Myopia

Myopia Management

Myopia (nearsightedness) is becoming an epidemic and there is a lot of research over the last several years on treatments to stabilize myopia. Dr. Olson and Dr. Yeung recognize the importance of myopia management and that it may start even before a distance glasses/contact lens prescription is necessary.

What is Myopia?

Myopia is the condition where one is able to see near (nearsighted) but requires glasses or contact lens prescription to see in the distance. There usually is a genetic component in being myopic but with the increased use of computers, tablets and smartphones, there is a heavy behavioral factor as well.

Historically, humans did not spend a lot of time in enclosed spaces, looking at devices upclose. Now, with the increased near work demands, the body experiences strain and stress. When the body has to deal with chronic stress, the choice is either to avoid the task or adapt to it. One way of adapting to near strain is to become nearsighted so that less accommodative effort is needed to do near work (like having built in reading glasses).

Why do we want to manage it?

High myopia can put you at risk for many eye conditions, some of which are sight-threatening. These include (but are not limited to) retinal thinning, retinal detachments and glaucoma. It is especially concerning for children and adolescents to have a prescription change of more than 0.75 diopters (units) each year. However, there has been lots of research on methods that can help slow the progression of myopia.

Our recommended methods for myopia management:

• Reading prescription: Due to the high behavioral factor, myopia can be viewed as a symptom as opposed to the main problem. When looking at myopia as a symptom or the body’s way of compensating for near strain, we may treat myopia with therapeutic glasses, typically for indoor use only. If we are concerned about someone starting to become nearsighted and there is some family history of high myopia, this is usually the first line of treatment. As aforementioned, a low nearsighted prescription is the body’s “build in” reading glasses. Often times we will recommend patients with low prescriptions to wear glasses only for near activities in an effort to relax how hard the eye works, thus the eye won’t grow longer causing the prescription to increase.
• Corneal Reshaping Therapy / Ortho-Keratology contact lenses: These highly breathable contact lenses are rigid permeable lenses that the patients sleep in. Overnight, the contacts will reshape the cornea so that no glasses or contacts are needed throughout the day (similar to a retainer for your teeth). This technology is commonly used in Asia where Myopia has increased dramatically in the past. It has been around since the 1960’s and the FDA has approved this to be a safe procedure since 2002 in the United States. It is one of the most consistently effective treatments for myopia control.
• MiSight / Multifocal contact lenses: These are soft contact lenses to be worn throughout th day. The design includes a lower prescription to help reduce near strain and enhance peripheral vision. Since most patients requiring myopia control are young, we recommend daily disposable contacts to reduce the risk of infection. MiSight was FDA approved 2019 for myopia management but prior to the release of MiSight, Drs. Yeung and Olson have successfully managed myopia with multifocal contact lenses.
• Progressive Glasses: We understand that contact lenses are not for everyone. If a patient’s glasses prescription is strong enough to require a distance correction, progressive/bifocal glasses offer a near prescription at the bottom to relieve near strain. Unfortunately, because children and adolescents are able to focus through the distance prescription, it is difficult to ensure they are using the reading portion. As a result, research has shown this method to be less effective than CRT or multifocal contact lenses.
• Stellest Lenses: Newly FDA approved (2025), this is the latest treatment option we've all been waiting for: special glasses lenses with defocus zones. Studies show it slows myopia in 70% of patients, similar to the data from MiSight. We are excited to offer another option for patients who aren't ready to start using contact lenses.
• Conjunction Vision Therapy: There are various visual skills required to do our daily activities. Visual acuity (the ability to see clearly) is only one of 19 skills. Patients with progressive myopia are often inefficient in other areas of their vision. As a result, they become myopic to compensate for the inefficiencies in order to meet their near demands. Vision therapy is a program designed to use activities normal in vision development to help train and enhance visual skills so individuals can perform to their potential.