What is Myopia?

Myopia, long considered a simple nuisance, can actually have a long-term and damaging impact to an individual’s ocular health.

How much myopia is “too much” myopia?

This is a difficult question, as some experts claim that there is no safe level of myopia. At Somerset Eye Care we look at two main aspects of your child’s myopia.

1. The first is what their age-expected myopia is:
If your child is 6-7 years old and already myopic, they are considered “early onset” and more likely to have a higher prescription later in life.

2. The second aspect is your child’s rate of progression:
If the prescription is progressing faster than 0.50 diopters/year, this is considered “rapidly progressing.”

If your child matches one or both of these aspects, it is important to find ways to slow down progression.

Options for Treatment

Several studies have shown that the following treatments are effective at reducing the rate of myopia progression.

OrthoK Lenses/Overnight Vision Retainers:
OrthoK is a unique treatment method that is effective in reducing the rate of myopic progression. The retainer lenses are inserted prior to bedtime and are slept in overnight. This custom designed lens gently molds the eye overnight and allows the patient to see 20/20 during the day without glasses or contacts. Patients are very happy with this lens because it provides both non-invasive vision correction as well as reduction of myopic progression. For patients that fit the parameters for this treatment, it is our primary recommendation.

Daytime Soft Multifocal Contact Lenses:
Specific soft multifocal contacts with a specialty design have been proven to reduce the progression of myopia. They are used as any normal contact lens: you put them in the morning, use them throughout the day for clear vision, and remove them at night prior to sleeping. The unique design promotes the reduction of progression.

Atropine Drops:
Atropine drops have been used for decades for dilating eyes. In recent years, studies have shown that those same drops effectively reduce the progression of myopia. The full-strength drops do cause some side effects (trouble focusing and light sensitivity), therefore we use highly diluted drops which still provide comparable reduction in myopic progression without the side effects.

Getting Started
To determine which myopia management option is ideal for your child, a comprehensive myopia management consultation will need to be completed. At this visit, the doctor will conduct testing to determine which treatment will be the most appropriate for your child. To schedule a consultation, please contact 732-658-6765 and specify that you would like a myopia management consultation. A complete eye exam is needed within the last 3 months. If it has been longer than three months, an eye exam will need to be completed prior to the consultation. The fee for the consultation is $200, however this fee will be applied to whichever myopia management treatment is chosen. Annual program fees (inclusive of drops or contacts) start at $1200 and can change depending on the treatment plan.

Prevention
Minimizing progression requires significant effort from both our children and our parents. Environment has a large impact on progression rates. Technology use, more specifically digital screens (laptops, tablets, phones), have sky-rocketed in use in the past 15 years. Now, with the pandemic, this “screen-time” is magnitudes greater. The amount of screen-time can increase progression so we recommend setting a limit on non-educational screen-time. In addition, we recommend having children spend more time outdoors (at least 1 hour each day). A combination of these environmental changes with a proper myopia management treatment program can substantially reduce myopic progression.

FAQs

1.  How long before there is a substantial decline in progression?
It is important to note that although we cannot reverse the level of myopia a child already has, there are proven treatments to decrease further progression. The amount of time it will take to see a substantial decline in progression can vary based on the individual, as well as the treatment being provided. Once enrolled in the program, we will monitor regularly for any progression and will make changes as needed.

2.  Are each of the treatment options safe for a child?
All three treatment options have been verified by several studies to have minimal risks. The contact lens options, the specialty daytime soft lens and the overnight lens, all carry the same minimal risk as routine contact lenses that millions of people wear every day. Atropine is also very safe; in fact, it has been tested for years with hundreds of patients with minimal risk. There is a possibility of mild side effects including light sensitivity and trouble focusing up close, although they are temporary and usually resolve within two weeks of starting the treatment.

3.  Which treatment option is the most effective?
All treatments are very effective – on average they decrease the myopic progression rate by about 50%. However, each child may respond differently to the myopia management treatment options. During the consultation, we will conduct tests to assess which option will be the best for your child.

4.  Is this treatment new/why haven’t I heard of it before?
Both the contact lens options and the atropine eye drops have been in use for many years. The contact lenses have been used in the past to correct vision and the atropine eye drops have been used as a dilating drop. However, it is only within the last 10 years that using these options for treatment of myopia has emerged.

5.  Is treatment covered by insurance?
Unfortunately, neither vision nor health insurance currently covers myopia management.  Certain vision insurances (such as VSP) may cover a portion of the contact lens material cost. As always, Flexible Spending Accounts (FSA) can be used towards payment for the myopia management program.