The first step in a thorough myopia assessment is refraction, axial ocular length measurements and a careful review of ocular health. From there, we can give advice on the treatment options available and we can customise the treatments for myopia that best suit your child.
Treatments options to slow myopia progression fall into 3 main categories
- Contact lens options – custom designed orthokeratology overnight lenses and, specialty soft contact lenses
- Glasses options – myopia control spectacle lenses
- Pharmaceutical options – atropine eyedrops
Bear in mind, these are the myopia treatment options for children with advancing shortsightedness. The options to correct myopia in adults with stable myopia are different.
Contact lens treatments for myopia control
There are two excellent contact lens options for controlling myopia in children: custom designed orthokeratology overnight lenses and specialty daily soft contact lenses.
Pros and cons of contact lens wear in children
Whilst some parents may feel apprehensive about kids wearing contact lenses, it’s really important to consider contact lenses for young children with increasing myopia.
It’s been shown that the earlier children are when their short sightedness develops, the more risk of progression, meaning younger children are more likely to experience rapidly worsening eyesight.
Weighing it up and considering all the pros and cons of contact lens wear in children is important as an 8 year old is likely to need to wear contact lenses for 10 years if they are going to continue the treatment throughout their growing years.
If we focus on the benefits, contact lenses have been shown to improve a child’s quality of life, their self esteem, how they feel about their appearance, boost their self confidence and their participation in sporting, outdoor and leisure activities. When asked in studies, most children who wear contact lenses prefer it to wearing their glasses.
Contact lenses can be difficult for young children and it’s common for some parents to be concerned about the safety of contact lenses in children. Contact lenses are a medical device worn on the surface of the eye so there is always a risk of infection. The reassuring news is the studies show the incidence of any contact lens related events is much lower in 8-12 year old contact lens wearers, than in adult contact lens wearers.
Also, there is no physiological reason to wait until children are older. Studies have shown that after 10 years of contact lens wear, there was no difference in the frequency of adverse events and ocular health found between those fitted as children compared to those fitted as teens.
Balancing it up, studies have shown the 10-year risk of a serious eye infection in daily wear soft contact lenses is 1 in 500, versus the lifetime risk of retinal detachment if the myopia becomes more than -5.00D being 1 in 20.
Orthokeratology vs Soft Contact Lenses for myopia control
Orthokeratology risks are comparable to or safer than soft contact lenses since they are typically worn for much shorter periods (7–9 hours rather than waking hours). As you are asleep during wear they are not exposed to the same environmental germs. Because you never wear orthokeratology lenses during the day, they typically never leave the cleanliness of your own home.
Which contact lens option is the most effective in preventing myopia progression?
A comparison of myopia control treatments (compilation of 30 studies) showed that orthokeratology reduces myopic progression by 45% compared to multifocal soft contact lenses at 33% reduction. Both of which are outstanding numbers compared to single vision spectacles which showed 0% reduction of progression, and undercorrection which actually accelerated progression by 9%!
*data compiled using meta-analysis by Huang J, Wen D, Wang Q, et al. Efficacy comparison of 16 interventions for myopia control in children: A network meta-analysis. Ophthalmology 2016;123:697–708.
