FREQUENTLY ASKED QUESTIONS
Is myopia control a new concept?
Myopia control may sound new and novel to you, but people have tried many various methods over the years trying to prevent children's eyes from getting worse, namely in Asian countries with very high numbers of short-sighted children and teenagers. Due to the rapid increase in myopia rates around the world, there is now much international research is being done on developing safe and effective myopia control strategies to help today's generation of children facing a lifetime of eye troubles from short-sightedness.
What evidence is there that myopia control treatments work?
There is much evidence in published scientific literature to support the effectiveness of myopia control treatments in helping to significantly slow down short-sightedness progression. Peer reviews evaluating and cross-referencing the validity of published research have also been done. A brief list of the more recent and relevant clinical research papers can be found on our Media page.
Are my child's eyes getting because of the iPad or computer games?
While it is easy to point to digital devices as a cause of eyesight deterioration, there are multiple factors that affect myopia development and progression. Genetics is a strong predisposing factor. With the environment, current evidence points to inadequate outdoor time as a significant cause of myopia. So any activities that involving spending too much time indoors — reading, studying, tutoring, music lessons, television, as well as iPads and computers — are potentially contributing to your child's myopia.
Which myopia control treatment is best for my child?
Every child is different, some will respond well to one form of myopia control treatment and for others perhaps a different strategy has more effect. Which option is most suitable depends on factors such as your child's prescription, eye biology, age, rate of myopia progression, maturity level, motivation and cost. Ortho-K and atropine eye drops are rated most effective in published research, followed by myopia control soft contact lenses, and then specially designed glasses. After our assessment we will present all suitable options to you, discuss the pros and cons of each, and work with you on an individual treatment plan tailored to your child's needs.
Can my child's treatment plan change?
The research on myopia control is ever-evolving as the science and our knowledge about myopia improve. When new evidence and treatments come to light we will let you know and we can change your child's treatment plan accordingly. And your child's visual needs can change also — a younger child may start on atropine eye drops first and wear glasses, then progress to contact lenses or Ortho-K a few years down the track. Also if one particular treatment is not showing the expected effect we can change to another treatment, or use a combination of treatments.
What's the earliest age that a child can be treated?
There is no minimum age for starting myopia control treatment if the risks are high enough to warrant initiating treatment. We have prescribed myopia control for children as young as 4 who are already short-sighted and whose parents have high degrees of myopia. Children typically develop myopia between 6-12 of age. The earlier the onset of myopia, the greater the risks. Early intervention is most effective in preventing high myopia.
What are the pros and cons of treatment?
We believe the benefits of myopia control far outweigh any potential negatives. The benefits for the child are improved long-term eye health, reduced risk of vision impairment, improved quality of life vs having very poor eyesight and thick, high powered glasses, and for the parents the satisfaction of knowing that you've done your best for your child's eyes. The cons are mostly related to the ongoing costs of treatment for the child, whether it be Ortho-K lenses, compounded atropine eye drops, multifocal soft contact lenses or special glasses. All treatment options we prescribe are based on proper scientific evidence with good safety profiles.
What if my child does not have myopia control?
We offer you our professional advice on what is best for your child's eyes, but you are never under any obligations to go through with myopia control treatment for your child if you have reservations. If your decision is not to start your child on myopia control, we will still review and monitor your child's eyes regularly and keep you informed of any progression at each visit. If your child is a progressive myope, however, it is highly likely that he or she will continue to progress until, eventually, their prescription stabilises naturally, with a strong possibility of having high myopia (over -6.00) at that point.
Can myopia control treatment improve my child's short-sightedness?
No, unfortunately any eye axial elongation that has already occurred with myopia development are permanent and cannot be reversed. It is for this very reason that children with progressive myopia should be treated as early as possible. Treatment does not cure myopia but helps to prevent further deterioration. Ortho-K lenses can often give the impression of your child's eyesight improving due to its vision corrective effect during daytime.
Can my teenage child have myopia control?
Yes, myopia control isn't limited to younger children. The highest rate of progression and eye growth tends to occur around puberty with the growth spurt, then tapers naturally. However many teenagers' eyes do worsen significantly with the increase of intense high school study at around age 14-17. And even university students often have worsening in their myopia. While most myopia control clinical trials involved younger children, we can treat your teenager if their eyes are still deteriorating — Ortho-K and multifocal soft contacts tend to be the best options. We have had good treatment success with teenage patients at our clinic.
Can my child have myopia control before becoming short-sighted?
Many parents who have high myopia are interested in preventing the onset of myopia in their children with normal eyesight. Current evidence points to spending more time outdoors for at least 90 minutes a day as a preventative strategy to delay myopia onset. While atropine eye drops may help, there are no published studies yet recommending using atropine as a preventative treatment for children who are not short-sighted. If your child has any binocular vision issues causing eyestrain when reading — which our optometrist can diagnose — then bifocal or multifocal glasses may be of benefit.
Does my child still have to wear glasses while on treatment?
Children wearing overnight Ortho-K lenses will not need to wear glasses during the day, as the Ortho-K treatment also corrects vision. With atropine eye drops, yes your child will continue to wear glasses to see as usual. Children on myopia control soft contact lenses will be wearing their contacts most of the time, with glasses as backup.
What is the length of treatment?
We expect treatment to be ongoing during the years of your child's life where there is significant risk of further progression without treatment. This is typically between the ages of 6-17 when eye growth is occurring. Ortho-K lenses can safely be worn for many years, as well as myopia control soft contact lenses. Low-dose atropine eye drop treatment has a recommended treatment period of 2 years, but clinical trials have been conducted over 5-year periods with good effect and minimal side effects.
Does wearing weaker glasses help with myopia progression?
There is a common misconception in some cultures that wearing weaker glasses can help prevent myopia progression. It is been shown in research that wearing a deliberately weaker prescription — a practise called undercorrection — not only does not help inhibit progression but actually increases progression — "undercorrecting the myopia in children may be not only unwarranted but even potentially harmful". At our clinic we do not support undercorrection for children.
Why have I heard different things from different optometrists?
Optometrists and practices are not all equal. Some practitioners are unfortunately out of touch with what's new in myopia management, continuing with a conventional optical approach with glasses. Many optometrists are not endorsed in ocular therapeutics, which means they are unable to prescribe medical treatments such as atropine eye drops. Different optometrists may have different areas of clinical interests and backgrounds. Some practices are more clinical, and some are more retail-oriented.
There are also practices that may offer only one or two myopia control options due to their limitations in clinical equipment, skills and product range, hence they may have a biased opinion as to which treatments are 'best', and some are even known to discourage patients from options that they are unable to offer. To get the most professional and unbiased opinion you should see an knowledgable myopia control optometrist who can offer all the evidence-based options that are available for your child.
How often does my child need an eye checkup?
We review all children on myopia control treatment every 6 months to monitor progression and treatment response. We assess myopia progression by checking for changes in your child's vision and prescription, as well as changes in their eyes' axial length with ultrasound biometry. Children using Ortho-K will have more regular reviews in relation to their OK lens fitting.
What about laser eye surgery?
Laser eye surgery for adults works on the front surface of the eye, the cornea. It has no effect on the axial length of the eyeball. A highly myopic eye that has had laser surgery, although now can see better, is still physically a stretched, highly myopic eye inside, with exactly the same risks of glaucoma, retinal detachment and myopic macular degeneration as before laser surgery. Myopia control is about prevention. Mild to moderate prescriptions are also more suitable for laser surgery than very high prescriptions when your child becomes an adult.
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