We just love this new video created by the Global Myopia Awareness Coalition! The campaign urges parents to recognize that one-in-three kids have myopia (nearsightedness), yet parents are unaware because they do not bring kids in for annual comprehensive eye exams.
Because Myopia is a condition that can be managed once it is detected, it’s important for children to be checked regularly in order to prevent serious eye conditions later in life.
For more information, our own optometrist, Dr. Jeri Schneebeck, recently gave a presentation about the causes of myopia, risk assessment, long term implications, and the various forms of myopia control available.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
The American Optometric Association reports that 1 in 4 children have a vision issue that negatively impacts learning. Even children with “perfect vision” can still struggle academically because other aspects of the visual system are not perfect. This makes 20/20 vision only one measure of the visual system. If the whole visual system is not functioning properly our kids may be missing out since 80% of all learning is visual! This makes a comprehensive eye exam with an optometrist essential for all children especially those experiencing learning issues.
When a child enters the classroom, they rely on basic visual skills to learn effectively. When one or more of these skills, like eye teaming or focusing, are not properly functioning learning becomes more effortful and often the child can’t keep up with the pace. As a child moves through each grade, the visual demands are greater as they take on more reading, writing, smaller print, higher standards of work, longer lectures, and more general stress. With the increase of these academic demands, it’s important to immediately address any suspected learning challenges with a comprehensive eye exam.
In fact, a comprehensive eye exam can prevent misdiagnosis or aid in diagnosis of other learning challenges like ADHD or dyslexia. Through a comprehensive eye exam, an optometrist can identify issues beyond refractive problems like near sightedness. In fact, eye teaming and tracking issues are frequently seen in children with other learning disorders. Appropriate diagnosis and treatment of the eye issues often help the child deal with the other learning issues.
Vision screeners that take place in schools, online or with a pediatrician are NOT a sufficient replacement for a comprehensive eye exam. The American Optometric Association reports that, “Even the most sophisticated vision screening tools, administered by the most highly trained screeners, miss one-third of children with eye or vision disorders.” That’s why optometrists recommend that students who have passed a vision screening still get a comprehensive eye exam for a full look into the child’s visual system.
SIGNS THAT MAY INDICATE A CHILD HAS A VISION PROBLEM INCLUDE:
Frequent eye rubbing or blinking
Short attention span
Avoiding reading and other close activities
Regular headaches
Covering one eye
Tilting the head to one side
Holding reading materials close to the face
An eye turning in or out
Seeing double
Losing place when reading
Poor reading comprehension
Complaints of discomfort and fatigue1
Colorado’s Doctors of Optometry recommend that your child follows the schedule below for comprehensive eye exams with an eye doctor for proper pediatric eye care. This schedule ensures that the child’s visual system is hitting developmental milestones as they approach and participate in classroom learning.
CHILDREN’S EYE EXAM SCHEDULE:
6 Months: First eye exam w/ optometrist
3 Years: Second eye exam w/ optometrist
5 Years: Third eye exam w/ optometrist
6+ Years: After age 5 eye exams should continue every 2 years for low-risk children (unless otherwise recommended by an optometrist).
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
One in every four students will drop out of college before completing their second year.
Those who participate in student loan programs must repay loans in full regardless of whether or not they complete college.
Students who fail out of college or their vocational technical studies face a future with fewer choices and career opportunities.
The change in scholastic demands from high school to college is a dramatic one. Your student may have earned great grades in high school with only moderate effort. In college or tech school, he/she will need to plan on greater amounts of reading and spending longer hours studying than ever before.
Many students have mild visual performance problems that cause them significant effort meeting this increased demand. It can make the student appear to be academically underprepared when in reality it is a physical problem causing the difficulty.
College level reading demands are exponentially greater than the demands in high school.
Note that not one of the visual problems listed below as a factor in slow reading is blurry vision!
Word-by-word reading – not seeing groups of words together.
Poor eye movement control – inaccuracy in tracking across a page, losing place, etc.
Repetition – unnecessary or unconscious re-reading of material.
Comprehension or test anxiety – causing a student to intentionally read more slowly.
Slow reading habits – in which a student can’t read faster because they always read slowly.
Poor determination of what is important and what is not.
Excessive memorization rather than remembering selectively.
Highline Center for Vision Performance Can Help!
Preparing for college by studying for and taking the four-hour college entrance examinations (ACT or SAT) is a visually demanding task. We can help your student be more successful in this endeavor and offer free Vision & Learning Screenings for college bound students.
Often, slow reading is related to performance based visual problems. These difficulties are not typically diagnosed in routine eye examinations where eye health problems and refractive errors (need for glasses) are checked. Note that not one of the things listed above as a factor in slow reading is blurry vision!
“I have been able to take tests faster and get better scores than I had before vision therapy. Before, I was reading at a first grade level with 60% comprehension, after VT I was reading at a college level with 80% comprehension. I trust that VT is one of the best things I have done because it moves me forward in school and gets me closer to my academic goals to go to college.”
— Jay, High School Sophomore
Save expense and heartache
Even high achieving students can have visual skills deficiencies. These students have devoted extra time and effort on homework while in high school in order to succeed. Struggling students may be working even harder to maintain average grades however, college and vo-tech training will demand more work in less time. Our visual training programs can make learning more efficient and give more stamina to the task of learning to ensure academic success with less effort!
Highline Center for Vision Performance offers a complimentary performance based screening which includes a specific test for faulty eye movements.
When problems are discovered, we offer a customized training program that addresses specific visual skills deficiencies. We have time to make this happen before your student begins testing or heads off for college.
Call us now to schedule your complimentary Vision & Learning Screening: 303-325-2014
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Nearsightedness (Myopia) among children has been rapidly increasing for decades yet the risks and treatment are widely misunderstood by parents and caregivers. Prevention and early detection are two keys to controlling this epidemic impacting children’s vision, development and classroom learning.
WHAT IS NEARSIGHTEDNESS?
Nearsightedness, also known as myopia, is a vision condition that impacts a child’s ability to see objects at a distance because the shape of the eyeball is too long, or the cornea is too curved. Nearsightedness is not an eye disease, but an imperfection in the eye known as a refractive error. The condition typically begins in childhood and often progresses over time as the child grows. Roughly, 41% of Americans are nearsighted as opposed to 25% in 1971.1 This upward trend exists throughout Colorado and across the world.
EARLY DETECTION AND SLOWING PROGRESSION
Doctors of optometry agree that the best way to slow myopia progression and possibly prevent it includes a combination of:
Consistentcomprehensive eye exams for children even without symptoms. Children should have their eyes examined by an eye doctor to get a full look at their eye health at 12 months, 3 years, 5 years of age and then every year for low-risk kids. These regular exams give your child the best chance at early detection and treatment to slow or correct nearsightedness.
Daily time outdoors has been shown to delay the onset of myopia.
Minimize screen time as this has been linked to increase in progression.
If one or both parents are nearsighted their child is at higher risk, making it not possible to prevent, but the progression of the condition can often be slowed with proper detection and treatment.
SYMPTOMS
Below are common symptoms for children experiencing nearsightedness. Keep in mind that many children don’t complain of symptoms and aren’t aware they are having a visual challenge. This makes a comprehensive eye exam key for early detection.
Blurry vision when trying to focus on distant objects.
Squinting to read far away text.
Sitting close to the TV or holding screens, books or objects close to the face.
Regular headaches.
RISKS OF UNTREATED NEARSIGHTEDNESS
It is important for caregivers to understand that children with moderate nearsightedness are at risk for additional serious eye conditions as adults. Such as:
These drops are administered daily to slow progression of myopia.
CORNEAL REFRACTIVE THERAPY (CRT)
Used in children and adults, CRT uses contact lenses that are worn only at night to reshape the cornea during sleep. No lenses or minimal correction is worn during the day. It takes about 2 weeks get the full effect and they need to be used every night.
MULTIFOCAL CONTACT LENSES
These unique contact lenses have different prescriptions in different locations of the lens. Often these are daily disposable contact lenses that children learn quickly to insert and remove.
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Age proofing your eyesight is a continuous process that is best when started early in life but can be implemented at any age for eye health benefits. The rate in which our eyes age can be reduced if we are mindful of what increases age-related eye diseases and what slows the eye-aging process. For instance, once UVA/UVB damage to the eye occurs it’s often not reversible.
The likelihood of good vision throughout the lifespan is increased by practicing these six areas of protection as early as possible; good nutrition, exercise, sun protection, avoid smoking, limit drinking, and get annual comprehensive eye exams with your Highline optometrist.
Dr. Tom Cruse, Colorado Optometric Association’s Board President says, “The more annual comprehensive eye exams that you can attend as you age translates to having a much higher chance of early detection and can equate to avoiding issues later in life that include low vision issues, blindness or even loss of life. Live that healthy lifestyle and see your optometrist regularly for the best chance at age proofing your eyesight.”
Annual Comprehensive Eye Exams: It’s simple, just because you don’t have any symptoms does NOT mean you should skip your annual comprehensive eye exam. Many vision threatening eye diseases such as glaucoma, macular degeneration, cataracts, or diabetic retinopathy have no or minimal symptoms until the disease has progressed. Early detection is key to slowing progress, managing disease, and saving vision.
Optometrists look at a lot more than just your visual acuity in a comprehensive exam and can even detect other health issues such as autoimmune conditions, allergies, medication complications, high blood pressure, high cholesterol, diabetes and more.
Regular Exercise: Regular exercise is helpful across the board for your general health, but it’s also essential for keeping your vision from diminishing. One study of more than 15,000 people discovered that individuals who exercised and drank occasionally had less vision loss over a 20-year period than individuals who did not exercise and did not drink.1 This finding outlines the importance of exercise. Find the exercise that works for you whether it’s walking, hiking, running, swimming, weightlifting, or the countless other ways to get movement in.
Good Nutrition: When choosing what to eat throughout your day make sure you’re getting the nutrients that promote healthy eyes. To support your eye health and reduce eye disease risks choose foods rich in vitamins C and E, zinc, lutein, zeaxanthin, and omega-3 fatty acids DHA and EPA. If you have already been diagnosed with an eye disease check with your optometrist to understand which foods can support your eye health and which foods can provoke your symptoms or even speed up the progression of the disease. Your eye doctor may even prescribe a nutritional supplement to support your eye health. More nutritional information.
Consistent Sun Protection: Sun exposure can increase your risk of cataracts and if you have blue eyes and fair skin your risk of cataracts is even higher. Once sun damage of the eye occurs, the long-term impact is not reversible making sunglasses more important than most people think. The Colorado sun is bright due to the elevation and the intense sun reflecting off of snow or water. Grab a pair of 100% UVA/UVB blocking sunglassesto safeguard your eye health and wear them when outside. Pair your sunglasses with a hat for even more UV protection since sunlight can slip in through the side of your glasses. Start your kids off right by protecting their eyes early on. Bonus, tiny sunglasses are cute!
Continue to Avoid Smoking or Quit Smoking If You’ve Started: The truth is that smoking tobacco increases the risk of age-related macular degeneration (ARMD), cataracts, glaucoma, diabetic retinopathy and dry eye syndrome. Many of these diseases can lead to vision loss or blindness. ARMD is the leading cause of blindness and studies show that smokers have up to four times the risk of developing ARMD. If you’ve been unsuccessful at smoking cessation keep trying and get support such as using the Colorado QuitLine, a free support program for Colorado residents. Call 1-800-QUIT-NOW or Enroll today.
Limit Alcohol Intake: It’s common knowledge that alcohol can impact your vision during use. The long-term effects of alcohol consumption can include increased risk of cataracts, age-related macular degeneration, and optic neuropathy. Heavy drinking can impact your body’s ability to absorb vitamins and nutrients, which are needed for proper eye health.
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Does my child need an eye exam? Many parents are unaware that by age 5, a child should have completed threeeye exams with an eye doctor. Vision screenings with a pediatrician are part of an essential health plan, but to get a complete look at how your child’s visual system is developing they need comprehensive eye exams with an eye doctor as they approach classroom learning.
“Three eye exams by age 5 are essential for early detection of treatable eye conditions like amblyopia, eye turns, clinically significant far-sightedness, and total refractive errors. These specific eye conditions can develop prior to age 5 and they have potential to hinder classroom readiness and learning as the child enters grade school. An eye doctor can get a complete look at your child’s eye health to make sure everything is developing appropriately for school success. It’s really about making sure each child can learn without difficulty from the visual system,” explains Sheryl Benjamin, Executive Director at the Colorado Optometric Association.
Colorado’s doctors of optometry recommend the following comprehensive eye exam schedule for ages 0-5:
6-12 Months | Comprehensive Eye Exam by Eye Doctor
3 Years | Comprehensive Eye Exam by Eye Doctor
5 Years | Comprehensive Eye Exam by Eye Doctor
One study by the National Eye Institute found that vision screenings miss detecting one-third of children with an eye or vision disorder.
WHAT TO EXPECT AT A PEDIATRIC COMPREHENSIVE EYE EXAM
Comprehensive Eye Exams for Infants (6-12 months)
It’s recommended that this eye exam takes place around the infant’s schedule picking a time when the infant is content and not fatigued. Infants usually find this exam painless and fun.
First, the caregiver will be asked to give a family history since many eye challenges are hereditary. At this age, the infant usually sits in the caregiver’s lap during the exam while the doctor engages the infant in testing. The optometrist will use handheld objects like lights and toys to check that the eyes are working properly together. The doctor may use drops or a spray to dilate the pupils and get a better look into the health of the eyes. Additional tests will be performed to look for nearsightedness, farsightedness, astigmatism, and any risk factors will be identified. The optometrist will then recommend when to schedule the next eye exam (usually at age 3 unless the infant is high risk).
Comprehensive Eye Exams for Ages 3-5
Children at this age do not need to know their letters or numbers to fully participate in the eye exam and it’s okay if they are too shy to verbalize. During this exam the optometrist will be assessing vision acuity and eye teaming while looking for clouding of the lens, refractive error, nearsightedness, farsightedness, astigmatism, amblyopia, misalignment, convergence insufficiency, focusing problems, poor depth perception, color blindness, and additional eye health issues.
Tell your eye doctor if your child has/had any of the following issues:
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Many people don’t realize that in addition to keeping your eyes healthy and addressing eye health challenges, optometrists can detect over 270 serious health conditions before symptoms ever occur.
That’s because the eye is the only place in the body where any doctor can look at blood vessels and understand the health of an individual’s eyes and body. This deep look into a patient’s health is performed by optometrists in every annual comprehensive eye exam. If you’re avoiding this annual examination, then you’re missing out on a full picture of your health and an opportunity for early identification.
The 270+ health conditions that eye doctors can detect include:
certain cancers
autoimmune diseases
diabetes
hypertension
high cholesterol
hormonal imbalances
brain tumors
In 2014, the American Optometric Association performed a study that found optometrists had detected over 250,000 diabetes-related manifestations that led to a diabetes diagnosis in patients who were unaware of their health condition.1
“Nobody wants to have a health issue, but Colorado optometrists are equipped and can detect both eye-related and general health conditions before symptoms ever occur. That can give any patient a better outcome and management plan than if the condition went unidentified. Optometrists provide an essential opportunity for early identification that can lead to saving vision and saving lives,” says Dr. Tom Cruse, Board President for the Colorado Optometric Association.
These conditions can only be detected by your eye doctor in a comprehensive eye exam and not in vision screenings or online exams. Colorado optometrists agree that there isn’t a replacement or hack to comprehensive eye exams, but the exam only takes about 30-60 minutes to get that detailed picture of your vision and health.
Studies show that lack of symptoms, cost of eye care, lack of insurance and/or lack of transportation as the most common barriers to treatment in patients 40 years and older. Other individuals assume that nothing can be done to improve their vision, which is a bold misconception as new technology is introduced regularly.
No symptoms is not an excuse! Colorado doctors of optometry want to be very clear that one of the best times to have an exam is before symptoms present. This means that if any eye health or general health issue is detected it can be possible to treat or and manage the issue before irreversible damage occurs to the body or eyes.
The American Optometric Association has noted, “58% of asymptomatic patients presenting for a routine comprehensive eye exam had either a change in ocular status or care-management plan, as compared to 77% of symptomatic routine eye exam patients.”2
Many eye diseases and health issues that an eye doctor can detect through a comprehensive eye exam are correctable or manageable with early detection. The financial impact and prominence of eye health issues can be reduced through early detection during an annual comprehensive exam. The sooner you know you have the health issue, the sooner you can address it and prevent progression of the condition.
WHAT CAN I EXPECT AT A COMPREHENSIVE EYE EXAM?
A comprehensive eye exam usually takes 30-60 minutes and is performed by an optometrist or ophthalmologist. The exam covers 12 areas of observation and testing, whereas screenings only check one area, vision acuity.
THE FOLLOWING DO NOT COUNT AS A COMPREHENSIVE EYE EXAM:
Eye screenings are not comprehensive (including the eye screening at the DMV)
Online eye exams are not comprehensive
App-based vision tests are not comprehensive
COMPREHENSIVE EYE EXAMS INCLUDE:
Patient History The doctor or staff will collect information on your health, family, and vision history along with current medications and symptoms. They will clarify your chief concerns.
Visual Acuity Testing Testing for your vision with and without correction or with glasses or contact lenses.
Preliminary Tests Testing eye pressures, screening for side vision, color vision, stereo acuity, pupil reactions, eye teaming and tracking.
Keratometry/Topography Measuring the shape of the cornea.
Refraction Checking the power of the glasses needed.
Eye Focusing, Eye Teaming, and Eye Movement Testing Looking at how the eyes work together during focusing and movement.
Eye Health Evaluation Evaluating the health of the front of the eye and inside the eye.
Supplemental Testing Depending on the findings of your exam the doctor may order further testing. This could include, but is not limited to: digital imaging of the retina, visual field testing, OCT, meibomography, photodocumentation. This testing is used to further clarify the diagnosis and treatment plans for such disease as: glaucoma, macular degeneration, dry eye, visual efficiency issues or the need for contact lenses.
Many of these serious health and eye health conditions can be threats to an individual’s vision, life, or quality of life when left undetected. Schedule a comprehensive eye exam today.
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
We are so pleased to share this news story by The Denver Channel about our patient, Michael Gibbs, who suffered a concussion in a car accident in 2015.
After years of searching for help, he found our amazing team who were finally able to help Michael heal and get back to the life he loves. Watch the video to hear from Dr. Jennifer Redmond, O.D., F.C.O.V.D; Stefanie Ohrns, Neuro Optometric Rehabilitation Therapist, and Michele Haase, Patient Care Coordinator.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
We’re so pleased to share that Channel 7 News in Denver, interviewed our patient, Michael Gibbs who was in a car accident in 2015. Vision Therapy was the key to Michael returning to the life he loved after a traumatic brain injury.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Recently, Dr. Jeri gave a presentation about Myopia in kids. Learn why myopia (commonly called “nearsightedness”) is increasing so much and about groundbreaking treatments available.
Below is a transcript of the presentation by Dr. Jeri Schneebeck, O.D., F.C.O.V.D.:
Thanks for joining me this evening, for this presentation. It’s about myopia management and our goal is with that to significantly slow the progression of nearsightedness. At Highline, we’ve always been in the forefront of trying to slow the progression of nearsightedness in our patients. Tonight, we’re going to talk about why this is so important, and review the variety of technologies that are available, and introduce a new lens that’s just been released.
WHAT IS MYOPIA OR NEARSIGHTEDNESS?
It’s the inability to see clearly at distance. On the left, the picture shows emmetropia, which is when there is no refractive error. The light rays enter the eye and automatically focus on the retina. With the myopic eye, on the right, you can see that the light rays enter the eye and focus in front of the retina leaving distance objects blurry.
CAUSES OF MYOPIA
Genetics is one of the things that’s very important. So, the likelihood of a child developing myopia increases to 50% when both parents have myopia, 33% when one parent has myopia, and 25% when neither parent has myopia. We also know that lifestyle is a big piece of developing myopia.
Research shows that modern lifestyles may influence the development. Insufficient time spent outdoors is believed to be one reason. Currently our children spend an average of 30 minutes a day outside. We also believe that prolonged time spent reading and playing and working on digital devices is a component of it. The same children who are only spending 30 minutes a day outside are spending an average of 7 hours a day in front of electronics. The statistics show that this may have serious consequences on their health and well-being. When our doctors are counseling patients, we recommend 2 hours of outdoor play daily to reduce the potential of developing myopia.
Think of the other benefits, more outdoor play can lessen obesity and lower body mass index, improve fitness, grows motor skills, muscle strength, reduced incidence of depression, improved relationships with peers and parents, and it develops an appreciation for the environment.
Myopia is becoming more widespread and more severe than ever. In the early 70s, only 25% of Americans were nearsighted. Today, more than 40% of Americans are nearsighted. That number’s increasing at an alarming rate, especially among school-aged children. By 2050, 58% of the North American population is predicted to be nearsighted.
LONG TERM IMPLICATIONS OF MYOPIA
Myopia is measured in quarter diopter steps. For every full diopter of increase in myopia, there’s a 30% increased risk of retinal detachment, and a 67% increased risk of myopic maculopathy. In addition to these health implications, if we can keep a child’s myopic prescription lowered, when they get old enough, their candidacy for refractive surgery, LASIK, or PRK may be improved, and the results may be better. Leaving myopia unmanaged may contribute to severe eye health complications and sight threatening conditions later in life.
MYOPIA RISK ASSESSMENT
You’ll notice that every single one of these risk levels has that recommendation for limiting screen time, limiting close work outside of school, and encouraging at least 2 hours of outdoor play per day. How do we know if a child’s in need a myopia management program?
LOW RISK
Low risk is if they’re a little bit farsighted, a little bit more than +.75 (farsightedness) at age 6 or younger, is what that tells us that there’s going to be a bit less of a risk for them becoming nearsighted.
Ideally a child is slightly farsighted, or hyperopic is the other word for that, which does then bring less risk for becoming myopic.
MEDIUM RISK
A medium risk happens when, even if they’re just a little bit lower than +.75 at age 6 or younger. At that age, if we’re not seeing nearsightedness yet, but we’re seeing a zero prescription, you would think that would be great, but, in reality, it does put them at a medium risk of developing myopia later. So, we watch for changes in their prescription over a short period of time at that time. It’s one reason why we recommend that school-aged children have their eyes checked every year.
HIGH RISK
The high risk comes if there’s any myopia at all confirmed in any pre-school or school-aged child. If we aren’t going to immediately enroll them in a myopia management program, we want to watch them extremely carefully at this point. We’re going to follow them every three to six months. And the ideal is, if they are changing at all, if their myopia is increasing at all, we want to get them going in a myopia management program.
MYOPIA MANAGEMENT TODAY – FOR THE FUTURE
For children who begin a myopia management program (the earlier, the better), their vision will not only be corrected today for distance, but the progression of myopia over the child’s growing years may be slowed. So, it will minimize the long-term impact of myopia:
Reduced eyeball elongation. Remember that one of the reasons for myopia is elongated eye.
We slow the progression of nearsightedness, and
We have a potential reduction in the health complications found more frequently in myopic patients.
Some of the methods we use at Highline to slow myopia progression.
Multifocal or anti-fatigue design spectacle lenses. These are used for children too young to wear contact lenses.
We use very low dose atropine drops, or can do that as a method to try to slow myopia progression.
CRT lenses. They are contact lenses called corneal refractive therapy, and we’ll go into those a little bit more and explain how that type of a contact lens works.
And then finally, we will discuss the MiSight® daily disposable soft contacts, which is the new lens just released with some really nice research behind it.
MULTIFOCAL OR ANTI-FATIGUE DESIGN SPECTACLES
For many years, multifocals have been the only option for trying to control myopia progression with spectacles. There are some new spectacle designs being released, being developed, right now that have the peripheral retinal defocus properties to slow myopia progression.
That’s a mouthful, I know. So, without going into too much detail, all myopia control modalities operate by creating a defocus on the retinal periphery while simultaneously providing clear central vision. From 2010 to the present there’s been a shift toward developing myopia management devices that alter periphery retinal defocus based on the landmark studies that found that the peripheral retina had a significant role in refractive error development.
You’ll hear me say that the number of our modalities is kind of the ultimate goal to create a clear central image at distance while creating a peripheral retinal defocus. That helps to stop the elongation of the eye.
LOW DOSE ATROPINE DROPS
These are used one drop in each eye before bed. They’ve been shown to significantly decrease myopia progression in children within a year. And, they can be used in conjunction with some of our other myopia control measures, so that’s a nice. If you have somebody you really feel is progressing rapidly, we may want to use more than just one method to try to control that.
They’re ordered from a compounding pharmacy with a cost of about $45 a month, so, they’re not real expensive. And, the disadvantages are this is a prescription medication and it does take motivation of parents and child to get the drops in nightly. Again, the atropine drops work by creating peripheral retinal defocus. So, again, that’s shown to slow that elongation of the eye that causes progressive myopia.
Benefits of choosing a contact lens-based myopia management approach
The vision is corrected for daily actives such as school and sports.
It’s thought to be a more comfortable experience for children versus wearing glasses, there’s some studies about self-esteem and so forth with contact lens wear versus wearing glasses.
There are no glasses to lose or break, although, I will say that “back up glasses” are always recommended for contact lens wearers. In the event that they can’t wear their contacts a given day due to an eye infection or whatever reason. We do recommend that with these contact lens modalities that we’re going to be talking about with that do the control of myopia, that they are worn a minimum of six days a week. So, it is a commitment to wearing the contact lenses.
Contacts accommodate a more active lifestyle versus wearing glasses. So, in this short term, the benefits of a contact lens-based myopia manage approach may look very much like correcting vision with traditional contacts. However, the design of all of these lenses is very different from a standard contact lens.
CRT LENSES – CORNEAL REFRACTIVE THERAPY
The first contact lens that we’ll talk about are the CRT lenses. That stands for corneal refractive therapy. They’re a rigid gas permeable lens that’s worn overnight while you’re sleeping. They work by gently reshaping the curvature of the cornea while you sleep. Then you remove them upon awaking and your vision is corrected throughout the day.
So, it’s a great choice for athletes, that’s why I’ve put these pictures up here. For swimmers especially, because you really should not be wearing soft contact lenses in a swimming pool at all. These are great for athletes who may lose or get daily wear contacts dirty and it may also be the lens of choice for those having moderate amounts of astigmatism and some of our other choices do not correct for astigmatism. And again, this lens design creates the peripheral defocus on that retina that’s needed to slow the progression of myopia.
MISIGHT DAILY CONTACT LENS
They’ve called it the Brilliant Futures Myopia Management Program. It’s a comprehensive approach built around that MiSight lens. I’m going to give you a little more information about that lens tonight. Because then the other things that we’d talked about, just because they were just released, and they have ten years of research to support their effectiveness.
Many studies involving contact lenses are retrospective. They use existing data that’s been collected from the eye exams that have already been done. And, they use that information to put together the success of the contact lens. MiSight lenses were studied for ten solid years before they were brought to market with randomized double blind placebo-controlled studies that are the gold standard in research.
Our program fee includes all of these things:
An annual supply of MiSight daily disposable lenses, they’re single use lenses, you put them in in the morning, you throw them away at night. They’re considered the healthiest alternative for children to wear.
Free shipping and free returns whether the prescription changes or not.
App: There’s a very helpful app that will help with appointment reminders, payment options, and a way to track program progress, and to communicate with our office. It will have periodic surveys to see how the child’s doing. So that we can figure out very early on if there are problems that are going to cause the child to fail with the lenses. We really want them to be successful.
It includes regular progress evaluations and
Access to the website support tools.
HOW MISIGHT 1 DAY WORKS
So, this a little tricky. This central purple area is the correction zone. That’s what corrects the vision and creates that focal point that gives you clear distance vision. And this is a nice little diagram because it’s going to show you what I’ve been talking about, this myopic defocus, this peripheral retinal defocus, that has to happen in order to stop the progression of the nearsightedness. And then the dark zones, the darker purple zones, are the treatment zones that create that defocus out here in the periphery of the eye. By including both types of zones in the lens is simultaneously corrects the child’s vision today while training the eye to resist changing shape. And that goal is to preserve vision for the future and to slow that progression of near sightedness.
EFFECTIVENESS OF MISIGHT 1 DAY
Over a three-year period, children in MiSight lenses had 3/4 of a reduced increase in myopia than children in standard daily disposables, and that equates to an average of 59% reduction in prescription change compared to a standard daily contact lens at 3 years. Those same children also had a reduced increase in axial length, that elongation of the eye. And again, that equates to a 52% reduction in the eye lengthening with the MiSight lenses compared to standard soft contacts.
CHILDREN LOVED THEIR MISIGHT LENSES
Children did really well with MiSight lenses. These studies were done on children 8 to 12 years old. That doesn’t mean that other aged children can’t be fit with those lenses. It’s just the way the study was done. And these young children did extremely well with contacts.
Over 90% of them preferred wearing them compared to their glasses,
Over 90% could apply and remove their MiSight lenses on their own.
And, parent reported that their child was happy wearing the lenses. They noted comfort, vision, ease of use, and freedom from glasses as benefits.
And, all the while their vision was clear for distance, for school, for doing their close work, for playing video games, for playing their sports. So, they had the best of all worlds.
Sequence of care in our office for being fit with these lenses.
We have the initial comprehensive eye health and vision evaluation, which is covered either by your vision plan or is paid privately.
After that, we talk a little bit about the myopia control, if the child is looking like a good candidate for myopia management, we provide the parents with the myopia management pamphlets, and then we email you the MiSight parent education digital book. Which gives you a lot of the information that I’ve gone over this evening.
Then we schedule a follow up consultation to go over pricing, answer questions, discuss the program. It’s advantageous for both parents to be present for this part. This can be done virtually, if for sometimes that’s easier to get both parents at the same time, that way.
And sometimes, number three and four are actually put together, and we’ll do the fitting at the same time as the consultation. Including teaching the child how to insert and remove their lenses, and at that time we set up the app access, so that you’ve got all those features available to you.
Number 5 is only for CRT lenses: We do see CRT patients at a one day progress evaluation. And that is, with CRT lenses that’s the only visit where people come in wearing the lenses. We have them come in so we can see how they did sleeping in those lenses the first night. And then we take the lenses out and check their vision after that. The rest of the time when they come for progress checks they will bring their contacts with them but will not come in wearing their lenses. With MiSight lenses, they will always come in wearing their contact lenses. We want to see the lenses on their eyes after they’ve had a chance to settle and watch for any problems that might be occurring as they’ve worn the lenses.
So, we do a one week progress evaluation. At that time the down payment’s required, and we order lenses. We do wait for that one week progress evaluation in case there’re just any problems, the child just absolutely is not going to wear the lenses. Those kinds of things we don’t want you to have lenses ordered that you’re not going to be able to use. So, we wait to that one week progress eval to order the lenses.
Then we do a one month progress evaluation
And then a six month progress evaluation
All of those numbers 2 through 8 are all included in the program fee along with a supply, the annual supply of lenses. All of that’s included. And honestly, if other progress checks are needed for any reason during that 6-month period, that would be included in the program as well.
HOW LONG SHOULD WE CONTINUE USING INTERVENTIONS WHEN WE’RE TRYING TO SLOW MYOPIA PROGRESSION?
A large study out of the University of Waterloo followed 6400 people and found that the average age when myopia stopped progressing was between 24 and 27 years old. I would say that average age appears a little bit more of the study. Historically, practitioners kind of think that myopia stops progressing at puberty or around the ages of 14 to 18. However, another large study showed that at age 15, 50% of pediatric myopes were still progressing. And at age 18, 25% were still progressing.
We can’t predict how any single individual child is going to respond to any intervention for myopia, but based on the averages, it’s best to keep them in the interventions into their mid-20s. I will tell you, especially with this year, with people being on computers more, we’re seeing a more rapid increase in myopia than ever before. So, with children now being on computers so much more than they ever were before, this is even more important that we keep the interventions in place so that we can keep that myopia to the minimum amount possible.
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