Question 1

What is myopia (short-sightedness)

Accepted Answer

Myopia (short-sightedness) is a refractive vision condition where distance objects appear blurry but objects up close look clear due to light being focused in front of the retina (back of the eye). Myopia typically occurs as a result of the eyes growing too long and is commonly seen in children and young adults. Other causes of myopia include: genetics and environmental factors.
Presently, there is no cure for myopia but recent research has provided us with additional insight into myopia and there are options to slow down and even stop the progression of it (myopia control).
 
The latest theory of myopia control suggests that myopia progression occurs when light is focused on the peripheral (side) retina. It is believed that making the light out of focus on the peripheral retina can reduce myopia progression (termed myopic defocus). Speciality contact and spectacle lenses can achieve this.

Question 2

Myopia Control Options- Orthokeratology

Accepted Answer

With orthokeratology (ortho-k) a specially designed contact lens is worn to correct and reshape your vision while you sleep! Upon waking the result is clear vision during the day without glasses or contact lenses.

The additional benefit with ortho-k is the myopia control effects. Research has shown this can reduce myopia by 43-50%. (1, 2)

This process is completely reversible, your vision will go back to its original shape when lens wear is stopped.
 
Learn more about orthokeratology here.

Question 3

Myopia Control Options- Spectacle Lenses

Accepted Answer

All the latest myopia control spectacle lenses are available at Frith and Laird (including the MiyoSmart (Hoya), Stellest (Essilor) and MyoCare (Zeiss)).

These lenses look like your normal lenses but are specifically designed to allow clear vision through the centre of the lenses but the peripheral area creates myopic defocus.
 
The MiyoSmart and Stellest lenses are the latest spectacle lenses for myopia control. These lenses can reduce myopia progression by using Hoya's DIMS (defocus incorporated multiple segments) and Essilor's HAL (highly aspheric lens) technology. The reported effectiveness of these lenses slowing myopia is approximately 50%. (3,4)
 
MyoCare from Zeiss is their latest myopia management lens. Previously, they  the MyoVision lenses and were the first optical lenses using peripheral defocus designed to reduced myopia progression. MyoCare uses Cylindrical Annular Refractive Elements or C.A.R.E.® technology.

Question 4

Myopia Control Options- MiSight Contact Lenses

Accepted Answer

The dual focus/ MiSight lens is the first lens to be approved by the US FDA for myopia control and were designed locally at the University of Auckland. They work in the same way as the glasses with a clear centre power and a reduced outside power. However this system works better in a contact lens as the lenses stay centred on the eye as the eye moves, meaning the powers always stay in optimum alignment.

Studies have suggested reductions in the short-sightedness of around 50% (5)

Question 5

Myopia Control Options- Atropine/ Medicated Eyedrops

Accepted Answer

These are a very weak form of an eye drop that is usually used to dilate (enlarge) the pupil of the eye. The mechanism by which the drug reduces short-sightedness is unknown but results have shown it can reduce myopia by 27-67%. (6)
 
Atropine is a prescription only medication. It can be prescribed by a therapeutically qualified optometrist or ophthalmologist. Currently only one pharmacy in Auckland is making preparations of these eyes drops at a concentration sufficiently weak for the use of preventing short-sightedness.

Question 6

Eyerising Repeated Low-Level Red Light (RLRL)

Accepted Answer

The Eyerising unit uses a patented technology to deliver a repeated low-level red light (RLRL) to the back of the eye. This red light increases blood flow in  the back of the eye to help slow the axial growth of the eye and control  myopia progression.

This is a home therapy and is designed to be used at the comfort of your home. The recommended treatment is twice a day for 3 minutes each session, 5 days a week. This treatment is on a subscription model.

Question 7

Myopia Control Options- Lifestyle Changes/ Outdoor Play

Accepted Answer

Spend more time outside!

Living in a city is definitely bad for young eyes. Auckland’s not huge on a world scale but all of the factors of sedentary urban living still are at play. Studies show rates of childhood short-sightedness as low as 3% in non-urbanised cultures such as the Sherpas of Nepal and in Vanuatu but rates as high as 60% in highly urbanised countries such as Taiwan. The prevalence of myopia among Singaporean Indians has been reported as high as over 70% while remaining 10-20% among Indians living in India.

It is recommended to spend 2 hours outdoors for emmetropic children with myopic parents. (7)

Question 8

Myopia Control/ Management Summary

Accepted Answer

Currently there is no cure for myopia but there are now multiple options available to help slow down and even prevent the progression of myopia.

All these options are available at Frith and Laird and our optometrists are constantly up to date with the latest research and will be happy to answer any questions.

Question 9

References

Accepted Answer

Cho P, Cheung SW. Retardation of myopia in Orthokeratology (ROMIO)  study: a 2-year randomized clinical trial. Invest Ophthalmol Vis Sci. 2012 Oct 11;53(11):7077-85
Walline J, et al. The children’s overnight orthokeratology investigation pilot study. Optometry and Vision Science. 2004;81(6):407-413.
Lam, C. S. Y., Tang, W. C., Tse, D. Y. Y., Lee, R. P. K., Chun, R. K. M., Hasegawa, K., ... & To, C. H. (2020). Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial. British Journal of Ophthalmology, 104(3), 363-368.
Bao, J., Huang, Y., Li, X., Yang, A., Zhou, F., Wu, J., ... & Chen, H. (2022). Spectacle lenses with aspherical lenslets for myopia control vs single-vision spectacle lenses: a randomized clinical trial. JAMA ophthalmology, 140(5), 472-478.
Arumugam B et al. Modelling Age Effects of Myopia Progression for the MiSight 1 day Clinical Trial. Invest. Ophthalmol. Vis. Sci. 2021; 62(8): 2333.
Yam, J. C., Jiang, Y., Tang, S. M., Law, A. K., Chan, J. J., Wong, E., ... & Pang, C. P. (2019). Low-concentration atropine for myopia progression (LAMP) study: a randomized, double-blinded, placebo-controlled trial of 0.05%, 0.025%, and 0.01% atropine eye drops in myopia control. Ophthalmology, 126(1), 113-124
Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology.2008;115:1279–1285.

Myopia Control

Preventing Short-sightedness