Myopia control?

[Innisfree]

We just saw a new optometrist who is suggesting this. The idea is completely new to me.

My initial reaction is that the three options which were presented (soft contacts with reduced peripheral vision, hard contacts worn overnight, and dilute atropine drops at night) don't sound great for older teens who are up late (early am) studying routinely and are relatively new drivers. I want them to have all the peripheral vision possible, lol. Also, I gather they are older than most kids who start this treatment.

Both are pretty myopic already and their vision is changing enough to require new glasses yearly. Seriously, if glasses weren't so expensive and if she had been driving more over this last year, one should probably have gotten a new prescription after six months. She won't need to drive much for the next few years, though.

I found this information online,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542412/

which suggests that it's not clear whether the benefits will continue long term once any treatment stops.

Does anyone have experience with this?

[prairiewindmomma]

So, I just had this discussion with our kids' ophthalmologist. it's normal to change half a diopter every year during the teen years, according to my kids' ophthalmologist.  Your eyes grow and change with you, and it's normal to change glasses prescriptions yearly until your early 20s.

AFA preventing worsening myopia goes, outdoor exercise of at least one hour a day and limiting screen time to less than 2 hours a day is what our opthamologist recommended. My husband has prescriptions of -10 in each eye, and genetically we have one kid who seems to be following that same path, and two that are following me so far. Our Youngest still has perfect vision, but we typically have seen the most vision change starting around age 12, so who knows what trajectory she is on.

The same things you mention are on the position page of the AAO: https://www.aao.org/eye-health/treatments/myopia-control-in-children but my opthamologist doesn't recommend them, even for my kid who already has known cornea issues. They don't seem to have long-lasting effect. 

[Innisfree]

8 minutes ago, prairiewindmomma said:

AFA preventing worsening myopia goes, outdoor exercise of at least one hour a day and limiting screen time to less than 2 hours a day is what our opthamologist recommended.

This is going to be hard. The outside time isn't a problem except in extreme weather, but both girls have a lot of screen time which isn't entirely discretionary: online school for both last year, and for one this coming year. I can let them know that this would be beneficial, though. One at least would be happy to hear that more outside time was recommended.

Older dd's myopia is already worse than mine, which is far worse than dh's, so I understand the suggestion to slow the progression. I'm just sceptical about how effective it will be.

I appreciate your thoughts.

[TechWife]

I have severe myopia. I began wearing contacts at age 14 in an effort to slow the changes in my vision. The information available at the time was anecdotal. I still needed a new rx every year, but I wasn’t dropping full points any longer. Whether or not this can be attributed to wearing contacts is anyone’s guess. My vision stabilized in my 20’s, as is normal. As I get older, the change is accelerating a little bit, but I now have to get custom made lenses due to my rx strength, which is extremely expensive. I only wear contacts on special occasions due to this. 
 

There is now one FDA approved contact lens that is for the purpose of slowing myopia. This may be what the dr. is talking about. It’s for 8-12 year olds. I don’t see any information on parameters for the prescription other than age. Personally, I can’t imagine a child that young putting in & taking out contacts as well as being able to deal with things like dirt or sand blowing into the eye, which can be quite painful and happens without warning no matter where you live. But, I don’t know what the risks are for your children otherwise. You also need to look into the overall risks of wearing contacts at any age, because there are real risks with accompanying unpleasant effects. 
 

Things I’ve been told over the years that have been proven effective to prevent or slow vision loss are: 

UV protection sunglasses - always 

Don’t smoke

reduce eye strain by frequently changing focus between items nearby and items at a distance

read In well lit areas

 

ETA - here’s some basic info on that contact lens I mentioned- https://www.fda.gov/news-events/press-announcements/fda-approves-first-contact-lens-indicated-slow-progression-nearsightedness-children

 

 

Edited July 22, 2021 by TechWife

[Arcadia]

My brother is looking at these two options for his 10 year old daughter. These are for glasses.

Miyosmart (longer studies) https://www.hoyavision.com/en-ca/discover-products/for-eye-care-professionals/specialty-lenses/myopia-management/

Stellest https://www.essilor.com/en/medias/press-releases/essilors-game-changing-stellest-lens-shown-to-slow-down-myopia-progression-in-children-by-more-than-60-after-one-year-interim-clinical-trial/

[Innisfree]

31 minutes ago, Arcadia said:

My brother is looking at these two options for his 10 year old daughter. These are for glasses.

Miyosmart (longer studies) https://www.hoyavision.com/en-ca/discover-products/for-eye-care-professionals/specialty-lenses/myopia-management/

Stellest https://www.essilor.com/en/medias/press-releases/essilors-game-changing-stellest-lens-shown-to-slow-down-myopia-progression-in-children-by-more-than-60-after-one-year-interim-clinical-trial/

Interesting, thank you!

[Lecka]

I had gas permeable contacts and bifocals both with one optometrist when I was about ages 12-15.

I despised it so much.

Then switched optometrists and had just regular glasses.

When I was 22 I had laser eye surgery.  One of my eyes corrected to 20/30 and one to 20/50.  I am happy with that.  I expect to need reading glasses in a few years.

I can’t express how much I despised the gp contacts, and I didn’t like the bifocals.  

I would never make my kids do either one.

I think for someone who was on board it would be acceptable to me.  
 

But honestly I just hated it and I don’t think it did anything to help my vision, either.  That is a big reason for getting off that train and switching optometrists. 

[kbutton]

The high myopia people in my family have tried things like gas permeable contacts to no avail. The drops don't offer long-term help according to an ophthalmologist I heard recently talking about myopia (context was Marfan Syndrome, but that tidbit was applicable across the board). I think most of the retinal problems have been minor--caught when there were slight problems and lasered. This presentation has information in it on myopia--you have to forward through a couple of speakers first. https://us02web.zoom.us/rec/play/cCEu6ALOKY0lbaDBG2RLjePgESzzLsF_5pWTqELW1tNqwSggeHQMe09VRpmMPiMGYA4T1cj9S13Ycppk.I2OFnDyfvO_CVcWa?continueMode=true&_x_zm_rtaid=qH645ocGScOqmRl6Qiq1yA.1626988088841.4f830dde7c8a23d84f8903edb7931882&_x_zm_rhtaid=756 

One relative wanted surgery, but her corneas were too thin. She eventually had cataract surgery and is very happy (she had really bad floaters, and the surgery for that often induces accelerated cataract growth, so her cataract surgery was early-ish, but within the typical age range). I think she's glad she didn't have to wait until she was older to get that taken care of after the disappointment with surgery.

A friend with very high myopia had surgery. I think she wears reading glasses or maybe bifocals, but it's SO MUCH better than the heavy duty glasses she used to have. She's many years down the road from surgery and very happy.

I dodged the hereditary high myopia, but there were times as a teen and young adult that my Rx changed like crazy too. I am going backwards now--getting more nearsighted. 

 

[prairiewindmomma]

Chiming back in—our opthamologist recommends PRK surgery over LASIK for high index folks because there is only so much you can shave off of the lens. We offered it to our late teen but they had a vision change again this year. You need to be stable in your vision for 2-3 years before you qualify.

We had a kid in online school too. The recommendation was to take a break hourly and use long vision—look out a window, walk around the block, toss a couple of basketballs, whatever, but give those eyes a break. Kid often would turn the audio reader on for coursework and give their eyes a break also if they were just working through screen slides.

[ktgrok]

7 minutes ago, prairiewindmomma said:

Chiming back in—our opthamologist recommends PRK surgery over LASIK for high index folks because there is only so much you can shave off of the lens. We offered it to our late teen but they had a vision change again this year. You need to be stable in your vision for 2-3 years before you qualify.

We had a kid in online school too. The recommendation was to take a break hourly and use long vision—look out a window, walk around the block, toss a couple of basketballs, whatever, but give those eyes a break. Kid often would turn the audio reader on for coursework and give their eyes a break also if they were just working through screen slides.

Yeah, I'm 45 and my vision still changes year to year...at this rate I'll never be able to have lasik 😞

 

[ktgrok]

I did some research on this, and the only thing really proven to help was sunlight, of all things! Wasn't about looking at stuff farther away - even reading was fine, as long as there was enough light - the amount of sun that you'd get under a tree was fine. But at least 2 hours a day. 

[Syllieann]

My oldest started wearing the soft multi focal contacts at age 11.  We use biofinity multifocal, which is the same design as misight, but in a monthly design.  He took a few days to get used to the multi focal aspect, but after the first week had totally adapted.  His peripheral vision isn't compromised at all, especially when compared to glasses.  They are working exactly as we expected in terms of slowing progression.

I don't know if the benefit will remain when he is 30, but I'm willing to take the chance that I spent extra money on something that won't last.  I'd really like to keep him below the threshold at which he's nonfunctional without glasses...things like being able to tell if the person who just walked through the door in the middle of the night is a family member or an intruder, and I don't want him to need lasik in order to be at that functional level.

My lasik was done at 22 yo, and corrected me to 20/15, which stayed that way for 15 years.   Then I developed an astigmatism that took me to 20/40 and now I am stuck with glasses because fitting contacts on post-lasik eyes is complicated.  I don't get along well with glasses because the weight bothers me, I swim a lot and participate in other sports, I enjoy my peripheral vision, and I like being able to see even if it's raining or I just opened the oven, dishwasher, or dryer.

Most kids have slowed down their progression by the time they are driving, but any child who is still progressing can benefit.  Personally, the ortho-k would only be on my radar for a competitive swimmer because it carries higher risks than the soft multi focals.  I think the atropine is a good choice for kids too young for contacts.  My 12 yo has no problem caring for contacts, but he is far more responsible than average.

The myosmart lenses aren't available in the United States last I looked, but they are available in Canada.

ETA:  there is a lot of evidence behind sunlight preventing the onset of myopia, but it is much weaker for slowing down the progression once it has started.

Edited July 22, 2021 by Syllieann

[Innisfree]

24 minutes ago, Syllieann said:

His peripheral vision isn't compromised at all, especially when compared to glasses. 

Okay, this is particularly interesting, thanks!