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Today, more children in Australia and around the world are developing short-sightedness (myopia) and from an earlier age. But thankfully we can now slow childhood short-sightedness progression and help prevent high myopia with effective treatments which weren't available a generation ago.
As one of Melbourne's leading myopia control optometrists, many of the kids who come to our practice have parents who have high myopia themselves (some as high as -10.00 to -16.00) and understandably very concerned about their children's eyesight growing up. Myopia is, at least in part, a hereditary condition. Children with both parents having myopia have a 6 times risk of developing short-sightedness, and more severely.
So at what age can we start myopia treatment for your child?
There is no age requirement for starting myopia control treatment. We recommend starting treatment as soon as we have identified that your child is at high risk of developing high myopia (> -6.00) in the future. This reduces your child's lifelong risks of glaucoma, retinal detachment and myopic macular degeneration — diseases with a potential for blindness.
Here at Eyecare Concepts, we have prescribed myopia control treatment for children as young as 3 years of age.
Which children are in the high-risk category for myopia?
Younger children, those at age 7 or under at the time of being first diagnosed with short-sightedness, are at highest risk. And the younger the child, the greater the risk — there is more time for the eyeball to grow and elongate as the child grows through the years of adolescence and puberty.
We also analyse individual data for each child to determine their rate of myopia progression per year. A documented myopia increase of -1.00 or more in a 12 month period is considered rapid progression that should be treated.
Is it possible to predict if a child will become short-sighted?
Yes, it is possible to make predictions based on a child's current level of refractive error. Generally, across the population, a normal 3 year old child should be long-sighted by around +2,00, a 4 year old around +1.50 and a 6 year old around +1.00. Long-sightedness acts as a buffer to prevent short-sightedness in a normally-developing eye.
If we identify that your child is less long-sighted than is normal for his or her age, your child has a greater risk of developing short-sightedness and needs to be monitored more closely. For example, a child who is only +0.25 long-sighted at age 4 has a very high myopia risk, especially if this child has other risk factors such as genetics. There are specific tests we do to accurately measure the refractive status of a young child.
Can we prevent the onset of myopia with treatment?
Recent studies have shown that spending more time outdoors (for at least 90 minutes a day) has a protective effect on the eye and can prevent or delay the onset of childhood short-sightedness. For children who are not yet short-sighted but are at risk, we prescribe an increase in outdoor time as a preventative measure.
Low-dose atropine treatment is highly effective in slowing progression once a child is already short-sighted, but there is little clinical data at present on its effect for myopia prevention in children with normal eyesight. There is some suggestion that it can indeed prevent myopia onset. We would assess the possibility of prescribing low-dose atropine for myopia prevention in a child without myopia on a case-by-case basis by weighing up the potential benefits vs risks.
Certain glasses may help children who have difficulties with near focusing and eyestrain that can increase their risk of myopia development. Binocular vision testing is part of the comprehensive children's vision assessment in our clinic to identify these at-risk children.
If you have questions about myopia control treatments for your child, please contact our clinic.
EYECARE CONCEPTS · THE MYOPIA CLINIC
MELBOURNE MYOPIA CONTROL OPTOMETRIST — KEW · KEW EAST · BALWYN
Philip Cheng - B.Optom (Melb) Ocular Therapeutics (GCOT). Optometrist at Eyecare Concepts Kew East, Melbourne. An experienced eye care & contact lens practitioner with expertise in myopia control & orthokeratology.