Myopia Management - Ortho-K

Managing Myopia

Myopia  (short sightedness) occurs when the eyeball is too long or too powerful resulting in blurred distance vision. People with myopia are unable to read the board at school, or need glasses for driving. Vision for near objects is clear, within a close range.  Once someone becomes myopic their vision tends to get worse over time and glasses and contact lenses become stronger. The greatest change is usually in childhood and teen years.

Why do we need to control myopia?
High levels of myopia are associated with increased risk of eye diseases such as glaucoma, cataracts, retinal detachment and macular degeneration later in life.

Can you (really) slow or stop myopia?
Yes! Most people can slow down or stop their eyes from becoming more myopic. This is exciting news which resonates with all parents who are short sighted.

What causes myopia development and progression? 
Genetics, individual characteristics and environment. 

In the last 10 years, there has been considerable research into finding the environmental factors which cause myopia progression. Much has been learned from work in animal models. Current understanding is the stimulus to axial elongation—and hence to myopia progression—is defocus not in the central retina but in the mid-periphery. In experimental models, peripheral focus has emerged as very important.

Optometrists can help reduce progression of myopia. We evaluate the whole clinical picture, measuring vision and prescription, recording family history, understanding reading habits and outdoor activity. There are different options to correct vision. Research shows us how each option will influence myopia development. We can intervene and hopefully stabilize vision changes

Techniques include progressive/bifocal glasses with reading power, multifocal soft contact lens, prescription eye drops and Ortho-K contact lenses to reshape the eye. When we have completed an eye examination we can discuss each of these options in full.

Orthokeratology (Ortho-K)

Ortho-K is the use of specially designed rigid contact lenses worn overnight. The contact lens gently reshapes the cornea giving clear vision the following day without contact lenses or glasses. The effect of the lenses is temporary, giving  a day of clear vision and lenses need to be worn every night. (If the lenses are not worn at night, vision will be blurred again the next day).

Overnight Ortho-K lenses produce a corneal shape that seems to be ideal for preventing axial length progression. Ortho-K makes use of “reverse geometry” lenses that are relatively flat in the center. Wearing these lenses at night causes the cornea to become temporarily flat centrally and a little steeper in the mid-periphery. As a result, the Ortho-K produces focused central and mid-peripheral images, which is useful for myopia control.

Although RGP lenses are not known for being comfortable, Ortho-K lenses are worn only at night when sleeping, so there is no discomfort from lens-lid interaction. These are large lenses that don’t move on the eye and provoke sensation. In addition, the materials used are highly oxygen permeable.

Ortho-K is very satisfying for the practitioner. For many children, getting out of glasses gives a big boost to self-esteem; and their parents are thankful to be doing something positive for their children by reducing their myopic progression. Among kids who are active, Ortho-K is safer than glasses for contact sports and safer than ordinary contact lenses for swimmers. Myopia control is just one of many positive benefits of Ortho-K.

Myopia Control

Myopia, or shortsightedness, means distance objects appear blurred and out of focus. In everyday language we use ‘myopic’ to describe a person with a short range focus. Myopia is a growing problem throughout the world. Uncorrected myopia is the second most common cause of blindness globally. Estimates show 22.9% of the world suffers from myopia. Of particular concern are the group with very high prescriptions, or high myopia.

Myopia is not just the need for glasses and high myopia is not simply thicker lenses. With myopia comes increased risk of eye conditions like glaucoma, retinal detachment and macular degeneration. These risks increase with higher prescriptions. 

It is understood there is a genetic component to myopia. Having one parent who is myopic doubles the risk of becoming short sighted. Two parents increase the risk by 8 times. Environmental factors also seem to influence the development of myopia. These include time spent indoors versus outdoors. More time outdoors seems to result in less myopia. Spending a lot of time on close range work, reading and screens, is also associated with more myopia.  

If a child is myopic, the likelihood is this will progress as they grow; while some children have slow rates of progression, for others vision changes rapidly. 

How to control myopia in children has become a hot topic for optometrists. Fortunately there are effective ways to intervene and slow myopia progression. These include Ortho-Keratology (hard contact lenses), multifocal contact lenses, atropine eye drops and progressive or bifocal glasses. Talk to us about the best options for you or your children.

For more information see our resource page, or contact us directly.