Myopia (short-sightedness)

Myopia, also known as short-sightedness or near-sightedness, is a common condition where close-up vision is generally clear, but further away objects are blurred.

diagram of myopic eye It is usually managed with glasses and/or contact lenses to allow clear distance vision. The causes of myopia are complex and are still being researched, but in simple terms it probably comes down to a combination of both genetic (family history) and environmental influences such as the amount of time spent reading vs time spent outdoors.

While it’s true that short-sightedness can be corrected by wearing glasses or contact lenses, or even eye laser surgery (LASIK or PRK), higher degrees of myopia are associated with serious eye conditions such as retinal detachments and glaucoma. So ideally, customised eyecare that prevents or slows the progression of myopia is better than simply accepting stronger & stronger lenses. Even laser eye surgery for myopia does not reduce these risks. Children, teenagers, and young adults seem to be the most susceptible to worsening vision from increasing myopia. As behavioural optometrists, at Custom Eyecare we are more interested in the prevention of myopia rather than the easy option of simply prescribing stronger & stronger glasses.

Over the years there have been many studies and much debate and controversy in the area of myopia prevention.

  • There is some evidence that specially designed glasses such as bifocals, multifocals, or reading lenses may slow down myopia progression, but the scientific evidence is “suggestive” rather than “overwhelming”. This is one technique that we do suggest fairly often, because it may help and it can’t do any harm.
  • There has also been a suggestion that wearing rigid (RGP) contact lenses may slow down myopia but again this is not fully supported by the latest research evidence (although rigid lenses do have some other benefits such as excellent vision especially for moderate to high myopia, with or without astigmatism).
  • Historically some optometrists have advocated prescribing less than the full strength correction in glasses or contact lenses, and accepting slightly blurry vision, in an attempt to avoid myopic progression. However one well known study in 2002 actually found that this may cause myopia to increase more rapidly. So while more research is needed, most optometrists who keep up to date with the scientific literature do not follow this recommendation.
  • atropine in myopia controlThere are probably only two treatments that have been shown in scientific studies to slow the progression of myopia in any sort of significant way. One is the drug atropine, and the other is a program of orthokeratology (overnight vision correction). Atropine works well but is rarely used in Australia due to its drug side-effects of dilated pupils & glare sensitivity. New information coming out suggests that weaker concentrations of atropine may be just as effective. Orthokeratology also works well, without the side-effects of atropine. Orthokeratology for myopia control is an option we are happy to recommend and prescribe for short-sighted people, including children, who are concerned about worsening eyesight.
  • There is also a newer suggestion that wearing some types of bifocal or multifocal soft contact lenses can help arrest myopia development. While this seems like a very promising idea, and is inexpensive & easy to try, the “jury is still out” on just how well this technique works, and more scientific studies are needed to prove its effectiveness.
  • One report suggested that people with a lower Vitamin D intake are more prone to myopia progression. Further study is needed before conclusions can be drawn about this one.
  • Lastly, outdoor time has shown to be protective against myopic progression in children & teenagers, regardless of how many hours are spent doing close work. Therefore we recommend that all children at risk of myopia spend some time outdoors every day. This advice may well apply to adults with progressing myopia too, although the actual scientific studies have not yet been conducted on adult subjects.

Contact us to arrange a myopia assessment and comprehensive general eye & vision check.

Links:

The Case for Myopia Control Now” – an article by a US professor of ophthalmology (eye surgeon) urging action to slow down myopia.

Go to this comprehensive external website www.myopiaprevention.org for some further interesting reading on the topic of myopia prevention, and links to actual scientific research articles.