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Myopia Management

What is myopia and why is it a concern?

  • Myopia, also known as short-sightedness or near-sightedness, causes vision to become blurred in the long distance, and the need for glasses or contact lenses to bring the eye back into focus.

  • In most cases, myopia starts in childhood, and then progressively worsens until early adulthood when it stabilizes.1 Myopia is a lifelong condition and increases risk of potentially sight threatening conditions in later life, causing the World Health Organization to classify myopia as a global health concern.2

  • Myopia is caused by either the the depth from the front of the eye to the back too long (called axial myopia), or the focusing power of the eye being too strong (called refractive myopia). Both cause the image of far distance objects to be focused in front of the retina. For the eye to see clearly the image needs to be focused on the retina.

  • Childhood myopia is the most concerning, because it can progress quite rapidly as children grow, and the fast eye growth that causes it can stretch some of the eyes structures, which increases risk of eye disease in later life.3 The aim of myopia control in children is to slow eye growth, to reduce myopia progression and also to lower the risk for eye problems in later life.4

myopia control retina.png

How can myopia control contacts lenses and eyeglasses help?

Myopia control soft contact lenses are designed to slow the accelerated eye growth of childhood myopia based on how images are focused in the different parts of the retina.5 The retina is the light sensitive layer which lines the inside back of the eye, receving all information about sight. Light needs to be accurately focussed on the retina for clear vision.

When standard vision correction is used, like single vision contact lenses or glasses, it has been found that the central part of the image is focused on the retina for clear vision, but the peripheral light rays instead focus behind the retina. Research indicates that this generates a 'grow faster' signal for the eye, but the myopic eye in childhood is already growing too quickly.5

The principle of myopia control spectacles and contact lenses is to create the opposite profile, by making the peripheral light rays focus in front of the retina. Vision is still clear centrally, but this type of peripheral optical profile generates a 'slow down' signal for eye growth. The result is that any slowing of eye growth will similarly slow progression of myopia.5

References

  1. Hou W, Norton TT, Hyman L, Gwiazda J; COMET Group. Axial Elongation in Myopic Children and its Association With Myopia Progression in the Correction of Myopia Evaluation Trial. Eye Contact Lens. 2018 Jul;44(4):248-259. (link)

  2. The impact of myopia and high myopia. Report of the Joint World Health Organization-Brien Holden Vision Institute Global Scientific Meeting on Myopia. 2015 (link)

  3. Tideman JW, Snabel MC, Tedja MS, van Rijn GA, Wong KT, Kuijpers RW, Vingerling JR, Hofman A, Buitendijk GH, Keunen JE, Boon CJ, Geerards AJ, Luyten GP, Verhoeven VJ, Klaver CC. Association of Axial Length With Risk of Uncorrectable Visual Impairment for Europeans With Myopia. JAMA Ophthalmol. 2016 Dec 1;134(12):1355-1363. (link)

  4. Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci. 2019 Feb 28;60(3):M184-M203. (link)

  5. Smith EL 3rd. Optical treatment strategies to slow myopia progression: effects of the visual extent of the optical treatment zone. Exp Eye Res. 2013 Sep;114:77-88. (link)

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