Cases of childhood myopia, also known as nearsightedness, have increased over the past few decades. The most severe form, high myopia, could affect 1 billion people worldwide by 2050. While corrective lenses (eyeglasses or contacts) help persons with myopia achieve near 20/20 vision, the condition can lead to retinal detachment and glaucoma. There are treatments that go beyond corrective lenses to improve vision.
Contact lenses
“Contact lenses? What’s so special about them?” you might be asking. There are multifocal contacts lenses that have been shown to slow the progression of myopia in children. A recent study showed that children who wore these contact lenses had improved vision, even after they stopped wearing them, and the benefits lasted into their teen years.
This study, funded by National Institutes of Health (NIH), followed a group of children from the original clinical trial. These lenses were designed to add high focusing power to the wearer’s peripheral vision, in addition to correcting distance vision. When the study began, participants were between the ages of 7 and 11. Slowing the rate of eye growth helps reduce the severity of myopia. In the follow-up study, participants wore high-add lenses for two years. In the third year, they switched to single-vision lenses to determine whether the benefits persisted.
When the follow up study ended, axial eye growth returned to age-expected rates. In addition, those originally in the high-add multifocal treatment group continued to have shorter eyes and less myopia at the end of the follow up study. Those who switched to high-add multifocal lenses during the follow-up didn’t catch up to those who wore those kinds of lenses from beginning of the original study.
While single vision glasses and contacts can correct vision, they don’t treat the underlying problem—continued eye growth. Whereas the multifocal contact lenses both correct myopic vision and slow the progression of myopia by slowing eye growth. The findings from this study suggests that children can be fitted with multifocal contact lenses for myopia control and continue treatment into their late teens, when myopia progression typically slows.
Red Light Therapy
Red light therapy, also known as repeated low-level red light (RLRL) therapy, involves exposing the fovea to long-wavelength red laser light (635 to 650 nanometers) for three minutes, twice a day. Twenty clinical studies in China have consistently shown that this therapy slows myopia progression and delays onset in pre-myopic children.
What’s great about RLRL therapy is that it doesn’t disrupt a patient’s daily routine; all that is required is looking into a device for a few minutes each day. It is a non-invasive and non-pharmaceutical treatment, which makes it a good option for both parents and children. Still before this treatment can be utilized in the United States, more research is needed on the long-term safety of the treatment and its mechanisms.
Two University of Houston College of Optometry researchers warned against the use of RLRL therapy. Lisa Ostrin, OD, PhD, FAAO, FARVO associate professor and co-author Alexander Schill, PhD senior research scientist wrote in the Journal of College of Optometrists that doctors need to reconsider this therapy until safety standards can be established. They stated that the treatment can put the retina at risk of photochemical and thermal damage, especially since the red light used for the treatment exceeds safety limits.
Although RLRL therapy shows promise, safety concerns must be addressed and more long-term studies need to be done to learn if the benefits last over the long term.
Atropine Drops
Wouldn’t it be nice if your child’s vision could be improved with just a few drops in the eyes? Well, there are atropine drops that have been used in Asian countries to slow the progression of myopia in children. Concentrations between 0.5 and 1.0 percent have proven effective, though they can cause side effects such as light sensitivity and blurred near vision.
There is interest in utilizing these drops in the U.S. but the establishment of proper dosage is necessary. A study was done to find out if low-dose atropine of 0.01 percent was effective in slowing myopia progression. A study funded by the National Eye Institute (NEI) tested whether a low dose of 0.01 percent atropine was effective. A group of 187 children in a randomized controlled trial were treated for two years and it was shown that the 0.01 percent concentration was no better than a placebo in treating myopia.
That doesn’t mean that atropine is ineffective. It just means that more research needs to be done. Would a high dose be better for American children, given the country’s diverse population? Could combining atropine with something else, to offset the side effects and get a better outcome? These questions highlight the need for further investigation.
When it comes to childhood myopia, it’s no longer just a matter of getting glasses and waiting for the next eye exam. There are therapies that can both correct vision and slow the eye growth. Once myopia is under control, what’s next? Perhaps the future holds solutions for presbyopia as well.
https://reviewofmm.com/red-light-therapy-for-myopia-merits-risks-and-questions/
https://uh.edu/news-events/stories/2024/january/01292024-ostrin-red-light-therapy-danger-eyes.php