I read the comment on "freeing from physical activity without having them worry about lenses". I am not a pediatric ophthalmologist but do kids worry about the lenses when they are in? Is there a high rate of displaced contacts etc? Educate me because I was totally unaware of that. I wore contacts as a kid and never worried about it etc.. and rarely had a displaced lense. Also, Do you have an article showing the data for ortho-k slowing down myopia. I am not familiar with that and would love to see the evidence. If that is the case, there may be some merit for it.
Thiaeyemd and Visionary,
Yes, soft and rigid gas permeable lenses are well tolerated by millions. Water sports may be the biggest problem for many while dry eye and allergies reduce comfortable wearing time for others. Neither option slows myopia progression.
The best source of references for methods of myopia prevention that I've seen is the web site
http://www.MyopiaPrevention.org It has lots of references with links to the abstracts or full articles. Atropine drops have been proven to be the best method of stopping myopia, but they aren't commonly used due to their side effects.
Methods of creating peripheral myopia (OrthoK is one) are the next best method, somewhere around a 50% slowing in most controlled studies although individual doctors often report much higher numbers, possibly due to customized designs. Lens designs are being worked on to optimize myopia prevention once it was found that standard orthok was having this effect.
Specific types of soft bifocal lenses also create the desired peripheral myopia and all major soft contact lens companies have patents on their version of the technology. Myopia control soft lenses are being marketed in Asia with advertised (unpublished) results of about a 30% slowing of progression. A spectacle lens with the same type of technology (radial refractive gradients) is also being marketed. I expect the companies to start advertising in the US within a year.
My statement that OrthoK was the best option is based on the controlled studies of 50% reduction and the reported 30% for soft lens designs. Some studies for both methods show much higher numbers, so the final story is yet to be told. It may be that short times of exposure to no lens wear in soft lenses is enough to make that option less effective than orthok where the change is always on the cornea. I consider both a reasonable option at the current time, but I think orthok is the standard for now.
I do think that the era of telling children that their myopic correction is going to just get worse each year is rapidly coming to a close and doctors who do not understand the options or offer them to their patients are going to be left behind.
There are many doctors who do not consider myopia progression a problem, unless we talk about higher levels such as a -9.00 where retinal detachments are more significant. Many profess to loving their myopia, especially presbyopes. But I feel that if you can keep a child from becoming a -6.00 and instead go through life as a -1.00 or even better, that is a great gift to offer. It is an offer, not a guarantee. But it is looking more realistic all the time.
In the meantime, send the kids outdoors! Lack of outdoor time, as opposed to too much reading, TV and other "near" tasks, has been found to be a significant risk factor for myopia. In one study, the risk of becoming myopic if the child had two myopic parents was 60%, but that reduced to 20% if the child spent an average of two hours a day outdoors. We don't know if it is the ability to focus on objects far away, Vitamin D, greater depth of focus from smaller pupils, increased dopamine production in the retina due to greater light levels or some other unknown factor. But studies are looking into it.
