Myopia Management: The Optical Strategy

Dr. Russel Lazarus, June 16, 2021

Myopia management options have slowed the rate of myopia progression by 30% to 80%.

Myopia, also known as nearsightedness, occurs when the eye elongates, and light rays are focused in front of the retina rather than directly on it.

For those with myopia, nearby objects remain clear which distant objects appear blurred. Although glasses and standard contact lenses can correct a person’s vision, they don’t treat the underlying cause of myopia or slow its progression.

Myopia is more than inconvenient but also significantly increases the risk of developing sight-threatening eye diseases later in life. 

Children with myopia tend to show regular progression of their vision over time. However there are ways to slow down this progression, called myopia management.

Optical Options for myopia management

Some optical interventions for myopia management include:

  • Single vision
  • Bifocal lenses
  • Progressive addition lenses (multifocals)
  • Orthokeratology (Ortho-k)

Among these optical interventions, ortho-k shows the most promising results in slowing myopia progression by 30-50%.

1. Single vision spectacle lenses

These standard type of single vision lenses are typically prescribed for vision problems in children and adults, where only one focusing distance (far or close) needs support with glasses.

For those who are myopic, they’ve been found to have only a small treatment effect of less than 14% reduction in myopia progression.

2. Bifocal spectacle lenses

Bifocal spectacle lenses have 2 optical zones, one for clear distance vision and the other for reading  – the top half corrects for long distance vision and the bottom half for up close vision and reading.

Bifocals are frequently prescribed to children with coordination and eye muscle teaming problems. The only downside to these lenses is the visible line between the top and bottom lenses.

JAMA Ophthalmology (2014), a 3-year randomized clinical trial, in a private practice, a total of 135 Chinese-Canadian children (aged 8-13 years), with myopia progression of at least 0.50 D in the preceding year were randomly assigned to 1 of 3 treatments.

This research showed that bifocal spectacles can slow myopia progression in children by close to 33%, after 3 years.

Contact an eye doctor near you to learn more about optical options for your child’s myopia.

SEE RELATED: Myopia Management: Children and Digital Devices 

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3. Progressive addition lenses

Progressive addition (PAL) lenses, also known as multifocal spectacle lenses, have a graded power for long distance correction at the top to full reading power at the bottom of the lens.

They are similar to bifocal lenses, but without the visible line in the middle.

Children may be prescribed PAL lenses to support their reading vision or for eye muscle coordination problems.

4. Ortho-K

Orthokeratology (also called ortho-k), is the use of specially fitted and designed gas permeable contact lenses that temporarily and gently reshape the cornea to correct refractive errors like myopia.

By wearing ortho-k lenses every night, anyone can enjoy clear, sharp vision during the day, without relying on eyeglasses or contact lenses.

Research shows that ortho-k lenses not only effectively remove the need to wear glasses or daytime contact lenses; they can also slow and sometimes stop the progression of myopia.

BMC Ophthalmology (Vol 7, 2017) published a retrospective cohort study that demonstrated that besides the immediate refractive effect during the day, orthokeratology may reduce myopia progression in children.

The World Society of Pediatric Ophthalmology and Strabismus (WSPOS) consensus document noted that ortho-k results in an approximately 40% reduction in myopia progression.

A two-year study of myopia Chinese children (ages 6 to 10) found that ortho-k contact lenses reduced lengthening of the eyeball, a key factor in myopia progression, by 43% compared with matched children who wore regular glasses for myopia correction during the study period.

Which strategy is best?

Each eye has its own shape, size, and level of myopia and more, therefore it’s best to visit your eye doctor who will be able to guide you on which Myopia Management option  is most suitable for your child.

LEARN MORE:  Guide to Myopia Management

Schedule an appointment with an eye doctor near you who can recommend the best myopia management treatment option for your child.