This year, I take on one of the hottest topics in vision care: myopia, also known as nearsightedness or shortsightedness. While this condition may seem like a mild inconvenience, it actually increases the risk of serious eye diseases such as glaucoma, cataracts, and retinal detachments. Most alarmingly, myopia rates are increasing dramatically in the developed world. In just the last generation, the rate of myopia has increased in the US by 65%.
Here is what you can do:
- Educate yourself - MyopiaControl.org, and MyopiaPrevention.org are all good places to start. While doctors cannot predict exact progression of nearsightedness for a particular patient, there are options. It is important to understand that there risks and benefits to every option and many of the options below are considered "off-label" by the FDA. Have these conversations with your doctor.
- Get your kids outside - There have been numerous studies that show that the more time younger children spend indoors the more likely they are to become myopic. So for 2016, make sure your kids include going outside for walks, trips to the park, or playing outdoor sports as part of their daily routine.
- Find the right eye doctor - Most doctors do not have specialty training in myopia control. While most know how to prescribe glasses and contacts to help people see clearly, some doctors have undertaken post-doctoral education in the methods of myopia control. You can go to the American Academy of Orthokertology and Myopia Control to find a doctor in your area.
- Start early - One thing we know for sure: the best way to control myopia is to prevent it. So the earlier action is taken for a patient, the less myopia they ultimately will have. In fact, we can now better predict who will be myopic before they start having blurry vision or before they would fail a school or pediatrician screening. So if you or your spouse are nearsighted, be sure your children have eye exams at the recommended ages and discus myopia with your doctor.
- Reduce eyestrain - People become nearsighted for a combination of genetic and environmental. Unfortunately, there are no large studies that guide us yet. However, there are some things that doctors to see clinically. Generally, excessive stress rarely improves any condition. The dramatic increase in eyestrain from digital device does seem to parallel the increase in myopia. In my own clinic, I have seen an increase in teenagers with blurry vision at distance that is not due to myopia from eyestrain. These patients are likely to become myopic eventually and best treated with vision therapy. Until we know more about the eyestrain/myopia connection, I think it makes sense to take it easy with the digital devices. A 5 minute break every 20-30 minutes has been shown to reduce focusing eyestrain.
- Do not ask for under-correction - the idea of intentionally wearing "weaker" glasses to keep the eyes from getting worse is a common misconception,
- Consider orthokeratology - One method that has been shown to effectively reduce myopia progression is orthokeratology (AKA Ortho-k, or OK). This has the added benefit of providing patients with clear daytime vision without glasses or contacts. Ask your doctor if this is an option for your child.
- Consider multifocal contacts - Additionally, certain multifocal soft contacts have been shown to reduce myopia progression. Ask if this is an option for your a child.
- Consider atropine eyedrops - One method that has been very effective in slowing myopia progress is the use of atropine. This is very common in Asia, but has been more slowly adopted in the US.
- Avoid myopia scams - Finally, beware. There are some websites that promise to reverse or eliminate myopia with special glasses or exercises. Some of these sites charge as much as $9,000(!) for their services. While these sites may sound informative and scientific, they are purely scams and cannot deliver what they promise. Ask your doctor (see #3), instead of spending money on these.
Nathan Bonilla-Warford, OD, FAAO, FCOVD