Myopia Management

Myopia Management

In your clinic, how do you identify children who are potentially at risk of developing myopia or may need myopia treatment for kids?

1.      You see, kids are supposed to be farsighted, and as they grow that farsightedness neutralizes to zero. That’s ideally the case, so children who are not far sighted at their initial exam, grow up to be nearsighted teenagers. A child who is less than +0.75 farsighted at the age of 6, is at high risk for becoming nearsighted as they grow and may eventually require CRT lenses or other myopia treatment for kids.

2.      Genetics also plays a factor. If one or both parents are nearsighted, the child has a higher chance of becoming nearsighted and needing early myopia treatment for kids.

3.      How we use our eyes is a determining factor as intense near work can make children nearsighted. Children who spend less than 90 minutes daily outdoors and more than two to three hours a day spent on near work such as computers, books, phones…etc are more likely to need myopia treatment for kids, including options like CRT lenses.

4.      Particular binocular vision conditions which are uncovered during an exam are linked to myopia development such as esophoria, intermittent exophoria, accommodative lag, and high AC/A ratios.

What factors determine the success of myopia management?

1. Starting early: together we break habits that don’t support our goal. It is easier to teach a 7-year-old to put down the phone and go play than to convince a 15-year-old to do the same thing. Starting parent education early, even before the children are nearsighted, pays off at the end—especially when considering myopia treatment for kids.

2. Picking the right treatment plan: there are many treatment plans for myopia management, including CRT lenses, based on the kid’s ability to adhere to the treatment plan and the level of parent involvement. My goal is to be on the same page as the child and teach them to be independent with the treatment plan, so they can take care of their contact lenses, insert and remove them with no help from mom or dad.

3. Dedication is key, this is a long term plan. Contact lenses designed for myopia management, including CRT lenses, do not work if used occasionally. Eye drops for myopia treatment for kids also do not work if used once in a blue moon.

4. Adjusting the plan as we go along: I recently started demanding that my kids (11 and 14) charge their phones and all their devices in my room overnight. That is something I had to implement to protect their eyes and their overall health. I get creative ideas from other parents as well; for example, a friend of mine now assigns the chore of walking the dog to her teenage son and that’s how she gets him to spend more time outdoors—an important part of myopia treatment for kids.

How soon do you recommend myopia management?

1. Children who are pre-myopic or have risk factors: change habits and educate parents, follow-ups every 6 months to ensure that the prescription is stable, and we don’t need to add anything else to their myopia treatment for kids plan.

2. Once the child becomes myopic I enroll them in myopia management using contact lenses such as CRT lenses. If the parents are very near-sighted, and the child is an avid reader, I follow them very closely and might start combination therapy (contacts and drops). Myopia progresses faster in young children so early intervention with myopia treatment for kids is key.

3. My goal is to keep the prescription symmetrical in both eyes and below -3.00D as that reduces the risk for ocular complications. If they’ve already passed -3.00D, I manage the case more aggressively than if they were, for example, -0.50D, often incorporating advanced myopia treatment for kids like CRT lenses.

When do you typically end your myopia management intervention or is this a life-long commitment?

50% of nearsighted children progress after age 16.

Approximately 25% of myopes progress after the age of 18.

20% of myopes can progress by at least one diopter in their 20s.

There is no way to tell exactly if your child will stabilize at the age of 14 or will continue to progress into their 20’s. The safest approach is to continue myopia treatment for kids, including CRT lenses, until the age of 18. If the patient has high visual demands at that age (going to school full time and working a desk job) then we can continue the treatment until the age of 20.

If the patient elects to discontinue at the age of 18, then 6 months follow-ups on the prescription to ensure stability would be helpful.