Myopia Progression Treatment in Children
Myopia progression is the progressive increase in the amount of nearsightedness in children due to eyeball elongation (axial elongation). It is thought to be caused by a combination of genetics and environmental factors. It has a higher prevalence in Asians, particularly East Asians. Children whose parents are myopic are at a higher risk of having it.
The recent myopia boom in children could be due to alterations in their current lifestyle. There has been a continuous decline in interest in outdoor activities, as kids prefer near activities such as reading books and using electronic devices. The resultant lack of exposure to natural light seems to have an effect on progressive axial elongation.
Optical correction in the form of glasses, contact lenses, bifocal, progressive addition lenses, specialty lenses (like Myovision), improve visual acuity but it does not slow down axial elongation. Orthokeratology is still an experimental treatment modality. Currently, the use of low dose atropine (0.01-0.05%) shows promising results in slowing down progression of axial elongation with little to no side effects. This alternative treatment requires monthly replenishment of the fresh low dose preparation because it is not readily available commercially. It also requires an annual measurement of axial length.
- Pugazhendhi, S., Ambati, B., and Hunter, A. (2020). Pathogenesis and prevention of worsening axial elongation pathologic myopia. Clin Ophthalmol, Mar 18; 14: 853-873.
- Walline, J., Lindsley, K., Vedula, S., Cotter, S., Mutti, D.., Ng, S., and Twelker, J. (2020). Interventions to slow progression of myopia in children. Cochrane Database Syst Rev, Jan 13; 1: CDOO4916.
- Zhao, Y., Feng, K., Liu, R., Pan, J., Zhang, L., Xu, P., and Lu, X. (2019). Atropine 0.01% eye drops slow myopia progression: a systematic review and Meta-analysis. Int J Ophthalmol, 12(8): 1337-1343.
