave him 20/20 vision without glasses. Before meeting her, I saw many ophthalmologist and optometrist for my son’s myopia but unfortunately his myopia kept getting worse. I saw Dr. Spokas after my Pediatrician’s recommendation and she took my son under her care. At first, I was nervous about ortho-k and vision therapy, which were suggested treatments for him, but I trusted her completely and follow through with them. This was a life changing decision for my son. Within a week he was seeing 20/20 during day without glasses and vision therapy helped him make his eye health in general stronger. Now my younger son is also under her care and happy with outcome. Also can’t forget Yanin, an amazing vision therapist and Rita optician who is always very helpful.”

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