Can anything be done about my nearsightedness? Myopia management tips and treatments

Written by Hollie Reina, St. George News

In some Asian countries around the world, cases of myopia have reached almost epidemic levels, said Dr. Ryan Robison, an optometrist at SouthWest Vision.

Though the United States is not quite at the level of Asia, Robison said, doctors and researchers have identified a similar trend, noting that cases of myopia here are on the rise.

What is myopia?
According to the National Eye Institute, myopia – or nearsightedness – occurs when the eye grows too long from front to back. The result is the misalignment of light on the retina.

People with myopia have good near vision but have poor vision at distance, meaning they may be able to read books or see images on a computer screen but struggle to see things that are farther away.

Myopia can also be the result of a cornea – the eye’s outermost layer – that is too curved for the length of the eyeball or possibly a lens that is too thick, the National Eye Institute’s website states.

Causes of myopia
Some of the most common causes of nearsightedness, Robison said, are children and adults spending too much time indoors and reading books and screens at close distances.

This is particularly exhibited in Asian cultures that put extreme academic pressure on schoolchildren and adolescents, according to a study led by Ian Morgan of Australian National University and printed in Time Magazine.

The report further stated that up to 90 percent of young adults in major East Asian countries, including China, Taiwan, Japan, Singapore and South Korea, are nearsighted.

While Robison wouldn’t encourage people to stop reading and studying, he did say that avid readers have a higher chance of developing nearsightedness due to the amount of time spent reading at close distances.

People who spend a lot of time on computers, smart phones and tablets are also at increased risk of developing myopia.

One of the most simple counter measures a person can take in these cases, Robison said, is go outside.

Both the natural light and vitamin D received from sunlight have been shown to help, he said, but the most key thing for vision that comes from being outside is the spacial visual demand of open space.

“When you have that open space it helps prevent that near exchange that happens when your world is so close to you all the time,” Robison said. “If you send kids outside more they will less likely become nearsighted than if they are indoors all the time.”

One of the biggest indicators that a child will develop myopia, however, is genetics.

“We have always understood that being nearsighted is some combination of environment and genetics,” Dr. Robison said.

When one or both parents are nearsighted the odds of the children developing myopia drastically increase.

This explains why cases of myopia have exploded in Asia, Robison said. As a general rule, Asian people are more prone to nearsightedness. Combine that with generation after generation of families passing it on to their offspring and a heavy focus on education, and the effects become compounded.

Additionally, myopia appears to be a progressive condition. Robison said the earlier a person develops nearsightedness, the worse it will likely become as they age.

“The reality is that kids, when they become nearsighted at an early age and they are continuing to go through growth spurts, the nearsightedness will grow with them,” he said.

There is a point when most people with myopia will experience a leveling off – usually in the early to mid-20s – but that still depends on how early the person developed nearsightedness.

Myopia management
The big question then becomes: Is there anything that can be done about it?

The short answer is yes, Robison said. Because myopia is being seen in such drastic and increasing numbers all over the globe, a lot of research has been put into treatment options that could manage the progressive growth.

When diagnosing myopia, early intervention is key to reducing the amount of distance vision loss a person will experience, Robison said. If one or both parents or any of a younger patient’s siblings have nearsightedness it becomes even more key.

Children should have their first well-check eye exam by the age of one, Robison said, and then every one to two years to monitor for any changes in their vision or eyes.

Once it has been established that a person has myopia there are a few treatment options available.

The first line of treatment at any age, but especially for young patients, is an eye drop that contains a low concentration of atropine, a drug that in its full strength is used to dilate the pupil.

When administered daily in a low dose, atropine stimulates the eye muscles enough to control the myopia and prevents the progressive change normally seen with the condition.

For patients who have had nearsightedness for a longer period of time and are already using some form of vision correction, Robison offered three main options for controlling myopia: low dose atropine drops, bifocal soft contact lenses or a hard contact lens worn at night that reshapes the cornea.

The preferred method of treatment will generally depend on the patient’s age and dedication in adhering to their treatment plan, Robison said.

However, when it comes to myopia management the best way to simultaneously manage nearsightedness and prevent it from getting worse is the hard lens worn at night similar to a retainer that is worn in the mouth to straighten the teeth.

This method of treatment is known as orthokeratology.

“We’re trying to reshape the cornea,” Robison said, adding that the effect is twofold. It makes it so the patient does not need to wear corrective lenses during the day, and it prevents or slows the progressive change that occurs with myopia.

This method of correction is great for adults who want to be free from glasses or contacts during the day and don’t want surgery to correct their vision. Dr. Robison said that adults can have orthokeratology correction to give them that freedom, and unlike LASIK, orthokeratology is reversible.