Myopia in kids: Contact lenses for children as young as eight are now available
How comfortable would you be with your primary school kid having daily disposable lenses? CNA Lifestyle takes a look at ways to keep myopia in children under control.
If your kids haven’t already joined the club, the membership might be on the way to you – especially if your primary school-going children spend most of their waking hours in front of the computer, TV or mobile devices.
The club’s name? Myopia.
Membership for short sightedness is expansive, according to the Singapore Cohort Study Of The Risk Factors For Myopia (SCORM) on nearly 2,000 school children. It found that 28 per cent of seven-year-olds; 50 per cent of 10-year-olds; 62 per cent of 12-year-olds; and 73 per cent of 15-year-olds are myopic, said Professor Saw Seang Mei, head of the myopia unit at the Singapore Eye Research Institute (SERI), who spearheaded the study.
If you’re short-sighted yourself, you’d know the inconvenience of wearing glasses. But in young children below the age of 11, the eye condition can spell another issue. Developing myopia early in life can set the child up for higher eye degrees and a greater risk of eye problems later in life, said Prof Saw, who is also an epidemiology professor at the National University of Singapore’s Saw Swee Hock School of Public Health.
To put that in perspective, three- to six-year-old children with myopia were found to have more than 500 degrees by the time they turned 11. In contrast, those who only developed myopia at age 10 had about 150 degrees on average when they became 11 years old, according to a study that is part of the SCORM; also conducted by Prof Saw and her team but on nearly 1,000 children.
Why is a high myopia of 500 degrees not good news? “High myopia, if left unaddressed, increases the likelihood of serious eye health conditions later in life such as glaucoma, cataract, retinal detachment and myopic maculopathy. These conditions may even lead to permanent blindness in future,” said Dr Cheryl Ngo, head and consultant at the National University Hospital’s Division Of Paediatric Ophthalmology and Strabismus.
It is certainly not a good start if your child already has 500 degrees by the time he is 11 years old as the myopia will continue to progress from ages 11 till about 25.
Twenty-eight per cent of seven-year-olds; 50 per cent of 10-year-olds; 62 per cent of 12-year-olds; and 73 per cent of 15-year-olds are myopic.
MANAGING MYOPIA EARLY
If you nag your kids to play less computer games, keep at it. Near-sighted work such as using the computer and handheld devices such as the smartphone and tablet strains the peepers. The eyes have to focus and refocus on the changing images on the screen, and cope with the screen’s contrast, flicker and glare.
“Lifestyle modifications such as the reduced use of handheld devices and TV time, ensuring frequent eye breaks every 45 minutes of near-work, ensuring there is adequate lighting when reading or writing, and spending more time outdoors, are important in managing myopia,” said Dr Ngo.
That aside, here are other ways of managing myopia in children, according to the experts.
- DAILY DISPOSABLE SOFT CONTACT LENSES
You’re probably thinking: I can’t even get my primary-schooler to clean his room. How can I give him contact lenses and expect him to clean them? Well, daily disposable soft contact lenses will lend a big hand in that department, like the MiSight 1 day soft contact lenses by CooperVision.
The lenses are worn just like your regular ones, and are the “first daily soft contact lenses clinically proven to slow myopia progression in children available in Singapore,” said Dr Fan Chi Shing, head of CooperVision’s Specialty EyeCare Division. The lenses can supposedly correct myopia ranging from 25 to 600 degrees in children aged eight to 15 years old.
Myopia is caused by the excessive elongation of the eyeball, which results in images focusing in front of the retina instead of on it. MiSight lenses’ myopia correction comes from the ActivControl Technology, which creates two treatment zones alternating with two correction zones like concentric circles on each lens.
Together, the zones refocus the images and slow down the eyeball’s elongation, said Dr Fan, who also heads MiSight’s Professional Services & Marketing Division in Asia Pacific.
Just how effective are the contact lenses? Close to 60 per cent of the 144 myopic children aged eight to 12, who wore the lenses for three years, had less myopia progression. Fifty-two per cent of them had less elongation of the eyeball, said Dr Fan.
The study compared the results to children who wore single-vision, one-day lenses. For the myopia controlling to take effect, Dr Ngo recommended wearing the lenses from 10 to 12 hours a day, six days a week.
Parental help and supervision are important, especially in the beginning. “We do advise parents to give their children sufficient time to practise and adapt to the routine,” said Dr Fan, who added that the same three-year study found that 90 per cent of children could insert and remove MiSight contact lenses on their own. However, it is worth reconsidering if you think your child’s maturity, level of personal hygiene and eye condition aren’t suited for using the lenses.
As with all contact lenses, MiSight 1 day is a medical device and should only be prescribed by registered optometrists and contact lens practice opticians.
- ORTHOKERATOLOGY TREATMENT
It basically involves wearing corneal moulds called ortho-k lenses to sleep to alter the shape of your child’s corneas. In layman terms, these lenses flatten the cornea’s centre and push the excess corneal tissues out to the sides to manipulate the way light reaches the retina.
The clear vision may last about 18 hours after the lenses are removed in the morning, said optometrist and orthokeratologist Titus Wu of Titus Eye Care in a TODAY article.
Upgrades in technology mean that the new ortho-k lenses can now correct up to 1,200 degrees of myopia, and is supposed to be suitable for all ages, even children as young as six years old, said Wu.
The clear vision may last about 18 hours after the lenses are removed in the morning.
But isn’t wearing contact lenses to sleep a bad idea? Wearing soft lenses to bed is akin to asking for trouble as they soak up your eyes’ moisture like a sponge. The customised ortho-k lenses are rigid gas-permeable lenses that allow oxygen through to the eyes.
However, these lenses aren’t without their downsides. The Singapore National Eye Centre (SNEC) has seen “five children between the ages of nine and 14 with severe corneal infections linked to the use of overnight ortho-k lenses” in 2007, according to the TODAY article. Corneal abrasion may also result if the lenses are not properly cleaned.
Another caveat: Since the lenses are customised to reshape the corneas, they have to be fitted by trained orthokeratologists, who are in short supply in Singapore despite the lenses being available locally for decades.
- ATROPINE EYE DROPS
For children with rapidly progressing myopia and are between the ages of six and 12, a prescription of low-dose 0.01-per-cent atropine eye drops may slow down their myopia. But how effective is it?
In a five-year trial by Professor Donald Tan and his team at the SNEC and SERI, the eye drops were found to slow down myopia’s progression by 50 per cent to 60 per cent over two years.
This means that if your child’s myopia is progressing at 100 degrees a year, it would cut down to less than 50 degrees each year. As the effect of atropine is accumulative, it is advisable not to miss your child’s daily dose.
Still, low-dose atropine eye drops are not a fail-safe against myopia. In some cases, the dosage has to be increased to 1 per cent, which has been used to treat myopia since the 1960s and has been prescribed by the SNEC since the 1990s.
However, the higher-dose atropine eye drops aren’t ideal even though they can slow myopia by 80 per cent over two years – they can cause uncomfortable side effects like glare and blurred near vision. And even then, in about 10 per cent of children, myopia may continue to progress rapidly.