What is myopia management?

Published on
February 17, 2022

Managing your child’s myopia and slowing it down is important so that their minus prescription won't continue to worsen. Multiple studies show that medium and high myopia (minus 5 or worse) will seriously affect your child’s quality of life as they age by increasing the risk of serious eye diseases. Furthermore, if your child’s prescription gets worse every year, the more blurry their vision will be in between an updated prescription. 

What is myopia?

A person with myopia, also known as nearsightedness, is unable to see clearly at a distance. This occurs when either the front part of the eye is too curved and too strong, or the eyeball is too long. When that happens, it means that instead of the light focusing in the back of the eye, which provides for clear vision, since the eyeball is too long, the light focuses in front of the eye, resulting in the patient experiencing blurry vision far away. 


What are the causes of myopia?

Myopia is usually the result of either genetics or environmental factors. When it comes to your genetic factors, if either one or both of your parents have myopia, you are at a much greater risk of developing myopia as well. Myopia is more likely to develop if you do a lot of near tasks all of the time or begin near tasks at a young age. Examples of near tasks include, looking at your phone, reading a book, or using your computer. Whereas an example of a far task would be engaging in any outside activities. Kids who spend a lot of time indoors have also been shown to have more myopia than those who spend time outside, which is why eye doctors recommend that children spend 2 hours per day outside. Your lifestyle and environment definitely have an effect on your myopia, too.

Why are standard contact lenses and glasses not enough to manage myopia?

A typical way to correct myopia is with standard glasses or regular contact lenses. By using the standard type of glasses, the light would now enter the eye and would land on the retina to correct the vision. Due to the perfectly spherical shape of the eyes, the light lands behind the retina instead of at the retina which is called hyperopic defocus. Thus, the brain signals for the eyeball to grow longer, and when that occurs, not only is it going to grow longer in the periphery, but it is also going to grow longer overall, causing the patient to start seeing blurry again. It's like a never-ending cycle.


How do eye doctors slow down the progression of myopia?

Unlike standard glasses and contact lenses that correct the myopia, eye doctors are now advocating for more to be done to prevent the progression. The following are the different treatment options for myopia that correct vision while reducing the progression:

Orthok or orthokeratology lenses

Orthokeratology is also known as corneal reshaping therapy. It involves wearing a hard contact lens at night. It reshapes the front curve of your eyeball so that when you wake up in the morning, you remove your lenses, and the light entering the eye now lands on the back portion of the retina allowing you to see clearly. It acts like a retainer for your eyes, trying to maintain the shape so that it doesn't keep progressing and doesn't get worse. After all the magic happens at night, you can see clearly without any corrective lenses in the morning and for the rest of the day. 

Multifocal contact lenses

Multifocal contact lenses are another type of specialty contact lenses used for myopia management. These are soft, daily disposable contact lenses just like standard contact lenses. The difference is that this lens has both concentric circles and a clear vision zone as well as a treatment zone. This lens allows light to focus in the periphery in a completely different way from a standard lens. It aims to address the problem of hyperopic defocus and slows down the progression of myopia. Like OrthoK, specialty multifocal contact lenses for myopia management correct your child's vision while reducing the progression of childhood myopia. 

Atropine drops

Low dose atropine drops are another option. However unlike the other options above, this option needs to be combined with either corrective glasses or contacts or another form of myopia management. Kids put these drops in their eyes every night. The goal is also to slow down the progression of myopia. Due to the low dose of atropine used for myopia management, there are usually no noticeable side effects, such as blurry vision that is a side effect from higher dose atropine used in a dilated eye exam. Atropine is the ideal option for younger or less mature patients that may have difficulty caring for multifocal or orthok contact lenses. 

Progressive glasses

Another option to manage this condition is wearing progressive glasses. Despite it not being the first line of treatment, it is shown to have some effects. Anyone who isn't ready to wear contact lenses can try this alternative, although this is usually done with atropine eye drops.


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Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!

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