Myopia Control Center

Several studies have shown the incredible capability of atropine to slow the progression of nearsightedness. Some studies have shown over a 90% reduction in progression rate with 1% atropine which is remarkable and the most effective treatment studied to date. Atropine isn’t without its drawbacks though. This medication will cause blurred near vision and sensitivity to light as it is a strong dilation agent. It often requires the use of photochromic progressive lenses during treatment to control the amount of light getting to the eye and help see up close. Fortunately, concentrations below 0.025% can be made at a compounding pharmacy and still show a meaningful reduction in progression rate without the side effects from dilation. Low dose atropine for myopia control is often the preferred starting point for small children that aren’t ready for contact lens based myopia control.

This treatment option may be combined with other prevention methods, though there are no studies demonstrating increased effectiveness of multiple therapies. Atropine has not been approved by the FDA to treat myopic progression, but the medication has been approved for other medical uses and has a long track record of safety. A similar method to low dose atropine therapy is pirenzepine, though this medication is unfortunately not available in the United States. The advantage of pirenzepine is that is does not dilate the pupil or incapacitate the focusing system, the disadvantage being a reduction in myopic progression of only 44%.

This popular alternative to glasses, daytime contact lenses and LASIK turns out to have a hidden beneficial side effect of reducing myopia progression by roughly half. In orthokeratology we use specially designed corneal molds to gently reshape the eye overnight in a process that is FDA approved for all ages. This is a great alternative for the child that does not wish to wear a correction during the day and is a safe and effective means of vision correction. Like atropine therapy, ortho-k is not specifically FDA approved for myopia control, but has long been an approved and safe method of vision correction since 2002. Click here to visit our orthokeratology page to learn more.

Soft multifocal contact lenses are often a parents first choice for their child as the lenses used are no different than the soft lenses they themselves are used to wearing. Published studies have shown around a 40% reduction in myopic progression. CooperVision currently manufactures the only commercially available soft lens designed specifically for myopia prevention called the MiSight. It is currently unavailable for purchase in the United States. While studies show many distance center multifocal lenses may be effective in myopia control, there are some theories that increased control may be possible using custom designs. The Visionary Eye Center offers custom multifocal designs and designs shown to mimic the effect of orthokeratology when using soft lenses for myopia control.

Rigid gas permeable (RGP) lenses have long been thought to slow progression of myopia. Studies have confirmed this, but the effect is mild at best. This lens type is still a great option for patients looking for the best visual clarity.

Research shows that wearing full correction single vision glasses do not seem to have any slowing effect, but that wearing progressives (4%) and lined bifocals (16%) had a small but insignificant effect on myopia progression rates. The most effective glasses for myopia control seem to be executive bifocals, at around a 20% reduction in the rate of myopia progression. Promotional materials for MyoVision lenses by Zeiss claim a 30% reduction rate, but this has not been seen in any published journal studies as of yet. Executive bifocals may be a great way to supplement those using atropine or soft multifocals for myopia control, but further research needs to be done on these combination therapies to judge the effectiveness.

Unsurprisingly, one of the most cost effective ways to slow progression is to stop it in the first place. It has been noted that children that spend 14 hours or more outside in a week (2 hours a day) are less likely to become myopic. Oddly though, once a child has become nearsighted, outdoor time does not seem to have a meaningful effect on slowing myopia progression. So get those toddlers outside and don’t forget their sunglasses!

There are no current studies to guide us on nutritional advice to slow progression of nearsightedness. Our general advice in this arena tends to follow common sense, eat your vegetables and get regular exercise for a happy healthy life.

There have been several studies looking at focusing and eye movement exercises to slow myopia progression. At this time there are no exercise regimens or relaxation techniques to slow myopia progression.

The image of the bookworm with glasses is an iconic one. Many scientific studies have looked at the rate of myopic progression in children that read a lot. The good news for studious children is they have found reading in and of itself is not likely to make your child more nearsighted. In patients that have a condition known as a lag of accommodation it is suggested that a pair of reading glasses may help slow their progression. Likely the biggest reason we see myopia in kids that spend too many hours in front of a screen or reading is likely due to the decreased outdoor time in favor of screen time, leading to the development of myopia.

Occasionally we are confronted by parents that believe undercorrecting or not wearing glasses that it can strengthen their child’s eyes to the point of not needing glasses. This couldn’t be further from the truth, as research has shown that not providing an appropriate correction will actually speed up the progression of nearsightedness and make it worse. While although patients that don’t wear glasses may learn to interpret blurry letters on a chart better, making them seem like they have better vision, axial length and where light focuses is how nearsightedness is truly measured. By those measures these methods do not work.