Options to slow down the change in your child’s prescription
Dr Jeff Goodhew, Optometrist, Abbey Eye Care
Everyday in our practice we see children who have prescriptions that are changing on a yearly basis. Undoubtedly parents will ask what they can do to either stop or slow down this progression (myopia control). This blog post highlights the most current research to give parents options they can consider to help slow down the rate of change in their child’s eyeglass prescription.
Nearsightedness or myopia (blurred vision in the distance), affects approximately 1/3 of the North American population and over 90% of the population in some East Asian countries. Myopia is caused by an increase in the length of the eye or the curvature of the cornea (window to the eye). This causes light to focus in front of the retina resulting in blurry vision while looking at objects far away, but clear vision while looking at close objects. Myopia typically develops around the age of 8 and progresses through 15 or 16 years of age, and the average rate of progression is approximately 0.50 D (diopter) per year.
Top image: nearsighted eye showing light focussing in front of the retina
Bottom image: glasses moving the focal point onto the retina, allowing for clear vision in the distance
What can parents do?
Recently there has been a lot of research trying to find methods of slowing down the rate of change of a child’s prescription. So far there are 3 options which appear to slow down myopia progression by nearly 50%. The options are as follows:
- Soft bifocal contact lenses
- Topical pharmaceutical agents (eye drops)
I will go through each of these in order:
As described in more detail on this website, Ortho-K is a technique where a hard contact lens is worn overnight. It gently reshapes (flattens) the front surface of the eye. This allows for clear vision without the need for vision correction (glasses or contacts) during the day. It appears that Ortho-K slows down the growth of the eye thus reducing the change in a child’s prescription by up to 50%.
Soft bifocal contact lenses
Soft bifocal contact lenses are typically worn by people aged 45 and up to help them read things up close as the eyes focussing ability declines with age. This same lens is now being successfully worn by children with nearsightedness. The centre of the lens provides clear vision in the distance while an outer ‘reading’ zone signals the eye to not grow/lengthen as quickly, thus reducing the prescription change by up to 50%.
Topical Pharmaceutical agents (eye drops)
Atropine in a diluted concentration of 0.01%, has recently been shown to slow down the progression of myopia as well. However, the drops do have some side effects which may include light sensitivity from the pupils being slightly dilated to blurred vision at near while reading. The therapeutic effect in slowing down a child’s prescription may, in fact, be temporary as some of the nearsightedness seems to come back once the child stops taking the drops. More research and clinical trials need to be done with this therapy before it becomes widely adopted.
Ortho-K contact lenses worn at night or soft bifocal contact lenses during the day both slow the progression of myopia by a similar manner, approximately 50%. If a child starts wearing glasses at age 8 with a prescription of -1.00 D, one would expect that child to have a prescription of -5.00 D by the age of 16. If myopia control strategies are adopted early on, that final prescription could end up somewhere closer to -3.00 D. To find out more about these exciting options or determine which option is best for your child, please talk to one of our Optometrists.