Aug 4, 2023

How myopia can affect children

August is Children’s Eye Health and Safety Month! In recognition of this important awareness month, we are sharing on the topic of myopia and how this eye condition can affect children. Keep reading to learn more.

What is myopia?

Myopia, or nearsightedness, is a common condition in which objects that are far away appear blurry or out of focus, but objects that are up close are clear. Most cases of myopia can be corrected with glasses or contact lenses. However, severe cases of myopia come with other risks, such as greater likelihood of having retinal tears or developing glaucoma or cataracts.

The Canadian Association of Optometrists estimates that 30% of Canadians experience myopia and rates are on the rise. Myopia is occurring in children (6-7 years old) and is progressing faster than it has in previous generations.

A 2018 study found that 6% of children that were 6-8 years old had myopia, and this rate jumped to almost 30% for children 11-13 years old. Research suggests that increased screen time is contributing to the rise in myopia and studies have shown that spending more time outdoors may help reduce the progression of this eye condition.

How does myopia affect the eye?

To see clearly, light enters the eye through the cornea and lens. These work together to bend the light, so it lands on the retina in the correct spot. The retina then transmits these signals to the brain, resulting in vision. In myopia, there are changes in the shape of the eyeball: instead of it being spherical, it becomes more elongated, like a football. This makes it difficult for the cornea and lens to do their job, causing blurred vision when looking at something far away. Both genetic and environmental factors impact the development of myopia.

If you notice your child is experiencing eyestrain, squinting to see things at a distance, having headaches or unable to see far, like the board at school, they may have myopia. An eye exam will determine if your child has the condition and can monitor how it is progressing. Children who have parents with myopia are also more likely to be nearsighted.

Ongoing myopia research

Various strategies have been used to try and slow the progression of myopia in children. Use of low-dose atropine drops, special hard contact lenses that flatten the cornea (called Orthokeratology), and other contact lenses that change the way the eye focuses have all been used. However, these treatments do not work for all children and may have side effects.

Researchers are looking into ways to slow myopia progression in children. Myopia cannot be reversed, but the hope is that future treatments would prevent it from getting worse and reduce the risk of other complications to eye health.

Myopia Treatments

Low-dose atropine drops

It has been thought for some time that atropine in low doses may help to prevent the lengthening of the eyeball that leads to myopia. Often used in children between 5-18 years old, these drops are placed in the eye at bedtime with the hope that they will slow the progression of myopia.

However, recent research suggests that we still have much to learn about the role atropine can play in myopia progression. Results from the Pediatric Eye Disease Investigator Group (PEDIG) recently published in JAMA Ophthalmology demonstrated that 0.01% concentration atropine drops were no better than a placebo for slowing the progression of myopia. In this American study, 187 children, 5-12 years old, were randomly assigned to receive atropine or placebo drops at bedtime. At the end of the treatment and 6-months post-treatment, there was no significant differences to the degree of myopia or the length of the eyeball between the treated and untreated children.

These results are in stark contrast to other recently published studies that suggested the same concentration had a protective effect. Four out of six randomized studies showed significant reduction of myopia in the treatment group, and three of the six showed significant slowing of eye growth. This points to the need for further research to see if these drops may have an effect in other concentrations and affect different populations in different ways. Higher dose atropine drops have been used as a treatment option, but often lead to other side effects including light sensitivity and blurry vision at time of drop use.

Diffusion optics glasses

Researchers have also been working on developing glasses that help reduce myopia progression. This would be a non-invasive way to treat myopia progression in children who may have difficulty with drops or contact lenses.

Previous research suggests that some cone cells in the eye, those that respond to red and green wavelengths of light, play a role in the way the eye is shaped. High-contrast signals between normal and defective cones may play a role in the lengthening of the eye that causes myopia. Building on this research, SightGlass Vision has developed Diffusion Optics Technology (DOT) in order to reduce signal differences between cones and hopefully slow the rate of eye lengthening.

The DOT lenses are covered with microscopic dots which reduce contrast. There is a small section in the central part of the lens that does not have the dots. The research tested two different concentrations of dots to see which was more effective over time. The glasses are worn for at least 10 hours daily.

The research group recently published the results of their 1-year randomized control study of the DOT glasses with positive results. 256 children with mild to moderate myopia were randomized to the treatment across 14 North American sites, including Canada. Their 1-year results show that the treatment was safe, non-invasive and effective in reducing development of myopia and lengthening of the eye. While other forms of glasses have been tested in older children, this was the first study to include children between 6-8 years old, and the lenses were found to be most effective in children who were 6-7 years old.

Image of Violet showing off her DOT glasses. Violet has two highly myopic parents who hope that these lenses will help reduce her chances of developing severe myopia as she grows.

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