top of page

Myopia Management

What is Myopia?

Otherwise known as Short or Near sightedness, myopia is when close-up objects look clear but distant objects are blurry.


Myopia happens when your eyeball grows too long from front to back, or when there are problems with the shape of your cornea (clear front layer of the eye) or lens (an inner part of the eye that helps the eye focus).  As Myopia increases, close-up objects can also become blurred meaning than glasses or contact lenses need to be worn full time. 


Myopia is measured on a scale called diopters, the higher the negative number the closer objects need to be to see them clearly.  Someone with -4D of myopia can only see things in sharply in focus at 25cms or closer.

Opticians in Perth - Childrens Eye Care
Opticians in Perth - Childrens Eye Care
Opticians in Perth - Childrens Eye Care

Why does it matter?

Myopia increases slowly and so children are often unaware that their distance vision has changed.

Myopia has more than doubled in UK teenagers since 50 years ago [1].  In 1950, 7% of teenagers were myopic but by 2010 this had risen to 16%.  This rise in myopia is related to the lifestyle of children with less time outdoors and more time on screens [2].

With increased myopia there is increased dependance on optical correction.  At low levels of myopia such as -1D, glasses need only be worn for specific tasks such as reading the whiteboard at school, whereas by -2D children will be wearing their glasses most of the time.  As the level of myopia increases corrective lenses also become thicker and heavier. 

With increased myopia there is also an increased risk to eye health with problems such as myopic maculopathy (damage to the central vision), glaucoma (damage to peripheral vision) and cataract (hazy vision).  There is also an increased risk of retinal detachment.   In adulthood, laser surgery treatment of myopia is also less successful at higher degrees of myopia.


What causes myopia?


As a child grows, there is increased growth of the eyeball length which is usually compensated by other parts of the eye such as the cornea (the front curve of the eye) or the lens inside the eye.   This is typical development of the eye and is called emmetropization.  In myopia, this typical development does not happen, and the eyeball length grows too long for the eye to focus correctly.   The risk of this non-typical development can depend on inherited genes (parents being short-sighted), but that is not the whole picture as myopia has increased across the world over a relatively short period of time.  Whilst diet and environment have also been implicated as risk factors as both are known to have changed over the past 50 years, there is currently no clear evidence for diet aside from the importance of a healthy balanced diet.

Can we do anything to prevent myopia?

Studies have shown that children that are given more time outdoors (more than 40 minutes a day) are less likely to become myopic[3].   In addition, making sure your child doesn’t hold a tablet, phone or book closer than 20cms for more than 45 minutes [3] can also lessen risk.   It is also advisable to avoid screen use 1 hour before bedtime, or switch the screens to night time mode, as using screens at night can also be an issue as blue light may affect eye growth.

At WJ Hendersons Optometrists we can use a device to estimate the length of the eyeball and can predict in children aged 6 and over who is likely to become myopic.  The eyeball length is longer in children up to four years before they develop myopia[4].  We can also use the same device to rule out a condition called keratoconus that can sometimes imitate myopia but requires very different treatment.  

Can we do anything to slow or stop myopia progression? 

Once your child is myopic it is not uncommon for the prescription to increase until the age of 21.  The younger age that myopia occurs, the higher level of myopia is likely to be.  Until recently, the only accepted solution to correct myopia was glasses or contact lenses.  However in recent years, 4 new methods have been identified to reduce the amount of myopia your child develops. 

1. Myopia Control Spectacle Lenses

These lenses are specifically designed to alter the focus of light in the areas of the peripheral areas of the eye that are responsible for increased growth of the eyeball.  The Zeiss MyoCare lens has perfectly clear vision when looking through the centre of the lens, with an initial slight distortion when looking to the side.  91% of children adapt to the lens within 3 days and 100% by 1 week.

This lens has been shown to work in a study of 8–13-year-old children over 2 years.  Those with standard spectacle lenses had myopia increases of -1.5D of myopia whereas those wearing the MyoCare lens only increased by -0.5D when worn for 12 hours a day [5]. 

2. Myopia Control Daytime Contact Lenses


Daily disposable contact lenses (MiSight) with dual focus also work by reducing the growth of the eyeball.  These work by focussing light differently in the periphery of the eye compared to standard contact lenses.  There may a slight awareness of ghosting around some lights, but most children don’t find it a problem.

Over 3 years, 8-12 year old children wearing the lenses had an increase of myopia of -0.5D whereas those wearing standard contact lenses increased -1.25D[6].  This effect is sustained over 6 years of use of the lenses [7]. 

3. Myopia Control Night Lenses

Night lenses or Orthokeratology has been used in WJ Henderson since 2005.  Contact lenses are worn while sleeping that safely reshape the front of the cornea. Theses lenses are custom made based on the exact shape of the cornea with the use of a corneal topographer.

This treatment also allows clear vision throughout the day without the need for contact lenses or spectacles which can be very beneficial for normal childhood play and activities.  

Night lenses alter the focus of light in the periphery of the eye reducing myopia progression. There has now been 5 randomised controlled trials on Night Lenses and they have found similar levels of effectiveness to myopia control spectacles and contact lenses [8]. 

4. Atropine Eye Drops

Atropine eye drops have also been shown to control myopia to a similar extent to the above 3 treatments.  However at the concentrations available in the UK, they have numerous unpleasant side effects such as blurring at near and light sensitivity[9].  Studies are being currently being undertaken to investigate if lower doses with fewer side effects are effective.

Will wearing glasses or contact lenses worsen my child's eye health or vision?


If your child develops myopia, wearing standard glasses or contact lenses to correct this does not make the eyes worse.  As mentioned above, myopia will usually progress in most children even if they don’t wear glasses because myopia is due to genes and the environment that the child is in.  Indeed myopia can worsen if your child’s myopia is not fully corrected [10]. 


Who is suitable for treatment?


Need more here about age and any other aspects e.g. hygiene for CLs etc

MyoCare spectacles lenses are available to correct up to -10 Diopters of myopia and -4 Diopters of astigmatism (astigmatism is when the eye has a rugby ball shape).

MiSight Daily disposable contact lenses are available to correct up to -10 Diopters of myopia.  Astigmatism up to and including -0.75D is acceptable.

Night lenses are available to correct up to -4.5 Diopters of myopia.  Astigmatism up to and including -0.75D is acceptable.

Is the treatment guaranteed?

The treatments have been proven to work in studies, however there is no guarantee that everyone will respond to that treatment.  If myopia progression does occur at a higher-than-expected rate with a treatment then it may be necessary to switch to another treatment or stop treatment all together.

Is the treatment costly?

All children should be assessed for their risk of becoming myopic.  At WJ Henderson Optometrists there is no charge for a myopia risk assessment and lifestyle advice.  

If your child develops myopia and there is rapid progression, then we would offer one of the 3 available treatment options described above. (At this time Atropine drops are not available as an option in the UK)

All 3 available treatments incurr an initial fee of £90 followed by £37 per month payable by direct debit. 

If you opt not to have treatment, then we would respect that decision and continue to monitor and advise on your child’s myopia at regular NHS eye examinations. 

What can I do next?

If your child is due their NHS eye examination or has experienced a recent change in vision then please phone and book an appointment.  If your child is not due but you would like to discuss myopia management then we can arrange a telephone consultation to discuss your options.  

bottom of page