Today, most of our children’s time are spent on viewing digital screens at near distances instead of playing outdoors, which is a key risk factor for an eye condition called myopia, also known as short-sightedness. It is no surprise that more children are increasingly developing myopia, particularly during their primary school years and even as young as 2 years old. Singapore is widely known as the myopia capital of the world, with 65% of our children developing myopia by Primary 6, and this number increasing to almost 80% by the time they leave secondary school [1].
The common signs and symptoms of myopia in children may include:
If you notice your children experiencing any of these signs and symptoms, it is important to schedule an appointment with an eye care professional to get their eyes checked.
If not detected and managed early, children with myopia are also at risk of developing a more serious form of myopia called high myopia. Children with high myopia have a much higher risk of developing other serious eye diseases later in life, such as early cataracts, glaucoma, and retinal detachment, all of which can lead to blindness.
Indeed, the increasing prevalence of myopia, particularly in young children, is a rising public health concern in Singapore, negatively impacting the health and well-being of our next generation [2]. Not only that, parents need to also understand how myopia has a direct impact on one’s learning ability, especially during their early childhood.
There is no doubt that being able to focus and pay undivided attention in class is key to succeeding in school. Children with vision problems such as myopia find it hard to read written notes on the board that are small or far away from their seats. This can inevitably impact their ability to focus on a classroom setting, thus interfering with their academic learning.
Poor vision also affects learning through lower reading comprehension skills. Children with vision problems usually confuse similar looking words as they can’t see the text well. This impedes learning as they may struggle to perform with their overall academic learning and keep up with class assignments. Furthermore, research has also shown that severe myopia is also linked to a lower self-esteem in children [3]. All of which can increase the chances of children falling behind in school.
While myopia tends to worsen as children get older, there are various interventions available that can help slow down the progression of myopia in their childhood and teenage years. Now, what can you do as a parent to help manage your child’s myopia progression and keep their eyes healthier?
Research over the past 10-15 years has shown that the progression of myopia in children may be slowed through lifestyle interventions. Here are a few lifestyle interventions and strategies to help reduce your child’s risk of myopia:
These lifestyle interventions have been shown to be effective in reducing the progression of myopia and therefore, reducing their risk of developing sight-threatening eye conditions associated with severe cases of myopia (high myopia) later in their lives.
While practising the above good behaviours can go a long way in slowing the progression of myopia, in some cases, children may have fast progressing myopia such that healthcare interventions are needed to slow its progression. It is important to note that myopia treatment options such as single vision glasses or contact lenses help to correct myopia and produce clear vision, but do not slow down its progression.
Today, several myopia control interventions are available to slow down the progression of myopia in children. These range from wearing special myopia control spectacles, using prescriptive eye drops (please consult an ophthalmologist to learn more about this intervention), and special myopia control contact lenses called Orthokeratology (Ortho-K). In the following sections, we will dive deeper to learn how Ortho-K can be a promising healthcare intervention for controlling myopia in your child.
Ortho-K custom-designed gas permeable contact lenses have been an increasingly popular choice of myopia control intervention for children in recent years. It is an effective, non-surgical myopia control intervention that involves wearing a rigid contact lens overnight during sleep to temporarily reshape the cornea, allowing the user to have clear vision during the next day without needing corrective glasses or contact lenses.
Abiliti™ Overnight Therapeutic lenses, for example, are CE-approved Ortho-K lenses that are specially designed to slow the progression of myopia in children. Research has shown that they have been successfully prescribed for controlling the progression of myopia in children as young as 6 years of age [5].
Children will need to wear this special contact lens overnight while they sleep and the lens puts pressure on the cornea to temporarily flatten its surface, allowing incoming light to be better focused onto the retina. With that, the vision of your child will be temporarily improved without the need to wear glasses or contacts during the following day. The effect of Ortho-K usually lasts for 1 to 2 days and wearing the lenses every night will give the best and most consistent results.
Here are some reasons why Ortho-K lenses are becoming an increasingly popular myopia control intervention among parents:
Ortho-K lenses have been shown to be effective in slowing the progression of myopia in schoolchildren aged 6 to 10 years by as much as 0.44 mm (1.22D or dioptre) over 7 years.[3] Specifically, the Abiliti™ Overnight lenses have been shown to reduce the axial elongation of the eye in myopic children by 0.28 mm (0.78D), on average, over a 2-year period. A reduction in the axial elongation of the eye is commonly associated with a reduced myopia progression rate.
Apart from controlling myopia, Ortho-K lenses may also correct mild cases of astigmatism, presbyopia, and hyperopia. For example, Abiliti™ Overnight lenses are able to correct corneal astigmatism up to 2.50D.
Ortho-K provides clear vision to people with myopia without the need to wear their corrective contact lenses or glasses all day. This is especially a great option if your child frequently engages in high-intensity sports or water sports activities like swimming, which require excellent vision and yet it can be rather impossible to wear glasses or contact lenses during the activity itself. In addition, children reported that these lenses subjectively improve their appearance and social self-perception as compared to wearing glasses [6].
The usage of Ortho-K lenses teaches kids a sense of responsibility. Children as young as 7 or 8 years old can learn how to clean and care for their lenses. This learnt attitude of responsibility could be transformed to other areas of the child’s life later in their future.
Ortho-K lenses are relatively easy to use and remove. In terms of comfort, most people also find the lenses comfortable to wear and in fact, they do not feel the lenses in their eyes when they are sleeping, which makes them a desirable choice. Abiliti™ Overnight lenses are specifically designed to fit each patient’s unique corneal shape and it comes with ample corneal oxygenation, making it a safe and comfortable wear for children.
At this point, you might be wondering if your child is a suitable candidate for Ortho-K lenses. Well, the good news is that most children with low to moderate myopia (having a myopia prescription of -0.50 D to -4.00 D) are generally suitable candidates for Ortho-K. With proper hygiene and regular appointments with your eye care professional, Orthokeratology is a highly safe and effective myopia control intervention for children.
All in all, every child responds differently and may require a different myopia control intervention. It is always best to consult with your eye care professional to assess your child’s needs to find the most suitable solution for them. For those of you who are interested to find out more about the Abiliti™ Overnight Ortho-K lenses, Plano is currently running a special campaign where you can get personalised advice from eye care professionals on whether Ortho-K is the best solution for your child. Click HERE to register your interest.
References:
[1] Karuppiah, V., Wong, L., Tay, V., Ge, X., & Kang, L. L. (2021). School-based programme to address childhood myopia in Singapore. Singapore medical journal, 62(2), 63–68. https://doi.org/10.11622/smedj.2019144
[2] Seet B, Wong TY, Tan DTH, et al. Myopia in Singapore: taking a public health approach. British Journal of Ophthalmology 2001; 85(5): 521.
[3] Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, Gutiérrez-Ortega R, Sugimoto K. Long-term Efficacy of Orthokeratology Contact Lens Wear in Controlling the Progression of Childhood Myopia. Curr Eye Res. 2017 May;42(5):713-720.
[4] Q. Zhu et al., “Retardation of myopia progression by multifocal soft contact lenses,” (in English), International Journal of Medical Sciences, Review vol. 16, no. 2, pp. 198-202, 2019, doi: http://dx.doi.org/10.7150/ijms.30118.
[5] Cho P, Cheung SW. Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial. Invest Ophthalmol Vis Sci [Internet]. 2012/09/13. 2012;53(11):7077– 85.
[6] Santodomingo-Rubido, J., Villa-Collar, C., Gilmartin, B., & Gutiérrez-Ortega, R. (2012). Myopia control with orthokeratology contact lenses in Spain: refractive and biometric changes. Investigative ophthalmology & visual science, 53(8), 5060–5065. https://doi.org/10.1167/iovs.11-8005
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Ortho-K lenses have proven to have most successful outcomes compared with other interventions methods to slow the progression of myopia. I as a candidate for PhD in Vision Science would love to try this lenses on my subjects.