Myopia, also known as short-sightedness or near-sightedness, is a common eye condition in Belfast and throughout N.Ireland. If your child has myopia, it means they might have trouble seeing things that are far away. Think of it like looking at a distant sign or the whiteboard in school – it could appear blurry.

Don’t worry; there are ways to help your child see better! Glasses or contact lenses are often used to make things clear for them. Plus, there’s exciting research happening right now (e.g. the NICER study in UUC, Northern Ireland) to find ways to slow down or even prevent myopia, especially in kids.

You might be wondering, why all this fuss? Well, myopia is becoming more common, and if it’s not managed well, there’s a chance it could lead to serious eye problems as your child grows up. Conditions like glaucoma, retinal detachment, and macular degeneration could become a concern if myopia isn’t taken care of.

So, by learning about myopia and the ways to manage it, you’re taking an important step to safeguard your child’s eye health for the future.

If your child has myopia, they might talk about not being able to see things far away. They could also get headaches, feel like their eyes are tired, or even get tired easily. Sometimes, they might not complain about their eyes or headaches, but you might notice other things like them being a bit clumsy, having trouble concentrating, behaving differently, or falling behind in school or with things they usually learn at their age.

If you’re worried that your child might have myopia, the best thing to do is take them to an optician’s. Kids can have these tests at any age, even if they can’t read or talk yet.

The optometrist might use a chart with letters for older kids, but for younger kids, they might show pictures or shapes. They can also figure out if your child is more comfortable seeing things up close or far away by shining a light into their eyes – this is called retinoscopy. It’s a bit like magic because the optometrist can find out if your child needs glasses without them needing to say anything. This way, the optometrist can understand your child’s eyesight really well even if your child can’t give exact answers.

When kids are born, they usually start with being able to see things up close pretty well. This is because their eyes are super flexible and can focus easily. As they grow, their eyes grow too, and this usually sorts out any vision issues.

The goal is for their eyes to grow just right so that the light coming in focuses perfectly at the back of the eyes, on a part called the retina. This gives them clear vision. But with myopia, things don’t quite work that way. The light ends up focusing in front of the retina, making far-away things seem blurry.  In Northern Ireland, almost one in five teenagers now have myopia!

Guess what? Sometimes, if you have myopia, your kids might have it too. It’s like a family thing. If one parent has myopia, their kids are at least three times more likely to get it. And if both parents have it, their kids are more than seven times more likely to have it! Also, some groups of people, like those from Asia, East Asia, and African American backgrounds, tend to have myopia more often.

The place you grow up in can also make a difference! Studies have shown that kids in the countryside, for example in China, are less likely to get myopia compared to those in the cities. Lifestyle matters too. A study in Ireland found that things like being overweight, not moving around much, and using screens too much can play a part. But scientists say they need to study this more to be really sure.

Recent studies have shown promising results in the effectiveness of myopia management techniques for slowing down the progression of myopia in children. Some of the key techniques that have demonstrated efficacy include:

Orthokeratology (Ortho-K):

Ortho-K involves wearing special rigid contact lenses while sleeping. These lenses reshape the cornea overnight, temporarily correcting myopia during the day. Multiple studies have suggested that Ortho-K can effectively slow down myopia progression in children. [1] Find out more here

Multifocal Contact Lenses:

Multifocal contact lenses, similar to multifocal eyeglasses, provide different prescription powers in different zones of the lens. Recent research has indicated that these lenses can help control myopia progression in children. [2] Find out more here

Atropine Eye Drops:

Low-dose atropine eye drops have gained attention for their potential to slow down myopia progression. Several studies have shown that atropine can effectively reduce the rate of myopia progression without significant side effects. [3] This treatment is not currently available in the UK or Ireland.

Increased Outdoor Time:

Spending more time outdoors has been associated with a reduced risk of myopia development and progression. Studies have suggested that increased exposure to natural light and outdoor activities might have a protective effect against myopia. [4]

Bifocal or Progressive Eyeglasses:

Some studies have explored the use of bifocal or progressive eyeglasses for myopia control in children. While results have been mixed, these lenses have shown some potential in slowing down myopia progression in certain cases. [5]

It’s important to note that individual responses to these techniques can vary, and the effectiveness of each method might depend on factors like the child’s age, the severity of myopia, and genetic predisposition.

To access the most recent and comprehensive research, I recommend checking peer-reviewed journals, articles on medical databases, and consulting with eye care professionals who are up to date with the latest developments in myopia management.

References:

1. Walline, J. J., Greiner, K. L., McVey, M. E., Jones-Jordan, L. A., & Sinnott, L. T. (2013). Multifocal contact lens myopia control. Optometry and Vision Science, 90(11), 1207-1214.
2. Chamberlain, P., Peixoto-de-Matos, S. C., Logan, N. S., & Ngo, C. (2019). A 3-year randomised clinical trial of MiSight lenses for myopia control. Optometry and Vision Science, 96(8), 556-567.
3. Chia, A., Chua, W. H., Cheung, Y. B., Wong, W. L., Lingham, A., Fong, A., & Tan, D. (2012). Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2). Ophthalmology, 119(2), 347-354.
4. Wu, P. C., Chen, C. T., Lin, K. K., Sun, C. C., Kuo, C. N., & Huang, H. M. (2013). Myopia prevention and outdoor light intensity in a school-based cluster randomised trial. Ophthalmology, 120(5), 1080-1085.
5. Aller, T. A., Liu, M., Wildsoet, C. F., & Gudmundsdottir, E. (2013). Bifocal optical defocus effects on emmetropisation and eye growth in chick. Investigative Ophthalmology & Visual Science, 54(12), 8004-8014.

When it comes to treating myopia in children, contact lenses and orthokeratology lenses stand out as safe and reliable options. These methods boast a low occurrence of severe side effects, and the risk of complications can be further minimised by adhering to proper hand hygiene and following recommended contact lens cleaning practices. In essence, transitioning from regular contact lenses to specialised myopia management lenses or orthokeratology lenses isn’t likely to introduce any substantial additional risk of eye infections in children, beyond what might be expected when anyone extends their standard contact lens wear time.

It’s worth noting that wearing myopia management contact lenses during the day doesn’t come with an increased risk when compared to wearing conventional contact lenses. However, there might be a slight uptick in the risk of corneal infections for children and young adults who wear lenses for extended periods or overnight, or those who shift from wearing only glasses to wearing contact lenses. But don’t worry – this risk can be significantly reduced with proper guidance on handling the lenses and maintaining good hand hygiene.

Children can indeed manage contact lens wear safely, as long as they are capable of maintaining hygienic practices. This involves undergoing a comprehensive contact lens fitting evaluation and receiving thorough patient instructions on how to wear and care for the lenses. Interestingly, the occurrence of corneal infiltrative events in children isn’t higher than that in adults. In fact, in the age group of 8 to 11 years, the incidence might even be notably lower [3].

For the sustained success and safety of orthokeratology, a combination of precise lens fitting, strict adherence to lens care protocols, consistent follow-up appointments, and prompt attention to any potential issues is crucial.

References

1. Gifford, Kate L., et al. “IMI–clinical management guidelines report.” Investigative ophthalmology & visual science 60.3 (2019): M184-M203.
2. Németh, J., Tapasztó, B., Aclimandos, W. A., Kestelyn, P., Jonas, J. B., De Faber, J. T. H., … & Resnikoff, S. (2021). Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. European Journal of Ophthalmology, 31(3), 853-883.
3. Bullimore, M. A. (2017). The safety of soft contact lenses in children. Optometry and Vision Science, 94(6), 638.
4. Liu, Y. M., & Xie, P. (2016). The safety of orthokeratology—a systematic review. Eye & contact lens, 42(1), 35.