Myopia

Myopia causes blurred distance vision. Myopia can be corrected by glasses, contact lenses and refractive surgery (Lasik).


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FAQ’s

My child is nearsighted and her vision seems to be worsening every six months. She keeps getting new glasses and she keeps getting worse. Is there anything that can be done to help her?

Myopia or nearsightedness causes blurred distance vision. It often starts around age 8 or 9 and frequently gradually worsens throughout college years or later. There is great debate about whether myopia is caused by genetics or the environment. Many researchers have shown that when there is a tendency for the eyes to excessively cross while reading, there is a greater amount of myopia and a faster rate of worsening. My research has shown that when bifocal contact lenses are prescribed to lessen or eliminate this excess crossing tendency, myopia progression or worsening is dropped by 90%. This is the most effective anti-myopia technique or therapy ever developed and is well worth considering for your child.

I am an adult, I wear soft contact lenses and my vision keeps worsening year after year. Is there any treatment to slow the worsening of my eyes? When I was younger, my eye doctor told me my vision would stop worsening after age 16 and that was 16 years ago!

Classic teaching about myopia did suggest that myopia would usually start at age 8 or 9 and would worsen gradually until “the age of cessation” at age 16 for girls and 18 for boys. That is still being taught and it may apply to some people with myopia, but it clearly does not explain the massive increases in myopia found throughout the world these days, nor does it explain the frequent experience of many adults that find that their vision worsens in adulthood. My research has shown that bifocal contact lenses, properly prescribed, can reduce the gradual worsening of myopia by about 90%. This is the most effective, proven technique to control myopia progression and is a particularly effective technique for adults.

My ophthalmologist told me that myopia is genetic and that there is no way to slow or stop it, including bifocal glasses. Why should I try your methods and treatments for my child?

There are many researchers that argue that myopia is caused only by genetics, but there has been a dramatic shift in the last 5 years or so in the number of highly respected researchers making very strong arguments based on very sound research, that not only is myopia influenced by the visual environment, i.e. how the eyes are used, but that there are techniques to effectively control myopia progression. My own research and clinical experience over the last 18 years has convinced me and many of my colleagues that bifocal contact lenses have unique advantages in the control of myopia and they are dramatically more effective than bifocal glasses. Bifocal glasses, by the way, have been proven to be reliably effective in controlling myopia progression in children whose eyes have certain focusing or alignment errors while reading. Your ophthalmologist would be correct that if you put bifocal glasses on all children with myopia, you may not see an effect, because not all children have the focusing or alignment problems that make bifocal glasses effective. However, if you want your child to benefit from a technique proven to dramatically slow down myopia progression, then there is no reason not to try bifocal contact lenses.

I want to do something to keep my child’s vision from getting worse, but she is only 8 years old and I’m not sure it’s safe for children to wear contact lenses. Have any studies been done to show that children can wear soft lenses safely?

The study that I performed to prove that bifocal soft contact lenses can control myopia included children as young as eight and there were no contact lens complications in the year long study. If a child is reasonably mature and responsible and takes proper care of their lenses, they do as well as adults. There was also a recent study by Johnson & Johnson to specifically answer your question, as to whether young children can wear soft contact lenses safely, and they showed that they did just fine, just the same as adults. I don’t recommend contact lenses for young children, if it’s just because they don’t like their glasses, but if bifocal contact lenses can help prevent the gradual worsening of their vision, then I recommend that they start wearing them at the first sign of myopia.

I am over 40 years old and have tried to wear bifocal contact lenses to help me see close, but I never saw well. Do children using these lenses for myopia control have similar experiences? I might want to help protect my child’s vision, but I don’t want him to have terrible vision while he is wearing these lenses.

Children do much better as a group with bifocal contact lenses than adults, for as yet unexplained reasons. I would estimate that 90 to 95% of children or young adults are successful and satisfied with their vision when wearing bifocal contact lenses, while it might be more in the 70 to 80% range for adults wearing bifocal contact lenses for presbyopia (difficulty seeing close). Because of the success of bifocal contact lenses in the control of myopia, there will be some new contact lenses soon that will be designed to control myopia while offering optimal vision quality. So, there’s no need to wait, as children do fine with bifocal contacts, but there will be new improved lenses soon!

What is Ortho-K?

Ortho-K or orthokeratology is the method of using precisely designed gas permeable contact lenses to reshape the cornea or front tissue of the eye in order to correct the vision. It has been practiced for about 40 years, but has really gone through dramatic improvements in the last 10 years. In the “old” days when I was an Ortho-K patient, orthokeratology involved the programmed application of a series of lenses worn during the day in order to gradually cause a moderate improvement in vision when the lenses were removed. The process often took years and was very complicated and the results were somewhat unpredictable. Modern or advanced orthokeratology involves the use of newer designs known as “reverse geometry” lenses made of highly gas permeable materials, designed to be worn while sleeping. These advances have allowed for very predictable and rapid vision improvements with excellent unaided vision during the day.

Am I a candidate for Ortho-K?

Ortho-K is most effective for myopia levels under -5.00 diopters and for certain types and levels of astigmatism. The easiest way to tell would be to call or email to schedule a free consultation with Dr. Aller.

Is Orthokeratology safe and effective? Does it have FDA approval?

Most of the modern systems of advanced orthokeratology have FDA approval and are considered safe and effective means for temporarily correcting refractive errors such as myopia and astigmatism. The safest type of lenses to wear in general and especially for extended wear of up to 30 continuous nights has always been rigid gas permeable lenses. Ortho-k uses only the most gas permeable lenses and because they are removed upon awakening, they are actually worn less than standard lenses and much less than continuous wear or extended wear lenses. In the FDA trials, there were no serious adverse events with orthokeratology lenses.

I have dry eyes and had to stop wearing soft lenses. Would orthokeratology lenses be easier or harder to wear because of my dry eyes?

There are some potential advantages with orthokeratology for dry eye patients compared to soft contact lenses. Soft lenses frequently act like sponges, drying out the eye (though there are some new lenses that are beneficial). Regardless, for dry eye patients, there is a limit to how many hours soft contact lenses can be worn with optimal comfort. Dry eyes may also make disposable contact lenses not last for their intended lifespan, requiring more frequent replacement. Orthokeratology lenses are worn only while sleeping and while they won’t enhance or improve the way eyes feel on awakening, the eyes only get more and more comfortable as the day goes on, rather than getting more and more uncomfortable. For maximum comfort and success, though, I like to treat my patient’s dry eye condition prior to beginning orthokeratology.

My 12 year old child has myopia and it seems to be getting worse. Is he a candidate for orthokeratology and will it stop his myopia progression?

Whether your son is a candidate for correction with orthokeratology depends on his current prescription and would have to be determined after an initial examination. There are several preliminary studies that suggest that orthokeratology treatment causes myopia to progress about 50% less rapidly than if a child were wearing regular soft contact lenses. Many children and adults with progressing myopia can have their myopia progression virtually halted with an alternate therapy using anti-myopia soft lenses, details of which can be found at www.stopmyopianow.com or www.draller.com.

My son is 6 1/2 years old and have been recently diagnosed with myopia. He has prescription of -1.25 in both the eyes. Is he a candidate for Ortho-K?

Ortho-K is FDA approved for use at any age, somewhat unusual for medication or devices or procedures. For any procedure, the best way to answer the question is to decide if the benefits outweigh the risks. For your son, the risks would be that at his age he might not take proper care of his treatment lenses. Perhaps he won’t wash his hands properly or use the proper solutions. Six year olds normally have more difficulty putting lenses on and taking them off, so parents have to expect to be involved. The benefits include seeing well without glasses or daytime contact lenses. Additionally, studies suggest that children that are treated with Orthokeratology experience about 50% less progression of their myopia over time, as compared to those children wearing regular glasses. A good alternative to Ortho-K for your son would also be bifocal contact lenses, as they have been proven to dramatically slow down the progression of myopia by about 90%. For details on this option, go to www.stopmyopianow.com or my office webpage www.draller.com.

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