Myopia Management

Unlike other common vision problems, such as simple astigmatism, myopia is not merely an inconvenience that can be corrected with glasses. Its primary cause is a permanent, abnormal elongation of the eyeball (an increase in axial length). Once the eye grows too long, it cannot shrink back to its normal size, making the condition permanent and irreversible. 

Link to sight-threatening complications

The stretching and thinning of eye tissues caused by the eyeball’s elongation significantly increases the risk of serious eye diseases later in life. The higher the degree of myopia, the greater the risk. Complications include: 

  • Retinal detachment: The stretched retina can tear and pull away from the back of the eye, a medical emergency that can lead to permanent vision loss.
  • Myopic maculopathy: The macula, responsible for central vision, can break down, leading to irreversible vision loss and legal blindness.
  • Glaucoma: The increased intraocular pressure and stretching of the optic nerve can increase the risk of glaucoma, a disease that damages the optic nerve and can cause blindness.
  • Cataracts: Myopia is also associated with an increased risk of developing cataracts. 

Need for active management

While low to moderate myopia can often be managed with corrective lenses, treating the symptom of blurry vision does not address the underlying disease process. Recognizing myopia as a disease promotes the need for proactive management, especially for children whose eyes are still developing. 

  • Treatment to slow progression: Myopia control treatments, such as special contact lenses, prescription eye drops, and increased time outdoors, aim to slow the elongation of the eye and reduce the risk of long-term complications.
  • Encourages earlier intervention: This approach encourages early screening and aggressive treatment to limit the progression of the disease

Myopia control treatments

  • Atropine eye drops: A low dose of atropine is administered nightly to relax the eye’s focusing muscles and slow the lengthening of the eyeball. Studies show that atropine can slow progression by about 50%, though side effects like light sensitivity can occur.
  • Orthokeratology (Ortho-K) lenses:  These specialized, rigid contact lenses are worn overnight to temporarily reshape the cornea. This corrects vision for the day and creates a peripheral defocus effect that signals the eye to slow its growth. This is a non-surgical and reversible option.  Total cost $800
  • Specialty soft contact lenses: Daily disposable, multifocal soft lenses, such as CooperVision’s MiSight and monthly lenses such as Biofinity Multifocal D work by using different lens powers to correct vision centrally while creating a peripheral defocus.   Total cost:  MiSight Dailies $1305 and Biofinity Multifocal D $435 for annual supply.   
  • Stellest glasses: If your child is not ready for contact lenses or Atropine eye drops, glasses are an excellent option! Essilor Stellest lenses are the first and only FDA market authorized to slow down Myopia progression.