How to prevent myopia from worsening in children? 預防兒童近視加深

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​If you have eyesight problems with short-sightedness (myopia) there's a good chance your children will develop the same vision issues as they grow up. Statistically there's a 3 times risk of a child having myopia if one parent is myopic, and 6 times risk if both parents are myopic. Genetics is certainly a strong predisposing factor for myopia development.

​We can't do much about the genetic makeup of your child, but we can reduce the risk of your child having short-sighted eyes, or worse, highly short-sighted eyes — a condition known as 'high myopia', conventionally defined as myopia with a glasses prescription of -6.00 or over (600 degrees +).

Many people, particularly of Asian descent, have even higher levels of myopia. -10.00 and above (1000 degrees short-sighted) are not uncommon. The highest we have seen in our practice is -16.00. Not only is having high myopia hugely inconvenient (nothing in front of your nose is clear without glasses) but the risks of developing serious eye diseases and blindness are exponentially higher.

Previously there wasn't a lot that could be done to slow down short-sightedness progression. But now there is, and all parents should know about these options available to preserve your child's eyesight. With the current medical and optical treatments no child today should grow up to have high myopia anymore. Early intervention and treatment is key to maintaining good eyesight. Treatments and strategies to prevent children's eyes from getting worse with myopia is called 'myopia control'.

Our myopia control clinic website (www.kidsorthok.com.au) goes into more detail about all the current options available to manage childhood myopia. Here is a summary:

REGULAR EYE TESTS

We recommend all children have yearly eye tests from the age of 3. Kids' eyes can change quickly and often without symptoms. Early detection of vision problems means earlier intervention. Undiagnosed and uncorrected short-sightedness can accelerate progression. And if there is significant progression, myopia control treatment should be initiated as early as possible. We monitor children with myopia progression every 6 months.
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ORTHOKERATOLOGY (ORTHO-K)

Ortho-K are overnight lenses that correct vision while your child sleeps. The two benefits of OK lenses are: (1) They correct your child's eyesight so that daytime glasses and regular contact lenses are not needed for them to see. This gives them complete freedom for all their schooling, sports and recreational activities without worrying about breaking or losing glasses or contacts. (2) They are clinically effective in slowing down your child's eyesight deterioration by around 50%, and sometimes more.

OK lenses work by gently reshaping the front surface of the eye with individually designed oxygen-permeable lenses that fit precisely on your child's eyes. You can think of orthokeratology as a little like orthodontic braces for align teeth. Over time the surface of the eye, the cornea, is molded to the shape of the lens to correct vision as well as provide myopia control.

​Some parents have concerns about safety of overnight contacts. Wearing contact lenses of all kinds carry potential risks of infection, but any significant adverse events with diligent Ortho-K wear are actually very rare. Studies have demonstrated that Ortho-K lenses for kids are no more risky than overnight wear of soft lenses by adults. OK lenses are worn at home under parental supervision, without the risk of contamination outside. Professionally fitted lenses, good hygiene and proper lens care will help ensure your child maintains healthy eyes wearing Ortho-K lenses. At our clinic we have any no episodes of infection or adverse events for our patients treated with OK lenses.

MYOPIA CONTROL SOFT CONTACTS LENSES

​There are now daily-disposable soft contact lenses that help slow myopia progression. As these lenses are replaced daily after each use, without any need for cleaning or storage, they are the safest type of contact lenses and ideal for kids and teenagers. We have the MiSight 1 Day with ActivControl Technology available at our clinic. This lens was developed specifically for short-sighted children to prevent eye deterioration.

These soft contact lenses are a 'multifocal' design with a clear distance zone in the middle, and a different power in the periphery of the lens. This mimics the effect of Ortho-K in modifying the focusing of light in the peripheral zone of the eye's surface. One key difference is that MiSight lenses are only effective while the lens is worn, so it needs to be worn at least 6 days a week, whereas the eye surface changes that occur with Ortho-K are longer-lasting and holds its myopia control effect even with occasional short breaks from overnight lens wear. OK lenses can also correct mild to moderate levels of astigmatism, while MiSight lenses are not available with astigmatism correction.

ATROPINE EYE DROPS

​Atropine is a chemical agent that helps prevent myopia progression by strengthening the structures within the eyeball to resist eye growth and elongation that occurs concurrently with adolescent growth spurts. Although atropine has long been known to exhibit this effect, it wasn't routinely prescribed for myopia control due to its known potential side-effects on the eye and elsewhere in the body — eg. pupil dilation, light sensitivity, headache, stinging, dry mouth, dry skin, heightened irritability and increased heart rate.

​In the past 5 years, researchers discovered that even tiny concentrations of atropine, thus much safer to use, can effectively help modulate myopia progression almost as well as the full-dose form. This low-dose 0.01% atropine is just 1/100th of the original atropine concentration. 0.01% atropine eye drops are very well tolerated in kids with minimal side-effects as a long-term treatment. In our clinic we have prescribed this treatment for children as young as 4 and have had good results. We have also combined atropine treatment with Ortho-K or soft contact lenses for even greater myopia control effect in some children with more aggressive progression.

MYOPIA CONTROL SPECTACLE LENSES

​Regular single vision glasses do not help to prevent myopia progression. There are special children's glasses specifically developed for myopia control. Although clinical research shows that glasses in general are not as effective forms of myopia control compared to the other options described above, they are nonetheless still beneficial for some children, and better than wearing ordinary glasses or no treatment at all.

​The myopia control spectacle lenses available from our clinic are the Essilor Myopilux lenses — developed originally for short-sighted children in Singapore and Hong Kong. These were special bifocal or progressive lenses and most effective for children with some near focusing difficulties or inefficiencies. Our optometrist will assess your child's eye focusing system to determine if he or she could benefit from wearing this type of lens.
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REGULAR BREAKS FROM NEAR WORK

Near work — which includes reading, drawing, study, homework, tutoring and computer use — is an essential part of your child's schooling and education. Many children are required to use an iPad or laptop computer at school. This is no avoiding digital technology that are intrinsic to our modern lives. We recommend following the 20/20/20 rule in regards to near work. That means for every 20 minutes of concentrated near focusing, take 20 seconds to look at something in the far distance 20 metres away. That helps your child to relax their eyes periodically. Also, children should always keep their books at least an elbow's distance away from their eyes when reading.
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SPENDING MORE TIME OUTDOORS

​If you child has been tested and found to have normal eyesight, the best you can do to preserve their good vision and potentially delay the onset of myopia is to let them spend more time outdoors in bright light. This is good scientific evidence that more outdoor time helps to prevent against myopia development. Ambient outdoor light is many magnitudes brighter than indoor light, and is believed to help modulate proper eye growth. We recommend all children spend at least 90 minutes a day participating in outdoor activities.

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If you have concerns about your child's eyes or would like to know more about our myopia control program, book a comprehensive kids' vision assessment with our experienced myopia control optometrist today.

BOOK AN APPOINTMENT

KIDS ORTHO-K | MYOPIA CONTROL

Philip Cheng — Myopia Control Children's Optometrist · 墨爾本兒童視光師
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EYECARE CONCEPTS · THE MYOPIA CLINIC
Kew · Balwyn · Balwyn North