How Does Myopia Progression and Management Work?
There is no safe level of myopia.
The goal of myopia management is to slow down the increase in prescription and the axial length of the eye.
What Is Causing the Increase in Myopia?
There are multiple factors that can cause an increase in myopic prescription. They range from genetics to environmental influences. Having one parent that is myopic increases risk of a child also becoming myopic. That risk is further increased if both parents are nearsighted.
Digital device use.
Extended screen use has been shown to increase myopia. Given today’s age in which most of a child’s schoolwork is done on the screen it is hard to avoid excessive screen use.
Between 18 and 24 months screen time should be limited to watching educational programming with a caregiver.
For children 2-5, limit non-educational screen time to about 1 hour per weekday and 3 hours on the weekend days.
For ages 6 and older, encourage healthy habits and limit activities that include screens. Maximum 2 hours per day of leisure screen time.
Myopic defocus.
The idea of peripheral defocus of light. Typically traditional glasses or contact lenses cause hyperopic peripheral defocus (behind the eye). The eye lengthens because of the defocus, which causes increases in the nearsighted prescription.
When Should We Start Myopia Management.
A change of 0.50D every 6 months or a change of axial length >0.22mm per year is considered to be fast progression. (1)
1. Hernandez J, Sinnott LT, Brennan NA, Cheng X, Zadnik K, Mutti DO. Analysis of CLEERE data to test the feasibility of identifying future fast myopic progressors. Investigative Ophthalmology & Visual Science. 2018;59(9):3388-3388.