Myopia (nearsightedness) is a condition that is most associated with blurred vision at distance. Increasing amounts of myopia do not only cause difficulty seeing, but myopia is also associated with an increase in sight-threatening eye diseases such as myopic macular degeneration, cataract, glaucoma, retinal holes and tears, and retinal detachments. Your doctor has recommended that you consider an intervention to help limit the progression of your child’s increasing myopia.
Evidence in the scientific literature suggests that some novel contact lens designs and eye drops may slow the progression of nearsightedness in children. However, no treatment is approved by the United States Food and Drug Administration (FDA) for this purpose, with the exception of MiSight contact lenses. All contact lenses used in the Myopia Management Clinic at Fogg Remington EyeCare have been approved by the FDA, just not specifically to slow the progression of nearsightedness. 1% Atropine eye drops are approved by the FDA for the treatment of amblyopia and strabismus, however lower concentrations of atropine for myopia retardation are still considered off-label use. There are three ways to potentially slow the progression of nearsightedness in children: corneal reshaping, bifocal contact lenses, and/or atropine eye drops. As explained below, each treatment has its own risks. Your child’s suggested treatment(s) is/are marked with a check.
Corneal reshaping contact lenses are worn during sleep and removed in the morning. They temporarily change the shape of the cornea, so that the wearer can see clearly all day long without glasses or contact lenses. During the first two weeks of overnight wear, your child will experience changing vision. When the vision gets worse, s/he may put on glasses to provide clear vision. Although the chance of an eye infection is still very low, it is greater for corneal reshaping contact lenses than usual daytime contact lens wear because the contact lens is worn overnight.
Multifocal Contact Lenses
Soft and rigid gas permeable multifocal contact lenses are worn in the daytime and are routinely used to help people over 40 years of age read clearly as well as see far away. Children may not see quite as clearly with these contact lenses as other types of contact lenses, but there are no additional risks compared to regular daily contact lenses.
Atropine Eye Drops
Atropine is an eye drop that typically makes light seem brighter because it makes the pupil (black hole in the middle of the eye) bigger, and blurs near vision because it reduces the ability of the eyes to focus while looking at near. Low concentration (0.01% to 0.1%) atropine has been shown to significantly slow the progression of nearsightedness without increasing pupil size or decreasing near vision dramatically. In a recent large study, only a very small percentage of children complained of problems with low concentration atropine, and glasses can reduce symptoms if your child notices poor reading vision or lights seem too bright.
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