Myopia Control
Myopia control are treatments that are intended to slow the progression of myopia (nearsightedness).
These treatments can induce changes in the structure and focusing of the eyes to reduce stress and
fatigue associated with the development and progress of nearsightedness. The younger one starts, the
better the outcome.
WHY SHOULD YOU BE INTERESTED IN MYOPIA CONTROL?
If your child has myopia (nearsightedness), most likely they will need stronger eyeglasses year after
year.
The more nearsighted someone is, the thicker their eyeglasses are and high levels of myopia puts
patients at risk of early cataracts, glaucoma, and detached retinas.
The good news is that recent studies have shown it possible to control myopia.
There are several types of treatments that have shown promising results for controlling myopia. Myopia
control may also be an option for young adults who are still experiencing changes in their prescription.
1. Atropine Eye drops
a. This drop is a medication that is used to dilate the pupil and completely relax the eyes
focusing mechanism. For myopia control, a very low dose (0.01%) is put into the child’s
eyes at bedtime. Upon awakening, there is generally no side effect from the drops.
Some studies have found a reduction of myopia progression of 81%. The
recommendation is to treat for two years with drops then stop the drops for a year to
see if progression occurs. If progression occurs, then re-start the drops for 2 more
years.
2. Multifocal cContact Lenses
a. These are special contact lenses that mhave different powers in different zones of the
lens. The child wears the contact during the day and removes at night. Studies have
found that children wearing the multifocal contact lens had 30-54% less progression of
their myopia. The vision with the multifocal contact lenses is generally not as sharp as
regular contact lenses or eyeglasses.
3. Atropine Eye drops and Multifocal contact lenses
a. The multifocal contact lenses are worn during the day and removed in the evening. The
eye drop is put in the eyes at bedtime each night.
4. Ortho-K
a. Ortho K is the use of specialty designed gas permeable contact lenses that are worn
overnight to temporarily correct nearsigtedness so glasses and contact lenses are not
needed during waking hours. Studies have shown an effect of 43% reduction in the
progress of myopia.
Treatment Plans for Myopia Control
After an in-depth compressive eye examination, we will develop a treatment regimen for your child on a
case by case basis. It may involve atropine drops, special multifocal contact lenses, Ortho K or a
combination of atropine drops and multifocal contact lenses. Pricing includes all visits, drops, and
multifocal contact lenses.
Year 1 cost = $1900-$2200 (Nowell’s cost)
Year 2 cost= $1600-$1900 (Nowell’s cost)
Schedule of visits
Initial visit: Eye exam with cycloplegic refraction. Start Drop and/or contact lens wear. Dilation
may last up to 12 hours
Followups:
o 1-2 week visit: intermediate eye examination. Check for any side effects, check pupils
o 1 month followup: intermediate eye examination, check for any side effects, check
pupils
o 3 month followup: Intermediate eye examination, check for any side effects, check
pupils
o 6 month followup: cycloplegic refraction (diation may last up to 12 hours)
o 12 month followup: Comprehensive eye examination
o **Any additional visits necessary will be included in fee. Wellness eye examinations are
not included. Does not include eyeglasses, solutions, or any other type of contact lens
Consider these facts if your child has myopia
In Americans aged 12 to 54 years, the prevalence of myopia has almost doubled to over 40% in
the past 30 years
High myopia is strongly linked to higher risk of cataracts, retinal detachment, and myopic
maculopathy. Increasing rates of vision impairment and blindness due to the latter are already
evident in Asian countries.
Even 1.00D of myopia doubles the risk of myopic maculopathy and posterior subcapsular
cataract, and triples the risk of retinal detachment compared to emmetropes (not requiring
correction).
At 3.00D of myopia, the risk of posterior subcapsular cataracts triples, and the risk of retinal
detachment and myopic maculopathy is nine times that of an emmetrope. Once children reach
5.00D of myopia, they hold a five times greater risk of posterior subcapsular cataract, a 21 times
greater risk of RD, and a 40 times greater risk of myopic maculopathy.
However myopia control is not just applicable to myopies; exhibiting less than 0.50D of manifest
hyperopia at age 6 or 7 years is the most significant risk factor for future myopia, independent
of family history and visual environment.
The fastest rate of refractive change in myopic children occurs in the year prior to onset, so
children who are less hyperopic than age normal should be loosely monitored, especially if
concurrent risk factors of family history or binocular vision status are evident.
Children who have one myopic parent have a three-fold risk of myopia development compared
to their peers who do not have this family history; two myopic parents double this risk again.
On the positive side, a strong family history of myopia has resulted in stronger treatment effects
in studies investigating efficacy of progressive and novel spectacle lens designs for myopia
control.
Initiating myopia management strategy for pediatric patients should ideally commence before
they become myopic in view of the risk factors described above
Other ways to slow myopia progression
Outdoor time: studies have shown that being outside 2 hours per day can help prevent myopia
progression. I.e. walking, biking, tennis, golf, walking the dog, skateboarding, rollerblading,
hiking, and yard work
Removing your eyeglasses when you are doing close activities such as reading, writing,
computer use, texting, and studying.
Replace all light bulbs with a full spectrum bulb (bulbs that are similar to the sun). These can be
found at Home Depot or Lowes
