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How to control the progression of myopia?

Myopia (near-sightedness) is affected by genetic and environmental factors. Myopic children’s parents often worry about fast progression, and the consequences of high myopia are not only to wear a pair of eyeglasses with thicker lenses, but also more prone to different eye diseases, such as glaucoma and retinal detachment. Therefore, parents often ask: "What can we do to slow down the progression of myopia?".

In the past decades, researchers have investigated and published numerous studies on the methods of myopia control, and the results are summarized as follows:

  • Progressive addition lenses (PAL) : Although there was statistically significant reduction of rate of myopia progression in using PAL over normal single vision lenses, the actual difference (approximate 0.25D in 3 years) was clinically insignificant.

  • Executive prismatic bi-focal lenses: This lens design could reduce the myopia progression rate by approximately 50%. Children should use the lenses with care as the upper portion is used for far vision and lower portion, for near reading. In addition, there is a marked horizontal line separating the upper and lower zone, some parents and children have hesitation to accept the cosmetic outlook of the lenses.

  • Defocus incorporated multiple segments lenses (DIMS): The centre part (9.4mm diameter) of the lenses is the child’s myopic correction. Numerous defocus circles are placed outside this zone to create images in front of the peripheral retinal, these defocus images thus interfere the signal for elongation of eyeball, and hopefully can retard the myopic progression. Study showed that this lens design could slow down myopic progression by approximately 52%.

  • Defocus incorporated soft contact lenses (DISC): By combining normal myopic correction and defocus rings, the DISC allows the far image clearly focusing on the retina, and at the same time creating a defocus image at the peripheral retina to control the growth of eyeball (myopia progression). Study showed that this method could slow down myopic progression by approximately 60% if the children wore the contact lenses for 8 hours per day.

  • Orthokeratology (OK lens): Results showed that the progression of myopia has retarded 50 % in children with OK lens when compared with children wearing eyeglasses.

  • Ophthalmic drugs: Results showed that the effects of myopia could be effectively controlled, but side effects (e.g. pupil enlargement and loss of near focus function, etc.) cause inconvenience to the children, and there are no publications about the side effects of long-term use of these medicines in children.

  • Other alternative therapies (e.g. pinhole glasses and visual training): There are no formal studies to support the effectiveness of myopia progression.

If your child has fast progression in myopia, you must study and understand the pros and cons of different methods before choosing a treatment for them. Remember the 20-20-20 rule to protect their vision, take a 20- second break to look at something 20 feet away after 20 minutes near tasks. In addition, outdoors activities also play important role in control the progression of myopia.

 

 

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