Myopia

Myopia Management

Is your child’s vision getting worse year on year? Increasing myopia (nearsightedness) is more than just needing stronger glasses.

Protect Your Child’s Vision with Myopia Management

Studies have found that high myopia can affect your child’s eye health for life. At Expressive Eyes, we’re pleased to offer myopia management, a specialized program designed to slow down the progression of myopia and protect your child’s vision for the future.

Why Myopia Management Matters

  • The Myopia Epidemic: By 2050, half of the world’s population is expected to be nearsighted. Early intervention is key to preventing high myopia, which can lead to serious eye conditions like cataracts, glaucoma, myopic macula degeneration and retinal detachment later in life.
  • More Than Just Glasses: Traditional glasses and/or contact lenses fix visual refractive errors but don’t address the underlying progression of myopia, they only compensate the refractive error. Myopia management goes beyond compensation to actively slow down or  re-train myopia progression by changing the retinal structural growth.

How We Can Help

At Expressive Eyes we provide personalized myopia management solutions.

Interventions:

  • Multifocal Eyeglasses or Contact Lenses: These lenses have different powers in different zones, which can reduce the strain on the eye and slow myopia progression.
  • Orthokeratology (Ortho-K): Special rigid gas-permeable contact lenses are worn overnight to temporarily reshape the cornea, providing clear vision during the day and potentially slowing myopia progression
  • Multifocal Contact Lenses: Daily wear lenses designed and researched to slow myopia progression while providing clear vision.
  • Peripheral Defocus-Modifying Lenses: These lenses alter how light focuses on the peripheral retina, which research has shown to help reduce myopia progression.
  • Atropine Eye Drops: Low-dose prescription eyedrops have been shown to effectively slow down myopia progression; this modality of treatment is only deliverable by ophthalmologists here in the UK. 

Behavioral and Environmental recommendation:

  • Increased Outdoor Time: Spending at least 2 hours a day outdoors has been linked to a reduced risk of developing myopia and slowing its progression.
  • Near Work Hygiene: Limiting prolonged close-up activities (e.g., reading, screen time) and encouraging regular breaks using the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds) can help. And here at Expressive Eyes we recommend further 20 blinks: 20-20-20-20 rule!

Regular Eye Exams:

Routine eye check-ups are essential for early detection and monitoring of myopia and progression, especially in children who are growing and so are their eyes.

Benefits of Myopia Management

  • Slows Myopia Progression: Reduce the risk of high prescriptions and associated eye health risks and especially in the elongating growth of children’s eyes.
  • Protects Long-Term Eye Health: Lower the chances of developing serious eye conditions in adulthood.
  • Fewer Prescription Changes: Enjoy fewer incremental stronger glasses because of eye elongation management.
  • Improved Quality of Life: Help your child to see clearly and confidently, both now and in the future.

At Expressive Eyes

  • Expert Care: Our experienced optometrist is trained in the latest myopia management spectacle and/or contact lenses and uses special technology and instrumentation to monitor your child’s eye growth.
  • Personalized Approach: We create customised treatment plan tailored to your child’s unique needs.
  • Advanced Equipment: The progress or effectiveness of myopia management strategies can be measured scientifically and objectively with biometry.    Axial length biometry accurately measures the distance from the anterior corneal surface to the retinal pigment epithelium which is vital in myopia control as it helps track the progression of eye elongation over time. By regularly monitoring axial length, we can adjust treatment plans to slow down myopia progression and reduce the risk of associated complications. Without biometry, myopic management can be  likened to working without the proper tools. Since, we are serious about myopia management we have invested in a biometer to measure axial length and other eye measurements to determine progress of treatment.
  • Support: We’re here to guide you every step of the way, from the initial consultation to ongoing care.

Gift of Vision Care

“Take the First Step Toward Protecting Your Child’s Vision!” Schedule a myopia management consultation today even if your child has recently had an eye examination. Let us help you give your child the gift of clear vision and a healthier future. Contact us now to book an appointment or learn more about our myopia management program.

Our optometrist has practiced myopic interventions for many years before the arrival of peripheral defocussing spectacle and contact lenses.  She has used bifocals, multifocal, degressive lenses and contact lenses for many years before the term “Myopia Management” was popularised.

What is Myopia?

A person with good vision is considered to have emmetropic eyes or a normal  refractive system termed as emmetropia. Whereas, eyes that are not emmetropic and have refractive error or refractive anomaly are ametropic or termed as ametropia. Ametropia can manifest as myopia, hyperopia, anisometropia and astignatism or a combination.

Myopia, also known as shortsightedness/nearsightedness, is a common eye condition that makes focusing on objects in the long distance difficult. This means that light coming into the eye will stop in front of the retina, instead of on it. The retina uses light to form pictures that it then sends to the brain, the resultant image will appear blurred.

While the retina normally controls eye growth by visual processing, it seems to give up during myopia development. The prevalence of myopia keeps increasing in recent years, especially in East Asia where 80–90% of 18-year olds are myopic and 10–20% are highly myopic . By 2050, the worldwide prevalence of myopia is projected to be 54%, and the prevalence of high myopia, the most severe form, is projected to increase to 10%.

Risks associated with Myopia

Research into eye health has shown that people with high myopia are at greater risk of developing eye diseases such as glaucoma (2012), cataracts (1987) and at greater risk of developing retinal tears which may lead to a retinal detachment (2008) and myopic maculopathy or myopic macular degeneration.

  • Cataracts: Recent studies have shown people with high myopia are at higher risk of developing cataracts than those who are not nearsighted. Furthermore, visual outcomes following cataract surgery are not as good among patients with highly myopic eyes. One theory why high myopia correlates with higher risk of cataract is due to the increasing axial length of the eye and deprives the posterior surface of the lens of nutrients, leading to reduced visual clarity.
  • Glaucoma: Glaucoma was significantly associated with the severity of myopia in a population-based Chinese study. In the study, adults age 40 or older with high myopia have a 4.2 to 7.6 times greater odds of having glaucoma compared to participants who either had no myopia or have hyperopia (are farsighted.)
  • Retinal Detachment: Retinal detachment is a very dangerous condition and one of the leading causes of blindness, and thinning layers of the eye caused by high myopia can be a big risk factor. In a study published in the American Journal of Epidemiology, researchers have found myopia is a big risk factor for retinal detachment. Results have shown eyes with high myopia are at least at a 5x odds of developing retinal detachment compared to normal eyes.

Related Studies

High Myopia
High myopia, typically defined as a refractive error of -5.00 diopters or more or an axial length of 26 mm or greater, is associated with significant ocular risks. The elongation of the eyeball in high myopia stretches and thins the retina, choroid, and sclera, leading to structural changes that increase the risk of sight-threatening complications. Below are the key ocular risks associated with high myopia, supported by references.

Ocular Risks of High Myopia

Myopic Maculopathy
Myopic maculopathy is one of the most serious complications of high myopia and a leading cause of irreversible vision loss. It includes conditions such as macular atrophy, choroidal neovascularization (CNV), and lacquer cracks. The thinning of the choroid and retina in the macular region can lead to progressive vision impairment.
Reference: Ohno-Matsui, K., Kawasaki, R., Jonas, J. B., Cheung, C. M. G., Saw, S. M., Verhoeven, V. J. M., … & META-Analysis for Pathologic Myopia (META-PM) Study Group. (2015). International classification and grading system for myopic maculopathy. *American Journal of Ophthalmology, 159*(5), 877-883.

Retinal Detachment
High myopia increases the risk of retinal detachment due to peripheral retinal thinning, lattice degeneration, and vitreous liquefaction. The elongated eyeball creates traction on the retina, making it more susceptible to tears and detachment.
Reference: Mitry, D., Charteris, D. G., Fleck, B. W., Campbell, H., & Singh, J. (2010). The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. *British Journal of Ophthalmology, 94*(6), 678-684.

Glaucoma
Individuals with high myopia have a higher risk of developing glaucoma, particularly open-angle glaucoma. The structural changes in the optic nerve head and the elongation of the eyeball may contribute to increased intraocular pressure and optic nerve damage.
Reference: Marcus, M. W., de Vries, M. M., Junoy Montolio, F. G., & Jansonius, N. M. (2011). Myopia as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. *Ophthalmology, 118*(10), 1989-1994.

Posterior Staphyloma
Posterior staphyloma is a localized outpouching of the posterior eyeball wall, commonly seen in high myopia. It can lead to progressive retinal and choroidal thinning, contributing to visual impairment.
Reference: Ohno-Matsui, K., Jonas, J. B., & Spaide, R. F. (2016). Macular Bruch’s membrane defects in highly myopic eyes. *Retina, 36*(3), 517-523.

Choroidal Neovascularization (CNV)
CNV is a complication of high myopia where abnormal blood vessels grow beneath the retina, leading to leakage, hemorrhage, and scarring. It is a major cause of central vision loss in myopic maculopathy.
Reference: Wong, T. Y., Ferreira, A., Hughes, R., Carter, G., & Mitchell, P. (2014). Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review. *American Journal of Ophthalmology, 157*(1), 9-25.

Cataracts
High myopia is associated with an increased risk of early-onset cataracts, particularly nuclear and posterior subcapsular cataracts. The exact mechanism is unclear but may be related to structural changes in the lens and vitreous.
Reference: Pan, C. W., Cheng, C. Y., Saw, S. M., Wang, J. J., & Wong, T. Y. (2013). Myopia and age-related cataract: a systematic review and meta-analysis. *American Journal of Ophthalmology, 156*(5), 1021-1033.

Peripheral Retinal Degeneration
High myopia is often associated with peripheral retinal changes, such as lattice degeneration, paving stone degeneration, and retinal holes. These changes increase the risk of retinal tears and detachment.
Reference: Burton, T. C. (1989). The influence of refractive error and lattice degeneration on the incidence of retinal detachment. *Transactions of the American Ophthalmological Society, 87*, 143-157.

Optic Neuropathy
High myopia can lead to optic nerve damage due to stretching of the optic nerve head and reduced blood flow. This may result in visual field defects and progressive vision loss.
Reference: Xu, L., Wang, Y., Wang, S., Wang, Y., & Jonas, J. B. (2007). High myopia and glaucoma susceptibility: the Beijing Eye Study. *Ophthalmology, 114*(2), 216-220.