Nearsightedness: What's the Big Deal?
Myopia, or nearsightedness, is a condition where the light entering the eye focuses in front of the retina, rather than on the retina, creating a blurred image for far away objects. Objects up close are often seen clearly, so this is how this condition got its name.
The eye on the left is a normal eye. The eye on the right has myopia, notice the light focusing in front of the retina. Photo taken May 5, 2023 from:
https://webvision.med.utah.edu/book/part-xvii-refractive-errors/the-science-behind-myopia-by-brittany-j-carr-and-william-k-stell/Nearsightedness is becoming much more common now than it was several years ago, and the problem has only been exacerbated by the COVID-19 pandemic. According to
https://coopervision.ca/practitioner/myopia-management, in a study of Canadian school children aged 11-13, almost 30% were nearsightedThere are multiple risk factors including family members with nearsightedness, time spent outdoors and the amount of time we are spending on the computer and tablets, often at close working distances.
So every time you or your child goes to the optometrist, the prescription increases and stronger glasses are needed to see clearly. Why is this important? Your child can simply get a new eyeglass or contact lens prescription and they will be able to see well again right?? WRONG!! Nearsightedness does not come without complications!!!
We want to make every effort to keep the length of the eye below 26mm. Myopic individuals with an axial length less than 26mm have a lifetime risk of vision loss of 3.8% (best corrected vision of 20/40 or worse by age 75)1. If the eyeball then grows larger than 26mm, this risk jumps to 25%. That statistic has really driven home for me, the importance of treating young myopes as early as possible so that the growth of the eye can be slowed enough to allow the eye to continue growing at a normal rate throughout the rest of childhood and through adolescence.
Who is at risk for Myopia?
There are multiple risk factors for the onset of myopia as well as myopia progression:
- Age 9 or under-one or both parents are nearsighted
- Asian ethnicity
- Lots of time spent on nearwork
- Minimal time spent outdoors
- Size of the eyeball increased from the age expected value (eyeglass prescription out of range for a child’s age). At Sage Creek eye centre, we are equipped with a device called an ocular biometer that can measure the length of the eyeball. This service is offered to all children during their routine eye exam.
Why is myopia a problem?
Having myopia puts you or your child at an increased risk for eye disease later in life. In some cases, eye disease caused from myopia can cause blindness. These include:
- Retinal tear or detachment
- Pre-mature cataracts
- Glaucoma
- Myopic maculopathy (myopia induced macular degeneration)
As our eyes continue to become more nearsighted, the eyeball continues to grow larger and larger. The problem with this is that as the eye grows, the retina (the thin layer of tissue that contains the photoreceptors (seeing cells)) gets stretched thinner and thinner to cover a larger eyeball. This can cause an increased risk of vision problems in the future, some with the potential to cause blindness.
According to the information on
MyopiaProfile.com, a -1.00 to -3.00 myope has 3X the risk of having a retinal detachment at some point in their lifetime. This risk increases to 9X if you get in the range of -5.00 to -7.00 and as high as 44X more likely if over -7.00!!!!!
This is VERY alarming! But the GOOD NEWS is, there is something you can do to slow down or prevent this progression.
What can I do to slow down the progression of nearsightedness?
Some of the most effective options are prescription eye drops, specialized soft contact lenses, hard lenses called orthokeratology lenses or specialized eyeglass lenses such as the HAL and SAL technology, among others. A certain combination of these may be indicated in certain cases.
Book a myopia management consultation with one of our optometrists today and ask which option would be best for you or your child.
Once myopia increases, it very rarely (almost never) decreases, so it is extremely important to begin treatment early if the trend of increasing nearsightedness is observed or even in cases where we suspect they may become nearsighted at all.
Further scientifically-based, independent advice on childhood myopia and its management, can be found at
myopia profile.
Myopia Management: What are the treatment options?
Daily soft contact lenses for myopia management
Daily soft contact lenses such as the Coopervision Misight and Naturalview multifocal lenses have been shown to reduce the progression of nearsighteness when worn for a minimum of 6 days per week, 10 hours per day. They are a great option for those with little to no astigmatism correction.
Peripheral Defocus Eyeglass Lenses
Eyeglass lenses with peripheral defocus have been shown to reduce the progression of nearsightedness when worn full time. There are several options available. This option is great for those first starting to wear correction, and can accommodate a large range of eyeglass prescriptions.
Orthokeratology Lenses (orthoK)
Orthokeratology lenses are hard lenses, or molds, worn on the eye overnight during sleep. They gently reshape the front surface of the cornea to correct for the prescription so that no additional eyeglasses or contact lenses need to be wor during the day
Low Dose Atropine eye drops
Low dose atropine eye drops have been shown to reduce the progression of myopia when taken in each eye at bedtime each night. These drops are a good supplement to any of the treatment options listed above. Low dose atropine must be used in conjunction with an optical correction in order for clear distance vision to be achieved.
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