By Thomas Weissberger, RO
There are three key rules for childhood visual environment
- Children and young teens should spend at least two hours per day outdoors. While this can seem hard to achieve, it may be mostly achieved at school for primary school aged children, when this intervention is most crucial to prevent or delay myopia.
- Sun protection without excessive risk of sun exposure e.g. wearing hats, sunglasses, and seeking shade, are vital for eye health.
- Kids should be physically active for at least 60 minutes per day. This should be moderate to-vigorous level activity spent outdoors which is all the better for their visual development. For primary school aged children, this may be mostly achieved during break times.
As important as lifestyle management is, compliance is difficult to adhere to, and thus we need to look at corrective actions. First, let us look at the two main contact-lens based treatments.
Contact-lens based childhood myopia remedies
Orthokeratology: (ortho-k) is a non-surgical treatment method for ametropias, that involves using specially designed rigid gas permeable contact lenses to reshape the cornea. By reshaping the cornea, ortho-k lenses can temporarily correct the refractive error allowing patients to see clearly without the need for glasses or contact lenses during waking hours.
Ortho-k lenses are worn overnight and removed in the morning, and the cornea retains its reshaped curvature throughout the day. The reshaping effect is believed to be achieved by redistributing the cornea’s epithelial and stromal cells, which causes a temporary change in the shape and thickness of the cornea. It is important to note that ortho-k is not a permanent solution and requires ongoing treatment to maintain the effect.
Atropine: Although the specific mechanism of atropine in myopia management is not fully understood, it is thought to inhibit scleral thinning or stretching, and hence eye growth. Low doses of atropine in 0.01%, 0.02%, and 0.05% concentrations have been found to be effective in slowing down myopic progression.
What childhood myopia remedies can opticians offer?
As Opticians, treatment options include specially designed contact lenses and spectacle lenses, as well as an innovative new idea based on contrast theory (currently only available in Japan).
Contact Lenses:
- MiSight® contact lenses from Coopervision are daily disposable, soft CLs designed to control myopia progression in children ages 8 to 15 years.
- MiSight® lenses are uniquely designed with concentric rings etched into the lens periphery. This design helps to focus light directly onto the retina and corrects the refractive error without causing the eye to grow longer.
Glasses: All the various treatments involve some type of concentric design in the lenses that create defocus effects on the peripheral retina without involving central vision.
The two largest developers/manufacturers of specialty lenses designed as childhood myopia remedies are Hoya and EssilorLuxottica. Each has developed their own lens design using slightly different technology. ZEISS also launched a new design in June, ZEISS MyoCare lenses.
The Practical Professor: Optical Solutions for the Real World
I am a second generation optician and have made all aspects of opticianry and optics my life. I have over 10 years of teaching experience as a former professor in the Dispensing Opticians’ program at Seneca College and at Georgian College. I was also responsible for
modernization of the optical curriculum.
I am a trainer and trainee (One never stops learning!), and I am available to share my knowledge and experience with today’s eye care professionals. As the owner of Special Eyes Optical Services, I am dedicated to supporting the optical industry. You can reach out to me at Tom@SpecialeyesOpticalServices.com.
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