Nearsightedness, or myopia, is becoming more prevalent in children and has almost doubled in the past 30 years. In fact, significant increases have been noticed in just one generation. Myopia is genetically related, but there are important environmental factors that also contribute to worsening nearsightedness. Time spent indoors and on electronic devices as well as prolonged near work (including tablets, phones, and handheld video games) has contributed to the increase in myopia in children.
Studies show that time spent outdoors prevents or reduces nearsightedness in children. No particular outdoor activity has specifically been linked to this but just the state of being outdoors rather than indoors.
Generally, myopia first occurs in school-aged children and progresses through approximately age 20 as growth occurs. Myopia can quickly progress during growth spurts as the axial length of the eye also grows. The longer the eye becomes, the more nearsighted a person is.
Controlling myopia progression is important for several reasons. High myopia can be debilitating to daily activities with constant need for glasses and/or contact lens correction. But even more concerning is myopic retinal degeneration that can occur in very high nearsightedness, typically after -10.00, but has been discovered with lower myopic prescriptions of -5.00. As the axial length of the eye grows, the retina thins which puts a patient at risk for retinal tears and detachments as well as new blood vessel growth and bleeding. Both can cause permanent vision loss if not promptly treated. Certain types of glaucoma and early cataracts can also be associated with high myopia.
Numerous studies have proven the effectiveness and safety of Orthokeratology in children as young as 8 years old. The SMART study, as well as many others, have proven that Orthokeratology rigid gas permeable “retainers” slow the progression of myopia by decreasing axial elongation (lengthening of the eye).
Orthokeratology is the process of fitting a reverse contour rigid gas permeable “retainer” or “mold” that the patient sleeps in overnight and removes during the day for clear vision without the need for glasses or contacts. This rigid retainer reshapes the cornea, the clear front surface of the eye. Orthokeratology slows axial elongation by causing the central cornea to be flatter than its natural shape (which allows clear vision for the patient during the day) while also steepening the middle zone of the cornea. This specific shape of the cornea neutralizes an optical phenomenon known as “peripheral defocus” which is present in progressively myopic patients. It is thought that this defocus is a major cause for axial elongation and thus progressive nearsightedness. Because orthokeratology specifically treats this peripheral defocus, the eye does not grow at the rate it would if left untreated.
If you are interested in an Orthokeratology consultation, an appointment can be made with Dr. Burrell who is certified and specializes in this procedure.