Myopia, more commonly known as “short-sightedness” or “nearsightedness”, is a common correctable vision issue whereby objects viewed in the distance appear blurred. This usually results from the eyeball being too long from front to back, but can be caused by an overly curved cornea and/or a lens with increased optical power. At what point the distant objects become blurred depends on the severity of the myopia. Myopia is corrected using spectacles or contact lenses.
As well as the negative visual aspects of myopia, it has become more widely known over the last few decades that moderate to high myopia is a significant risk factor in a number of sight threatening conditions in later life. These include increase in the risk of macular degeneration (58%), retinal detachment (30%) and glaucoma (20%).
From Mark A. Bullimore, Eric R. Ritchey, Sunil Shah, Nicolas Leveziel, Rupert R.A. Bourne, D. Ian Flitcroft, The Risks and Benefits of Myopia Control, Ophthalmology, 2021, doi.org/10.1016/j.ophtha.2021.04.032.
While laser refractive surgery can address the visual aspects of myopia, it carries its own risks and does not reduce the likelihood of developing these conditions.
The prevalence of myopia is increasing, and the degree of myopia also appears to increase from one generation to the next. This has resulted in a dramatic increase in research as to possible ways of reducing or preventing the development of myopia.
This has led to the development of three proven and approved methods of managing myopia in children and young adults:
Modified Multifocal soft contact lenses
Defocus Incorporated Multiple Segments (DIMS) spectacle lenses
At Keith Murphy Opticians we have always sought to offer the very best in care to our patients investing in training and equipment to enable us to do this. For the last seven years we have been involved in active myopia management with our patients. This means that we have a wealth of experience backed up by the latest cutting edge technology to deliver the best advice and outcomes for our patients.
We will help you to determine which of these current myopia management options is going to be the best for you or your child during an in-depth, myopia management consultation.
MYOPIA MANAGEMENT AT KEITH MURPHY OPTICIANS
Each of the myopia management options are offered as part of a comprehensive care plan that includes six- monthly regular check- ups and any emergency appointments– you cannot purchase them as one- off items. Check- up appointments include monitoring of axial length changes with Topcon MYAH technology, corneal topography and general eye health assessments.
EyeDream lenses are replaced every six months and costs include cleaning solutions and any recommended lubricating eye drops. You will also qualify for one pair of replacement EyeDream lenses if lost or damaged per year.
Supply of MiSight 1 Day contact lenses are included and any recommended lubricating eye drops.
MiYOSMART spectacle lenses and frames up to a maximum value, and replacement of damaged lenses within reason.
WHAT IS INVOLVED IN A MYOPIA MANAGEMENT CONSULTATION?
This assessment covers a whole range of baseline measurements including eye axial length measurement, corneal topography and tear film assessment with the Topcon MYAH, OCT and Optomap scans, as well as a complete eye health check. These allow us to predict the possible progression of myopia in the individual based on the person’s age, current refraction and eye measurements.
This also allows us to do a very thorough ocular health check to establish if there are any significant risks with for example contact lens wear.
At the end of this consultation, a report will be given and a discussion of the optometrist’s recommendations and what they feel is the best myopia management option for you or your child.
Orthokeratolgy - is a technique whereby specially designed gas-permeable contact lenses are worn overnight. The contact lenses reshape the cornea overnight, and correct vision for people with myopia without the need to wear contact lenses or spectacles during the day.
EyeDream is a form of orthokeratology, and at Keith Murphy Opticians we use EyeDream lenses as they have been shown to safely reduce or halt the progression of myopia in children.
EyeDream lenses are also suitable for adults with myopia who are sporty or active, worried about the risks associated with laser surgery or are not suitable for laser surgery because their corneas are too thin. These lenses are also ideal for adults with myopia who find contact lenses uncomfortable or spectacle wear inconvenient.
Orthokeratology is a proven method to effectively correct vision and if a person decides they would like to wear spectacles again, their prescription returns to what is was at the start with no adverse effects.
Myopia is most likely to develop in children whose own parents are short-sighted. There can, however, also be other factors in its development.
Children who use Ortho-K contact lenses can slow or halt myopia progression in a proven, safe way.
Further reading and clinical research on this topic can be found at www.myopiaprevention.org
The Ortho-K method is ideal for sporty or active people, people who are worried about the risks of laser surgery and people who find contact lenses uncomfortable or glasses inconvenient.
It is a proven method to effectively correct vision and if a patient decides they would like to wear spectacles again, their prescription returns to what is was at the start with no adverse effects.
MODIFIED MULTIFOCAL SOFT CONTACT LENSES
The MiSight 1 day is a dual-focus, daily disposable, soft contact lens specifically designed for myopia management. MiSight 1 day was the first soft contact lens to be approved by the Federal Drug Administration (FDA) for slowing the progression of myopia in children.
The lens is worn during the day and fully corrects the person’s myopia giving them clear vision in all positions of gaze whilst slowing myopia progression with its special optical design. Specialised optics of the lens has been shown to slow myopic progression. The lenses are daily disposable so reducing the risk of infection and potential adverse reactions to cleaning solutions.
DIMS SPECTACLE LENSES
There are several spectacle lenses that have been developed to help slow down myopic progression. The one with the most clinical evidence showing its effectiveness is the Hoya MiYOSMART lens. This utilises Defocus Incorporated Multiple Segments (DIMS) technology that gives the wearer excellent corrected vision while having specialist multiple zones on the lens that act as a slow-down or stop signal for eye growth. help to correct peripheral defocus so slowing the stimulus for the eye to elongate. Daily wearing of the DIMS lens has been shown to slow myopia progression by 52% and slow axial elongation by 62% over two years. A two-year randomized clinical trial reported that about 21% of children who wore DIMS had no myopia progression compared to only 7% of those who wore single vision spectacle lenses.
The lenses come with an anti-reflective, water-repellent, hard coating and UV protection as standard in an impact-resistant material to protect your child’s eyes.