My child has nearsightedness; what are my options?

Myopia or Nearsightedness is an error of refraction where a person has difficulty seeing at far.

On the left, light coming inside the eye can be seen focused on the Retina. On the right, the image can be seen to be focused in front of the retina due to the eye being longer, and/or the lenses of the eye having dioptric power higher than what is needed.

The most common reasons why a person has nearsightedness are:

The transparent lenses, the Cornea, and the Lens are too strong (+) in comparison to the length of the eye. This is why people with nearsightedness need to wear minus (-) lenses to see clearer.
The axial length of the eye is too long in contrast to the lenses in the eye. The rule here is the longer the axial length of the eye, the higher the nearsightedness is.

The second reason mentioned above (the axial length) is significant to children who had inherited or have developed nearsightedness at an early age. The axial length is significant because as a child’s body grows, along with it is the axial length.

Some factors can influence the speed of progression of their nearsightedness, factors like:

Amount of time spent outside the house, especially in the daytime.
Less time outside may speed up the progression of Nearsightedness.
This is why children with nearsightedness who spend some time playing outside may develop lower nearsightedness as compared to children always indoors.
The amount of near work.
This includes books, personal computers, laptops, smartphones, tablets, simply everything you can reach with your hands. Children with nearsightedness that do near work for a long period of time may cause their Nearsightedness to progress faster, as compared to children with less near work.
Having both Myopic Parents.
Children with one or both parents with Nearsightedness will have a higher chance of growing up and developing nearsightedness. This is why it’s important to screen your children’s vision at an early age if one or both parents have Myopia.
(Source: Liao C, Ding X, Han X, Jiang Y, Zhang J, Scheetz J, He M. Role of Parental Refractive Status in Myopia Progression: 12-Year Annual Observation From the Guangzhou Twin Eye Study. Invest Ophthalmol Vis Sci. 2019;60(10):3499-3506.)
Southeast Asian Ethnicity
People with Southeast Asian ethnicity have a big chance of developing Myopia.
(source: Jiang X, Tarczy-Hornoch K, Cotter SA, Matsumura S, Mitchell P, Rose KA, Katz J, Saw SM, Varma R; POPEYE Consortium. Association of Parental Myopia With Higher Risk of Myopia Among Multiethnic Children Before School Age. JAMA Ophthalmol. 2020 May 1;138(5):501-509.)

How do we deal with Childhood Myopia?

Most of the time, children with nearsightedness are only given single vision lenses to make their vision clear, not addressing the progression of their nearsightedness.

Although it's hard to completely stop the progression of nearsightedness, many kinds of researches have shown that we can slow down nearsightedness by effectively slowing down the axial length growth.

Here are some of the ways to slow down nearsightedness:

1. Atropine Drops

In the Philippines, the drops are prescribed mainly by Ophthalmologists. These eye drops have been used for years in slowing down nearsightedness. Atropine drops may be used alone but are more effective when used with other Myopia management methods.

2. Orthokeratology

Orthokeratology is the process of wearing a unique lens that corrects your vision while sleeping. It gently reshapes the Cornea while sleeping. This method has also been seen to slow down the progression of Myopia in children and has one of the strongest effects in slowing down Nearsightedness. In fact, combining Atropine and Orthokeratology can even slow down the growth of Nearsightedness than using Orthokeratology or Atropine alone.
(Source: Gao, C., Wan, S., Zhang, Y., & Han, J. (2021). The Efficacy of Atropine Combined With Orthokeratology in Slowing Axial Elongation of Myopia Children: A Meta-Analysis. Eye & Contact Lens, 47(2), 98-103.)

This is an Orthokeratology Lens placed in front of an Eye. While the lenses are worn, it slowly reshapes the central part of the Cornea. The user wakes up with clearer vision without wearing any correction.

3. Soft Contact Lenses

Many Soft Contact Lenses, especially those with a Center Distance design, have proven to slow down nearsightedness. Take note that these special soft contact lenses are different from the single vision Contact Lenses.

4. Spectacle Lenses

There are spectacle lenses designed to slow down the progression of nearsightedness. Some of these lenses are MiyoSmart by Hoya, MyoVision, and MyoKids by Zeiss, as well as Myopilux by Essilor. Each lens manufacturer has its own papers regarding how effective it slows down nearsightedness. These can be combined with Atropine drops if the speed of progression is high.

In summary,

It is important to have your child’s vision examined by a Pediatric Ophthalmologist or a Pediatric Optometrist if one or both parents are Nearsighted. The earlier we manage their nearsightedness, the more nearsightedness we can prevent. The lower the nearsightedness, the shorter the axial length, and the less chance of any Nearsighted related eye disorders in the future.
Single Vision lenses do not help with the progression of nearsightedness.
Atropine Drops, Orthokeratology Lenses, Center Distance Soft Multifocal Lenses, and Myopia Management lenses are good options in slowing down nearsightedness. Never be afraid to ask your Eyecare Practitioner about these options.

Are you worried about your child's vision increasing? Send us a comment down below! Will do our best to answer your questions.