Over 40% of Americans are myopic, according to the American Optometric Association, and this percentage is rising quickly, particularly among school-age children. According to eye specialists, this trend will persist in the upcoming decades.
What is Myopia?
Myopia or nearsightedness is a refractive error that causes blurry distance vision in children and adults. The condition arises when the cornea is too curved, or the eyeball is too long. This affects the corneal surface and the eye lens, causing the light entering the eye to focus in front of the retina rather than on the retinal surface.
Types of Myopia
Generally, myopia is diagnosed during childhood, when the eyes are rapidly developing, and it can get worse until they reach adult size, usually around age 18. There are three kinds of myopia, namely:
High Myopia
This is a severe level of nearsightedness that increases the risk of developing conditions like cataracts, glaucoma, macular degeneration, and retinal detachment. Usually, high myopia involves measures of -5.00 to -6.00 Diopters (D) or higher or uncorrected 20/400 visual acuity or worse. Typically, high myopia has a major hereditary component. The child is significantly more likely to develop it if both parents have it.
Progressive Myopia
This is a serious eye condition that worsens year after year. Typically, it occurs in childhood due to the continual elongation of the eyeball and can continue to the early adult years. It is a disorder that can increase the risk of vision-threatening eye diseases. More so if it progresses rapidly, with a large increase in optical prescriptions over a year.
Degenerative Myopia
This also is known as malignant or pathological myopia. It can present when high myopia advances quickly and can cause degenerative retinal abnormalities, including myopic macular degeneration.
An Eye examination during a routine checkup can help the doctor to spot any changes and identify any issues with your eye health.
Myopia has no cure, but there are multiple effective therapy options.
Myopia Treatment Options
Glasses
Glasses offer a quick and effective remedy for correcting myopia. The lenses correct the refractive error by changing the angle that light reaches the retina. The eye professional prescribes the eyeglasses after a diagnostic eye exam. The simplicity of eyewear makes this therapy option perfect for kids.
Contact Lenses
Contact lens prescriptions are generated using the same vision exams used to determine eyeglass prescriptions. Like spectacles, contact lenses also change the angle at which light enters the eye. The lenses float easily on the cornea because of the eye’s natural lubrication. Contacts are also considerably thinner since they are placed far closer to the cornea than spectacles.
Atropine
Atropine eye drops can successfully slow down children’s myopia progression. The eye drops have long been used to treat kids with amblyopia, sometimes known as “lazy eye.” The solution can dilate the eye pupils and treat uveitis. According to a study published in Ophthalmology (2019), using low-dose atropine eye drops (0.01%) before bed can successfully stop myopia from getting worse.
Although the exact mechanism of action is yet unknown, it blocks some visual signals to shorten the signal and make it longer. This can immediately affect the rate of myopic advancement by slowing the rate at which the axial length increases.
Orthokeratology or Custom Overnight Contacts
Orthokeratology (ortho-k) contacts can temporarily correct mild to moderate myopia by reshaping the eye’s cornea. In contrast to conventional lenses, ortho-k lenses are only worn at night. Once removed, the vision-improving effects, in the form of the corrected cornea shape, are maintained throughout the entire day.
You must wear the lenses every night to correct daytime vision continuously. Compared to glasses and other lenses, Ortho-k lenses have demonstrated a reduced degree of myopia over the long term, even after the usage of the Ortho-k has been discontinued. Studies have revealed that the technology is quite good at slowing the advancement of myopia, even though it was primarily developed to aid in improving patients’ vision.
According to the hypothesis, light in your peripheral vision is focused in front of the retina. The optical impulses the eye receives are altered by the Ortho-k lenses, which promote eye growth. To ensure their safety, patients must be meticulous about handwashing, cleaning, and disinfecting the lenses. But research indicates that this is a remarkably safe and successful course of treatment for treating kids of nearly any age with good hygiene.
Corrective Eye Surgery
Refractive surgery is the only available long-term treatment for myopia. Refractive surgery options include:
- Laser-assisted in-situ keratomileusis (LASIK): It is the most widely used procedure to treat nearsightedness. An ophthalmologist performs LASIK using a laser to make an incision through the cornea’s surface, restructure the inner corneal tissue, and then replace the flap.
- Laser-assisted subepithelial keratectomy (LASEK): The eye surgeon uses a laser to cut a flap through the corneal surface layer, remodels the outer layers, and then closes the flap.
- Photorefractive keratectomy (PRK). It is a less invasive laser eye surgery that helps to correct mild or moderate nearsightedness. It may also treat astigmatism and farsightedness. In a PRK procedure, an eye surgeon uses a laser to flatten the corneal surface, which allows light to focus on your retina. The doctor does not cut a flap like in LASIK. Because it disturbs less corneal tissue than a similar LASIK procedure, PRK is preferred for individuals whose corneas are thinner or have a rough surface.
Implantable Contacts
Phakic intraocular lenses (PIOL) are a great option for patients whose corneas are too thin for PRK or LASIK or who have high myopia. The ophthalmologist installs the PIOL inside the eye between the cornea and the iris or between the iris and the natural eye lens. If necessary, an ophthalmologist can remove these lenses at any moment.
With an intraocular lens implant, the ophthalmologist surgically replaces the natural eye lens with a new one. This process is carried out before a cataract develops.
Conclusion
There is no cure for myopia. Corrective lenses, whether spectacles or contact lenses are the conventional treatment for the disorder. However, while eyeglasses can enhance the clarity of vision to help you see better, they cannot stop the advancement of myopia. Specialized treatments aim at slowing or stopping myopia from worsening and can reduce myopia progression by up to 78%. The specialized treatments are individualized and consider the patient’s age, optical prescription, and personal lifestyle.
