Progressive Myopia and its Possible Complications
As we mature, the eye becomes more nearsighted due to natural growth of the pediatric eye. When the amount of nearsightedness is extreme, the condition is known as progressive myopia.
Myopia is nearsightedness, which means objects near are clearly visible but objects farther away are out of focus and blurry. It occurs when the shape of the eye bends (refracts) light so that it is focused at a point before it strikes the retina. By the time the light strikes the retina it has begun to scatter and the image it is conveying to the retina is a blurry one.
In some children their eyes continue to elongate as they grow, and this causes progressive myopia. Children with this type of myopia typically need a higher eyeglass prescription every year and often develop high myopia.
High myopia is generally defined as nearsightedness of -6 diopters and higher. A person who requires an eyeglass prescription of -6 diopters may find it difficult to see anything clearly that is more than a foot away from the face.
Having high myopia can increase the risk for serious eye problems in adulthood. That is because the elongation of the eye stretches the retina and other delicate eye tissues until they become thin.
High myopia triples the likelihood of experiencing a retinal detachment. High myopia also increases the risk of glaucoma, cataracts, and damage to the macula from progressive elongation of the eyeball.
Strategies to manage and slow high myopia
According to a 2019 study, if myopia is slowed by 1 diopter in childhood, the risk of pathological myopia is lowered by 40%.
Low-dose atropine eye drops
Atropine eye drops are used to dilate pupils for an eye exam, but when given to children in small amounts for 2 to 3 years, the drops may slow the progression of myopia. The drops can be used in children between 5 and 18 years of age and placed in the eye each night at bedtime. Side effects may include eye redness or itchiness around the eye.
Peripheral defocus contact lenses
These are multifocal contact lenses with different areas of focus. The center portion of the lenses corrects the distance vision while the outer portion of the lenses defocus or blur the peripheral vision. Blurring side vision is thought to slow eye growth and limit myopia.
Orthokeratology is a common type of vision correction. It is sometimes referred to as “Ortho-K” or corneal reshaping contact lenses. The lenses are gas permeable contact lenses that are worn overnight. The lenses flatten the front surface of the eye (the cornea) during sleep. The vision improvement gained overnight is temporary but can be maintained by wearing the lenses every night during sleep.
More time outdoors
In a meta-analysis of several studies, researchers found that spending time outdoors had a protective effect for the onset of myopia. Limiting digital screen time and increasing outdoor time may help limit your child’s myopia progression.
Gregory Scimeca, M.D.
Ophthalmologist and Medical Director
The Eye Professionals