The most important tool that doctors use to shape our treatment and management practices is the outcome of the peer-reviewed research. These studies show the importance of early treatment of myopia and show a cumulative effect of treatment in slowing progression over time.
TOOLS FOR PARENTS
- Myopia Care: assess risks for myopia
- Brien Holden Vision Institute Myopia Calculator: allows you to see progression of myopia based on studies, and compare different treatment methods
- Role of genetic factors in the etiology of juvenile-onset myopia based on a z longitudinal study of refractive error (Pacella R, McLellan J, Grice K, Del Bono EA, Wiggs JL, Gwiazda JE.)
- A 24-year study on refractive error determined children with two myopic parents were 6.42 times as likely to become myopic as children with one or no myopic parents.
- Myopia, Lifestyle and Schooling in Students of Chinese ethnicity in Singapore and Sydney. (Rose et.al.)
- This study compared 6 and 7 year olds in Sydney and Singapore to evaluate the prevalence of myopia which was 3.3% in Sydney vs. 29.1% in Singapore.
- Sydney children read more books per week and did more total near work activities (29.93 hours/week) compared to Singapore children (23.53 hours/week).
- Children in Sydney spent significantly more time outdoors (13.75 hours/week) compared to Singapore (3.05 hours/week) which was the most significant factor associated with the differences in the prevalence of myopia between the 2 sites.
- Outdoor activity reduces the prevalence of myopia in children (Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, Smith W, Mitchell P.)
- This study monitored 1765 6-year-olds and 2367 12-year-olds and determined that higher time spent outdoors was associated with less myopic prescriptions, after adjusting for near work, parental myopia, and ethnicity.
- The complex interactions of retinal, optical and environmental factors in myopia aetiology (Flitcroft, DI.)
- This study evaluates the impact of near work and quantifies the amount of focusing (or accommodation) measured in diopters is required with near work vs. distance viewing and the impact this could have on myopia.
- Undercorrection of myopia enhances rather than inhibits myopia progression (Kahmeng Chunga, Norhani Mohidina, Daniel J.O’Leary)
- This study evaluated 95 children corrected with glasses and concluded under-correcting the myopia in children may be potentially harmful. Also, it is suggested that this under-correction results in the stimulation of eye elongation when blur is present.
- Effect of spectacle lenses designed to reduce relative peripheral hyperopia on myopia progression in Japanese children: a 2-year multicenter randomized controlled trial (Kanda, H., Oshika, T., Hiraoka, T. et al.)
- This study enrolled 207 myopic children aged 6-12 to evaluate the benefits of single vision spectacle lenses vs. a MyoVision spectacle lens designed to reduce relative peripheral hyperopia to try to slow the progression of myopia. The results of this clinical trial could not verify the therapeutic effect of MyoVision for slowing down myopia progression in Japanese children.
LOW DOSE ATROPINE
- 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 (Yam JC, et al.)
- The study evaluated 438 children with myopia treated with various concentrations of Atropine eye drops daily and determined all three concentrations (0.01%, 0.025%, 0.05%) reduced myopia progression after one year.
- Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2 (‘ATOM 2’; Audrey Chia, Qing-Shu Lu, Donald Tan)
- The follow-up study from ATOM 1 monitored 400 myopic children treated with various concentrations of Atropine eye drops (0.01%, 0.1%, 0.5%) daily and concluded that each concentration slowed the progression of myopia over 5 years, with the 0.01% concentration being the most effective and causing the least visual symptoms
- To read more: https://www.aaojournal.org/article/S0161-6420%2815%2900675-2/abstract
- The safety and efficacy of SYD-101 in children with Myopia (STAAR)
- This study is currently ongoing and aims to evaluate 840 children with myopia treated with atropine in hopes of gaining FDA approval of use for myopia management.
- Review of latest research: https://www.myopiaprofile.com/the-latest-and-greatest-research-on-atropine/
SOFT DUAL-FOCUS CONTACT LENSES
- A 3-year randomized clinical trial of MiSight® lenses for myopia control (Chamberlain P, et al.)
- This study treated 144 myopic children with MiSight daily disposable soft contact lenses and determined the contact lenses were effective in slowing change in spherical equivalent refraction and axial length over 3 years.
- Multifocal Contact Lens Myopia Control (Walline, Jeffrey J et al.)
- This study corrected 40 school aged myopic children with multifocal contacts and concluded soft multifocal contact lens wear resulted in a 50% reduction in the progression of myopia and a 29% reduction in axial elongation during the 2-year treatment period.
ORTHOKERATOLOGY (ORTHO-K) LENSES
- Efficacy, Safety and Acceptability of Orthokeratology on Slowing Axial Elongation in Myopic Children by Meta-Analysis (Shi-Ming Li, et al.)
- This review of 6 studies managing 667 children with myopia who were fit with either ortho-k lenses or glasses, and concluded that Orthokeratology has significantly greater efficacy in controlling axial elongation in children compared to Spectacle correction.
- Stabilization of Myopia by Accelerated Reshaping Technique (SMART) Study (Robert L Davis, et al.)
- This study enrolled compared 172 children fit with reshaping contact lenses overnight with 110 children fit with single vision soft contact lenses and determined myopia progressed at a significantly higher degree in the soft contact lens group (-1.03 diopters) versus the corneal reshaping lenses group (-0.13 diopters) over 3 years.
- The synergistic Effects of orthokeratology and Atropine in Slowing the Progression of Myopia (Lei Wan, et al.)
- This study treated 84 patients with orthokeratology (OK) lenses in combination with atropine drops and determined combined treatment better controlled the development of myopia over 2 years.
IS IT SAFE FOR KIDS TO WEAR CONTACT LENSES?
- Misight FDA Approval News Release: https://www.fda.gov/news-events/press-announcements/fda-approves-first-contact-lens-indicated-slow-progression-nearsightedness-children
- The Safety of Soft Contact Lenses in Children (Mark A. Bullimore)
- This analysis reviewed 9 studies representing 1800 patients from 7- to 19-years old and determined the incidence of corneal infiltrative events in children is no higher than in adults, and in the youngest range of 8 to 11 years, it may be markedly lower.
- Benefits of contact lens wear for children and teens (Jeffrey J Wallne, et al.)
- This study evaluated the results of a pediatric quality-of-life survey of children fit with contact lenses and determined contact lenses significantly improved the quality of life of these children and improved how children and teens feel about their appearance and participation in activities, leading to greater satisfaction with their refractive error correction.
- Centers for Disease Control and Prevention (CDC) Healthy Contact Lens Wear and Care
OTHER REVIEWS OF MYOPIA MANAGEMENT METHODS AND RESOURCES
- World Health Organization: The Impact of Myopia and High Myopia