What you have learned so far is that myopia (nearsightedness) is an optical error of the eye where images at a distance appear blurry.
You have also learned that myopia is more prevalent in school-aged children, with the most likely causative factors being genetics, nutrition and the environment.
What I set out to do now is show you a few methods that are currently used to prevent, slow down and correct myopia.
Over the years, I have used several of the myopia remedies listed below:
- lens implantation
- bifocal glasses
- outdoor play
- pharmaceuticals (atropine)
- and others
A few of these I cannot validate (or invalidate). I can only tell you what has worked for my clients. Let us now discuss a few of the more popular remedies from the list above.
On the national and world stage of myopia control, there is no topic more exciting, and promising, than the field of orthokeratology (ortho-k).
With all the talk of myopia progression in children, clinical studies have now proven the noninvasive efficacy of ortho-k.
Ortho-k lenses are rigid contact lenses that are worn overnight while you sleep. Properly designed lenses do not touch the eye itself but instead rest (float) on the tear film that covers the cornea.
Closing the eyes starts a chain reaction that gently transfers pressure from the eyelids to the ortho-k lens and then to the tear film. The tear film then transfers this gentle pressure to the cornea, gently reshaping your corneas as you sleep. When you awaken in the morning and remove the lenses, you experience clear, comfortable vision throughout the entire day.
Since the corneal reshaping process is not permanent, patients should expect to wear the lenses every night to every other night (much like wearing a retainer to keep teeth straight). In some cases, wearers have experienced clear vision three or more days between ortho-k lens wear. Although rare, it does happen.
For children, there is an even greater benefit to sleepSEE ortho-k lens wear. Not only will these lenses free your child from having to wear glasses or contact lenses during the day (school, sports, etc.), but clinical studies now show orthokeratology is very effective in slowing down the rate of nearsighted progression in children. This is why sleepSEE ortho-k is quickly becoming the world’s No. 1 choice for nonsurgical vision correction.
With the additional benefits of being nonsurgical, reversible and less costly than LASIK, the sleepSEE overnight vision correction system shows great promise for patients of all ages.
Another attainable approach to myopia control is through proper nutrition.
It is hard for anyone to argue against the detrimental effects poor nutrition has on the human body. Researchers and scientists are continually discovering new links between high blood sugar and human debilitation in the form of disease (diabetes, Alzheimer’s, etc.). Not discussed often enough by these professionals, however, are the secondary effects poor nutrition and subsequent high blood sugar levels have on the eyes in relation to myopia development /progression.
Because the eye has one of the highest rates of blood flow of all human organs, these blood vessels serve as a conduit, delivering high blood sugar levels throughout the eye. If you talk to any eye doctor, you will hear the common thread about high blood sugar and the retinal problems it causes. High blood sugar also affects other parts of the eye outside the retina — tears, cornea, lens, ciliary muscles and sclera, for example.
So, what does all this “sugar” talk have to do with myopia?
A lot, I’m afraid.
- High blood sugar levels can weaken the structure of the sclera, thereby, making the eye more prone to stretching — elongation. This elongation of the eye is the anatomical mechanism of myopia (nearsightedness).
- High blood sugar can also cause changes to the eye’s tears, cornea and lens, which could induce high levels of visual stress due to a loss of visual clarity.
- The ciliary body is the muscle that contracts/relaxes to control the focusing ability of the eye. High sugar levels can hinder this muscle from returning to its normal state, creating another form of visual stress.
Clinical studies have demonstrated how cultures introduced to western diets soon manifested myopia at levels never seen before. Studies have also demonstrated that people of lower economic status also demonstrate a high prevalence of myopia, most likely because of poor nutrition and/or poor eating habits.
Improvements in diet (nutrition) promote healthy eyes and can help prevent the development and/or progression of myopia.
Surgery (LASIK, PRK, etc.)
In 2005, I stopped offering surgical vision correction (i.e., LASIK, PRK, etc.). My practical side said, “Why offer surgical vision correction when there is a nonsurgical alternative?” Candidly speaking, I am indifferent to those who choose LASIK surgery. The only thing that greatly concerns me is many who choose LASIK surgery are not told there is an nonsurgical alternative.
You have to do your homework here. Do not base your decision on LASIK from a conversation with the ophthalmologist doing the surgery. Nor should you leave the decision-making to the hands of your optometrist. Eye care professionals have their own set of preferences and biases. You, as the consumer, need to do your own independent research. Be familiar with the pros and cons of all your options. It never ceases to amaze me how people haphazardly choose surgical vision correction without giving it the slightest thought. Like with a fad, people follow the herd, and many later experience regrets due lifelong irreversible symptoms of poor vision. Visit LasikComplications.com to get a different perspective on what “could” go wrong.
Lastly, understand that there is always a risk with surgery. Likewise, there are also risks associated with wearing contact lenses, especially if the wearer does not practice good hygiene and proper lens care. Outside of this, sleepSEE ortho-k vision correction offers the benefit of reversibility (if you stop wearing the lenses, your eyes return to their normal shape). No surgical vision correction procedure (LASIK, PRK, etc.) has this benefit.
Bifocal / Reading Glasses and Myopia
Of all the things I could say to strike fear into a client, the statement, “You need a bifocal,” appears to be the most ominous. For the 40 and over population, it comes as quite a shock to learn that wearing a bifocal is the answer to resolve visual discomfort while reading. More difficult is trying to convince a parent that his or her child needs a bifocal when the child has no visual/reading complaints.
There are many children that come into my office complaining about blurred vision when performing near tasks (reading, video games, mobile phones, etc.). Often, a bifocal lens is all that is needed to ameliorate their problem. More often is the case when a child has complaints not with near vision but with distance vision. Here too, I often prescribe a bifocal.
“But wait! Why prescribe a bifocal when the visual complaint is blurry vision in the distance?”
Let me explain.
Like hypertension (high blood pressure), visual stress is a silent threat to visual development, visual performance and overall ocular health. You may recall from the second post of this series that stress can be a catalyst to myopia development and progression. Generally, school-aged children are unaware of the signs and symptoms of visual stress. It is up to parents and teachers to recognize and rectify environmental conditions that produce visual stress.
For some children, wearing a low-plus bifocal lens, prescribed for near tasks only, helps reduce visual stress. At the same time, it can also decrease blurry vision in the distance by enabling the focusing mechanism (ciliary muscles) to return to its normal resting state. In this case, eyeglasses are used as a tool for prevention, not correction.
Eye Exercises (Vision Therapy)
This modality of myopia reduction/prevention uses muscular and cognitive therapies to strengthen the connection between behavior, vision and motor skills. Sometimes, you will hear the terms “Behavioral Vision Therapy” (BVT) and “Functional Vision Therapy” (FVT). They are basically the same thing.
To understand the how Vision Therapy (VT) works to correct myopia, you have to know a little about what vision is, and is not.
When you are sitting in the exam chair and the optometrist asks you the read the letter chart on the wall, is she checking your vision or sight? Often people ask me, “Doc, do I have 20/20 vision?” Technically, no. To be frank, no one has 20/20 vision. The reason is that “vision” is not defined as the ability to see small letters on a chart across the room. More appropriately, the eye chart measures your “sight.” Bear with me as I go into a little more detail.
Sight is the process that occurs inside the eye. Anatomical eye structures — cornea and lens — focus light from objects under view so that the resulting image appears on the back of the eye (retina). Believe it or not, it’s that simple!
Vision is more complicated. You could say vision picks up where sight leaves off. Vision is a process that starts not at the front of the eye (cornea and lens) but at the back of the eye at the retinal level. The image from “sight” is light energy. The retina transforms this light energy into chemical energy. The chemical energy then travels from the retina to the optic nerve and, lastly, to the processing areas of the brain. The operative word is process. Vision is an emergent process that occurs from the coordinated interactions among several parts of the brain.
There are hundreds of books written about the visual process. This blog post does not touch the surface; the point of this discussion is to provide grounds for how Vision Therapy (VT) can be beneficial to myopia control. Vision Therapy is designed to create changes at the cognitive level. It is the cognitive level that controls the motor functions involved with sight. The result? Improved visual skills and reduced visual stress.
Here is another site related to vision therapy that clearly explains myopia and the visual process.
Outdoor Play and Myopia
I played football in college. I recall on one occasion when the quarterback threw the football where there was no receiver. The coach, with his arms stretched above his head yelled, “Son! It don’t take a Phi-Beta-Kappa to know there’s no receiver on that side of the field!” Today, whenever I think about all the reasons why children should spend more time outdoors, I feel as though my coach is screaming at me.
Over the past 30 years, school systems across America have reduced the amount of time children spend outside during the regular school day. We bottle up all this energy, forcing our children to sit still behind a desk, staring at a book (now computer screen) for six or more hours a day. When the school day ends, children are given enough homework to keep them busy all evening, well into the night.
Outdoor activity allows children to release all the pent-up energy that is inherent in youth. Allowing otherwise could induce stress — vision, body, mental — that could prove detrimental to overall development. If we continue along this path, will there be any wonder why our children are becoming more myopic?
“We see life through our visual system; our visual system then projects the life we want to see.” – Dr.J.Singletary –