Myopia Management | Medicine Hat

What is Myopia?

Myopia, also referred to as nearsightedness, simply means that without glasses or contact lenses, a person cannot see well in the distance. Myopia is very common; In fact, if you were to survey a large group of people who wear glasses, you would find that most of these people would be nearsighted. It is found that undiagnosed myopia in children can lead to a lower quality of life and potentially lead to eye conditions and diseases down the road.

In addition to being very common, it is becoming increasingly more prevalent globally. The incidence of myopia is increasing at such an accelerated rate that it is now considered an epidemic (not to be confused with a pandemic 🙂).

20/20 Vision Care provides myopia management options for kids as well as a great selection of kid’s glasses for you to browse. Visit us today!

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Importance of Myopia Management

If myopia is diagnosed in a person’s childhood or teens, their myopia will almost always increase every year until their late teens/early twenties. Many studies have investigated these rates of progression in children and teens and they have found that the rates of change of myopia are rather predictable, depending on the age, race, and prescription of the child. As myopia increases through childhood and the teen years, this is not only a nuisance for the children and teens living through these rapid changes, but it is also an annoying and expensive ordeal for parents due to the frequency of replacing and updating lenses is not cheap.

As optometrists, not only are we very aware of these challenges, but we also have our own concerns with respect to the long term health of the eye. You see, the more myopic a person becomes, the longer their eye becomes, which means that the retina is more stretched. As such, a person with high myopia is much more likely to develop ocular health concerns such as retinal detachments, retinal breaks, early onset posterior vitreous detachments, posterior staphyloma, lacquer cracks, and more.

Myopia Management Options

This has been a question that has echoed loudly in the ears of eye care professionals and researchers for many years. Hundreds, if not thousands, of studies have been published about this very topic. Over the years we have learned a lot about what works, and what doesn’t. In this article we will only focus on the things that have been clinically proven to successfully reduce the rate of change of myopia in children and teens.

Before reading about what works, please note these important details:

These clinically proven methods will only work for children and teens (not adults).
These methods must be used on a regular/daily basis in order to be effective. They will not work if they are used for a short time (like weeks or months). Each of these management options are most effective if used every day throughout childhood and into the late teens.
More than one of these proven management strategies can be used at the same time, which increases the effectiveness. See an example of data here.
None of these strategies will reverse myopia. However, each of them have been clinically proven to effectively reduce the rate of change of myopia. In other words, your child’s prescription will likely still change, but not nearly as much as it would without these strategies.

Even though small amounts of myopic change are still expected with these strategies, please remember that the less myopic a person is, the less likely they are to develop the serious ocular health conditions listed in our previous question.

Low concentration atropine eye drops

This approach of controlling myopia involves putting a single drop of prescription eye drop in each eye before bed. The most famous study about this approach is the LAMP study, which has now published over 3 years of data proving that low concentration atropine eye drops can effectively slow the axial lengthening of the eye, which is what causes myopia to worsen through childhood.

Myopia control glasses

Most lens manufacturers have now produced a lens that is proven to slow myopia. A couple examples of these types of lenses (and their manufacturers) include:

MiyoSmart (made by Hoya)
Stellest (made by Essilor)

Probably the most well known of these lenses is the MiyoSmart lens because it was the first of its kind, and it has the most data to prove its effectiveness. Each of these types of lenses contain highly advanced technology embedded into the lenses. The lenses contain lenslets which redirect the light coming into the eye to change its focal point so that the light is focused at its optimum location along the retina.

Myopia control soft contact lenses

These types of soft contact lenses operate on a similar principle as the glasses described above. The peripheral aspects of the contacts redirect light to its optimum location along the peripheral retina in order to successfully achieve reduced rates of progression of myopia. There are also years of data to support that this option works well. One of the most well known contact lenses of this type is the MiSight lens made by coopervision.

Orthokeratology

Orthokeratology was perhaps the first proven method of slowing the rate of change of myopia and has the most long term data to support its benefits. Hundreds of scientific studies have been conducted about this method alone. Interestingly, orthokeratology is the use of hard contact lenses that you actually sleep in (yes, you heard that correctly) and while the person is asleep, these contacts reshape the front refractive surface of the eye (the cornea).

This is not a permanent reshaping, but when the person wakes up, they are able to remove the hard contacts and enjoy clear vision without the use of glasses or contacts during the day. The lenses however, must be reinserted each night.

This strategy not only makes for a convenient visual experience during the day, but the cornea’s new shape also contributes to reduced rates of progression of myopia.

The Cost of Myopia Control

It is important to know that investing in Myopia control is important for your child’s health. That’s why we’ve included a breakdown of the cost of each of these Myopia control strategies.

Low Concentration Atropine Drops

Cost: At present, Atropine drops cannot be purchased at most pharmacies. These drops must be compounded in a compounding pharmacy that specializes in eye drops. Right now there is one pharmacy in Medicine Hat that can order these (Solutions Pharmacy). Alternatively, there is a pharmacy that can make these drops is in Lethbridge. Because of the complex process of making these drops, each bottle of eye drops costs about $90.

The total cost for these drops is about $540 per year.

Myopia Control Glasses

MiyoSmart lenses cost $800 per pair (not including the frames). Despite the high cost, the manufacturer of these lenses knows that kids’ prescriptions change regularly, so gratefully these lenses come with three free replacements over a 2 year period even if the prescription has changed! In addition, there are other warranties with scratches that are also covered.

As such, purchasing these lenses is a $800 investment that will last at least 2 years.

Myopia Control Soft Contact Lenses

One of the only myopia control soft contact lenses on the market is called MiSight. These lenses must be worn by the patient at least 6 days per week for at least 10 hours per day to be effective. MiSight contacts are 1 day disposable contact lenses (so kids and teens don’t have to worry about challenges of cleaning the lenses). The cost for these lenses is $120 for a box of 90. Each eye is usually a different prescription, so for 90 pairs of these contacts (3 month supply), it is $240.

A one year supply of these contacts is $960.

Orthokeratology (Ortho-K)

Orthokeratology is quite a process to fit and make work and can take several visits to the office before the lenses can be ordered.

The cost of the contact lens fitting and the contacts is about $950. These lenses are reusable and usually last 1-2 years.

Advantages and Disadvantages

Before making this important decision for your child’s eye health, it is important to understand the pros and cons of each Myopia Management option.

Low concentration atropine eye drops

Disadvantages: 1) The drops must be refrigerated. 2) For some patients, they will notice mild blur for near tasks for a short time in the early morning, 3) The pupils are slightly larger when using these drops, so some children are a bit more light sensitive when using this approach.

Advantages: Simplicity! One drop in each eye before bed and that’s it. Like all the methods mentioned, it is proven to reduce the rate of progression of myopia.

Myopia control glasses

Disadvantages: There are almost no disadvantages to this approach. After all, children will need to wear glasses anyway. The only potential disadvantage we can think of is that some children feel their vision is not as clear for the first few weeks of wearing the lenses, but children get used to things after a week or two.

Advantages: When you consider that the $800 purchase of lenses covers prescription changes and warranties for two years, this is one of the most economical ways to engage in myopia control. It is also not a deviation from any daily tasks. No drops, no contacts, just put on your glasses and go!

Myopia control soft contact lenses

Disadvantages: As you can see, myopia control soft contact lenses is among the most expensive of the options.

Advantages: Despite the cost, if your child is able to tolerate contact lenses, this is a great option. Many children and teens don’t like glasses, so this is a wonderful option, espeically for those who are involved with sports. Once again, like all the other methods discussed, this is also an effective way of reducing the rate of progression of myopia.

Orthokeratology

Disadvantages: The fitting process is quite costly and will sometimes require many visits to the office. Sleeping in the contacts can be somewhat challenging for some children/teens. Also, Orthokeratology will only work for a certain prescription range, so it is not for everybody. Another disadvantage we as doctors have noticed is that it is not uncommon for the parents to be more enthusiastic about this option than the child. As such, we have noticed that the biggest reason for a child stopping the use of orthokeratology is because the child notices the inconveniences of this option and discontinues wearing the contacts despite the parents wanting them to continue.

Advantages: This option allows for the patient to see well without glasses or contact lenses during the day, and it is also an effective way of reducing the risk of progression of myopia.

We encourage parents to think about these options and to decide what is best for their child. Additionally, the opinions of the child are of also important, and we have found that the most successful approach for ensuring long-term management throughout childhood and teens is when the child is involved in the decision making process.

Can we switch management strategies halfway though childhood?

Absolutely. Sometimes a child will get tired of one option and want to try another choice. This is perfectly fine, and not uncommon.

To understand what Myopia Management strategy is best for your child, book an appointment with us, or give us a call to learn more.

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Our Family

At 20/20 Vision Care, we provide comprehensive vision care services, including eye exams, contact lens exams, dry eye therapy, and a wide selection of frames and lenses.

Designed specifically to best manage eye-related health concerns and disease. We also handle urgent eye care matters like foreign bodies, infections, and trauma.

Your children undergo crucial visual development at a young age, and we want to be a part of this journey. We offer children’s eye exams and myopia management to help your children thrive.

We understand that not everyone can make it into our office, so we offer mobile services for those that are homebound, and service the senior homes in our area as well.