Myopia, or nearsightedness, is becoming a worldwide public health crisis. In the United States, about one-third of the population has myopia and the prevalence is increasing. Incredibly, nearly 90 percent of the population of Taiwan is nearsighted, and up to 20 percent of its population has high myopia. Researchers have long thought that myopia has a genetic component, but today they are also focusing on environmental factors such spending time outdoors.
"If both parents of a child are myopic, their child will have about a 50 percent chance of becoming myopic too. However, recent research shows that if a non-myopic child with two myopic parents spends two or more hours per day outside, the child will decrease his chances of having myopia to that of having no myopic parents," says Andrew Pucker, OD, PhD, FAAO. "However, once a child develops myopia, being outdoors will not slow the progression of the condition. The eye will continue to grow disproportionately longer, which can cause complications, including retinal detachments, later in life. Therefore, we should make an effort to have young children spend some time outdoors every day. Spending more time outdoors may also help improve mood. However, we should make sure that children are taking proper sun precautions like using sunscreen and wearing sun glasses."
Myopia sufferers now have a place to go for help. UAB Eye Care has opened a new referral Myopia Control Clinic in the UAB School of Optometry at 1716 University Boulevard. "Every optometry practice treats myopia with glasses or contact lenses, but few practices are currently offering myopia control options," Pucker says.
Controlling myopia is important because greater amounts of myopia have been associated with a higher chance of developing common vision-threatening conditions like cataracts, primary open angle glaucoma, and retinal detachments.
"The risk of developing these conditions depends on the severity of the myopia," Pucker says. "So reducing a person's chances of developing myopia or even reducing one's amount of myopia could also decrease the chances of developing one of these vision-threatening diseases. Most people don't understand these dangers, which could also occur in addition to the decreased visual quality of life experienced by myopic patients."
The Myopia Control Clinic provides three cutting-edge treatments for controlling the growth of the eye. Referred patients get a thorough myopia work-up and a series of tests to determine if a patient is a candidate for one of the myopia control treatments.
- Treating a patient with a 0.01 percent drop of atropine in each eye before bed can slow myopia progression by about 60 percent without the side effects (light sensitivity and decreased vision up close) noticed with higher concentrations of atropine.
- Soft multifocal contact lenses are worn routinely by people who are 40 years or older to help with reading clearly up close. "These lenses are also thought to slow myopia progression by bending light as it enters the eye in a beneficial way. These lenses are thought to slow eye growth by about 50 percent," Pucker says.
- Corneal reshaping contact lenses, also known as orthokeratology (Ortho K) lenses are worn during sleep and are removed in the morning. They create the same optical effects as the multifocal lenses. "These lenses temporarily change the shape of the cornea so a person can see clearly all day without glasses or contact lenses," Pucker says. "They also are thought to slow myopia progression because they bend light in a beneficial way. These corneal reshaping lenses have been shown to reduce myopia progression by about 50 percent."
Pucker says these treatments are long-term and once started, a patient usually continues them until age 16 or longer, which is about the time when the eye stops growing. "There is no good data on when to stop treatment, but I tell patients to use the treatments as long as they can," he says. "I also emphasize to them that these treatments do not cure myopia. They only help slow eye growth."
While all three of these treatments have been approved by FDA, they aren't approved specifically for myopia control. "All of these options are safe, but we aren't at the point yet where the FDA has approved their use for controlling myopia," Pucker says. "So our clinic is somewhat experimental in that way."
Researchers in the UAB School of Optometry have studied myopia for over 30 years and have been part of multiple National Institute of Health (NIH) funded studies. Because of its success in research, the School of Optometry is one of 10 sites selected in the United States to conduct another NIH-funded study of nearsightedness, this time using 0.01 percent atropine.
"We continue to discover exciting findings through our research, and we try to keep treatments clinically relevant and use them in a way that patients understand," Pucker says. "Patients are more likely to follow a treatment plan if they know what it does and how it works."