Myopia or nearsightedness, is a condition that makes it hard to see in the distance. When the eye grows too long from front to back, the light entering the eye focuses images in front of the retina (the light-sensitive tissue in the back of the eye) instead of on the retina, leading to blurry vision. Eyeglasses, contact lenses, and refractive corneal surgery all change the angle of light that enters the eye, resulting in clearer vision.

High Myopia
Conventionally, an eye is considered to have high myopia if it requires -6.00 diopters (D) or more of a lens correction. Diopters indicate refractive strength and are the unit used to measure glasses and contact lens prescriptions. High myopia increases the risk of many eye diseases including retinal detachment, cataract, glaucoma, and eye crossing, all of which can lead to permanent vision loss. Some people with high myopia can develop pathologic myopia, a condition which is characterized by progressive retinal damage that can cause permanent vision loss.
Myopia is now an epidemic with increasing rates around the globe. Estimates predict that approximately half of the world’s population will have nearsightedness by the year 2050. That statistic is astounding considering that very few other diseases affect so many people. As a cutting-edge clinical, teaching and research institute, the Shiley Eye Institute now has a Myopia Control Clinic for this common eye disease.
Since myopia naturally increases early in life, childhood is the only time to change the trajectory of eye growth and levels of myopia. If left unchecked, higher degrees of myopia can lead to other eye diseases in adulthood, such as early onset cataracts, retinal detachments, glaucoma, and crossed eyes. Some people with high myopia can develop pathologic myopia, which is characterized by progressive retinal damage that can cause permanent vision loss.

Below are several common questions answered:

Will my child’s vision and myopia continue to get worse every year?
Once a child develops myopia, the average rate of progression is about 0.50 diopter (D) per year. Diopters indicate refractive strength and are the unit used to measure glasses and contact lens prescriptions. Based on expected progression rates, an average 8-year-old child who is -1.00D may be -6.00D by the time he or she is 18 years old. Myopia generally stops progressing in the late teens to early twenties.

What is Myopia Control?
“Myopia control” is the term used to describe specific treatments to slow the progression of nearsightedness in children. Myopia control measures are prescribed by an eye doctor—an optometrist (OD), or an ophthalmologist (MD). Treatment may include specialty eye medication drops and/or fitting of customized contact lenses and glasses as well as education about lifestyle influences and changes. These interventions have been shown in recent research to be highly effective in controlling myopia progression.

What is the Myopia Control Clinic at the Ratner Children’s Eye Center?
As a cutting-edge clinical, teaching and research institute, the Ratner Children’s Eye Center, part of the Shiley Eye Institute, has opened an advanced treatment center of excellence for this eye disease. The Myopia Control Clinic is a specialty clinic designed to closely monitor myopia in patients who have or are at risk of rapid myopia progression.

We use specialty equipment and techniques to comprehensively evaluate the refractive errors (i.e., myopia) and the ocular length of our patients’ eyes. These measurements, along with the myopia progression history of the patient and family, combined with our doctor’s expertise are used to determine an optimum management strategy. The patient will be monitored frequently throughout the year to determine whether s/he is responding well to the treatment or if changes need to be made to the regimen. As part of the Shiley Eye Institute, we have access to and may participate in cutting-edge research for new treatments to expand the understanding of myopia.

How will this be different from a typical pediatric optometrist or pediatric ophthalmology visit?
Monitoring and treating progressive myopia takes time. These patients require specialty testing to investigate all myopic risk factors, close monitoring to establish adequate control, and thorough education with the patient and family to ensure understanding of treatments and diseases processes. Due to the in-depth education and specialized testing required to offer and use these promising treatments, insurance is not accepted.

How to enroll in the Myopia Control Clinic?
Children and young adults who fit one or more of the following criteria are eligible to enroll in the clinic:
• Onset of nearsightedness before the age of 10 years
• Increase in myopia (glasses prescription) of 0.75D/year or more
• High myopia (glasses prescription) of -6.00D or more
• Positive family history of high myopia (parents or siblings with myopia of -6.00D or more)
• Desire to learn about viable treatment options

Shira L. Robbins, MD, Professor of Clinical Ophthalmology specializing in Pediatric Ophthalmology, will join efforts with optometrists Caitlin Jomoc, OD, and Carol Yu, OD, to offer state-of-the-art myopia treatment, including multiple modalities aimed at slowing the progression of myopia. They have already been involved in studies to reduce nearsightedness using eye drops. With these therapies, parents may be able to keep their children’s eyes from getting severely nearsighted. This service will have a clinical and research focus aimed at contributing to new treatments. An important emphasis of this clinic will be on education and time spent with patients and their family to fully explain treatment options.

To be scheduled for an evaluation in the Myopia Control Clinic, please call the Ratner Children’s Eye Center at (858) 534-2020.

Symptoms
The most common symptoms of myopia, or nearsightedness, are:
• Trouble seeing things that are far away
• Needing to squint to see clearly
• Eye strain (when your eyes feel tired or sore)

Some people who are nearsighted get headaches, but this is not common. If you have mild nearsightedness, you may not notice any symptoms. People who have severe nearsightedness or high myopia may also be at risk for other eye conditions. Nearsightedness usually starts between the ages of 6 and 14 and continues to worsen until your 20s.

Treatment
The most common treatments for myopia or nearsightedness are eyeglasses or contact lenses. Adults can also get surgery to treat nearsightedness which changes the shape of the cornea so it can focus light clearly. For progressing myopia in pediatric patients, treatment may include specialty eye medication drops and/or fitting of customized contact lenses and glasses as well as education about lifestyle influences and changes. These interventions have been shown in recent research to be highly effective in controlling myopia progression.

Related Conditions
• Retinal Detachment
• Cataract
• Glaucoma