Pediatric optometry is more than just kid sized phoropters and having a supply of stickers and lollipops. Just as there are advances the treatment of adult vision conditions, pediatric conditions have seen their share of advances. In particular, research on treatments for children with either amblyopia or myopia has shown promising results.
For years, the gold standard to treat amblyopia, also known as lazy eye, was put a patch over the healthy eye. Kids weren’t crazy about wearing a patch, since it interfered with the activities of daily living. As a consequence, there were problems with compliance. Enter Amblyz™ occlusion glasses (XpanD). These are programmable electronic glasses, where the lens in front of the healthy eye is programmed to be darkened at regular and intermittent periods in order to force the amblyopic eye to function and develop.
Researchers at the Glick Eye Institute at Indiana University wanted to see if these glasses were just as good as patching. They studied 33 children between the ages of three to eight years old who have amblyopia. One group wore a patch for two hours a day and another group wore the occlusion glasses for four hours a day. While the study found that both groups gained two lines on a reading chart, the group with occlusion glasses were less distressed since the healthy eye was covered for only 30 seconds at a time. This made it easier for them to go about school and play activities. In fact, the makers of the occlusion glasses report that some kids like them so much that they want to continue wearing them even when they no longer have amblyopia.
While myopia or nearsightedness is easily corrected with glasses, a child with myopia has to get stronger glasses every year. Still, there are ways to control nearsightedness so that it isn’t necessary to get stronger glasses every year. These include atroprine drops and orthokeratology (“ortho-k”) lenses.
Four studies were done on atroprine drops, the medicine used to dilate pupils for eye exam, between 1989 and 2010. These studies showed that 81 percent nearsighted children show a reduced rate of myopic progression with the drops. The thing is, these results don’t last after the first year. So, atropine drops aren’t a good idea for long-term use.
Orthokeratology or ortho-k lenses is the use of gas permeable contact lenses that are worn while sleeping to temporarily correct vision problems so that corrective lenses aren’t needed during the day. In 2011 researchers in Japan found that children who wore the ortho-k lenses had less of an increase in the mean axial length of their eyes than children who just wore glasses. Also, the wearing of these lenses slowed the advancement of myopia past the first year of treatment. Studies in Hong Kong, Spain and Taiwan showed similar results. So, the future may see an increase in the use of ortho-k lenses in kids with myopia.
While the use of corrective lenses won’t go away, these alternatives will soon become commonplace. Even with these advances, it is still best to keep a supply of stickers and lollipops in the office for the kids.