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Orthokeratology in Clinical Practice Across the World

12/15/2016

 
by Bruce T. Williams, OD, FIAO / Sergio Garcia, OD / Javier Prada, OD / Dennis Leung, OD, FIAO / Cary M. Herzberg, OD, FIAO

Many factors must be taken into account when controlling myopia progression. There is no doubt genetics plays a role in the development of myopia in children.  But lifestyle is also an important factor to consider. In terms of safe and effective treatment, orthokeratology is now known to be successful in controlling myopia and has even been shown to slow down progression in individuals with high myopia. While it has developed substantially in Latin America, it is effectively mainstream in the US and a common treatment in China, where there are numerous orthokeratology clinics in city hospitals. Currently, orthokeratology is also on the rise in Europe.

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Orthokeratology for Hyperopia and Presbyopia

8/3/2016

 
by Bruce T. Williams, OD, FIAO

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Half of the world will be short-sighted by 2050: new research

2/18/2016

 
Source: AAP
Kids at risk of myopia may need to spend less time on electronic devices, says study on rapidly increasing global rates of short-sightedness.
Half the world's population will be short-sighted by 2050 with many at risk of blindness, says a study on the rapidly increasing prevalence of myopia.

​The researchers estimate that it will affect 55.1 per cent of the Australasian population by then, up from 19.7 per cent in 2000, if current trends continue.

The rapid increase of myopia and high myopia is widely considered to be largely driven by people spending less time outdoors and more time on "near based activities" including using electronic devices.

The findings point to a major public health problem, say the authors from Brien Holden Vision Institute, University of New South Wales Australia and Singapore Eye Research Institute.

Their systematic review and meta-analysis study, published in the journal Ophthalmology, included data from 145 studies.

Myopia is a common cause of vision loss, with uncorrected myopia the leading cause of distance vision impairment globally.

The researchers estimated that 49.8 per cent of the world's population, nearly five billion people, will be short-sighted by 2050.

Up to one-fifth of them will be at a significantly increased risk of blindness if current trends continue.

The number with vision loss from high myopia is expected to increase seven-fold from 2000 to 2050, with myopia to become a leading cause of permanent blindness worldwide.

Planning for comprehensive eye care services is needed to manage the rapid increase, as is development of treatments to control the progression of myopia, the authors said.

"We also need to ensure our children receive a regular eye examination from an optometrist or ophthalmologist, preferably each year" said co-author Professor Kovin Naidoo.

If found at risk, preventative strategies can be used such as increasing time outdoors and reducing time spent on near based activities requiring constant focusing up close.
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"Furthermore, there are other options such as specially-designed spectacle lenses and contact lenses or drug interventions but increased investment in research is needed to improve the efficacy and access of such interventions," he said.

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10 Ways To Protect Your Eyes in 2016

1/5/2016

 
A happy New Year to all from Seattle Vision Care Center.

Myopia, also known as nearsightedness or shortsightedness. While this condition may seem like a mild inconvenience, it actually increases the risk of serious eye diseases such as glaucoma, cataracts, and retinal detachments. Most alarmingly, myopia rates are increasing dramatically in the developed world. In just the last generation, the rate of myopia has increased in the US by 65% more.
 
Here is what you can do:

  1. Educate yourself –  MyopiaControl.org, and MyopiaPrevention.org are all good places to start. While doctors cannot predict exact progression of nearsightedness for a particular patient, there are options. It is important to understand that there risks and benefits to every option and many of the options below are considered “off-label” by the FDA. Have these conversations with your doctor.
  2. Get your kids outside – There have been numerous studies that show that the more time younger children spend indoors the more likely they are to become myopic. So for 2016, make sure your kids include going outside for walks, trips to the park, or playing outdoor sports as part of their daily routine. 
  3. Find the right eye doctor – Most doctors do not have specialty training in myopia control. While most know how to prescribe glasses and contacts to help people see clearly, some doctors have undertaken post-doctoral education in the methods of myopia control. You can go to the American Academy of Orthokertology and Myopia Control to find a doctor in your area. 
  4. Start early – One thing we know for sure: the best way to control myopia is to prevent it. So the earlier action is taken for a patient, the less myopia they ultimately will have. In fact, we can now better predict who will be myopic before they start having blurry vision or before they would fail a school or pediatrician screening. So if you or your spouse is nearsighted, be sure your children have eye exams at the recommended ages and discus myopia with your doctor. 
  5. Reduce eyestrain – People become nearsighted for a combination of genetic and environmental. Unfortunately, there are no large studies that guide us yet. However, there are some things that doctors to see clinically. Generally, excessive stress rarely improves any condition. The dramatic increase in eyestrain from digital device does seem to parallel the increase in myopia. In my own clinic, I have seen an increase in teenagers with  blurry vision at distance that is not due to myopia from eyestrain. These patients are likely to become myopic eventually and best treated with vision therapy. Until we know more about the eyestrain/myopia connection, I think it makes sense to take it easy with the digital devices. A 5 minute break every 20-30 minutes has been shown to reduce focusing eyestrain. 
  6. Do not ask for under-correction – the idea of intentionally wearing “weaker” glasses to keep the eyes from getting worse is a common misconception.
  7. Consider orthokeratology – One method that has been shown to effectively reduce myopia progression is orthokeratology (AKA Ortho-k, or OK). This has the added benefit of providing patients with clear daytime vision without glasses or contacts. Ask your doctor if this is an option for your child. 
  8. Consider multifocal contacts – Additionally, certain multifocal soft contacts have been shown to reduce myopia progression. Ask if this is an option for your a child.  
  9. ​Consider atropine eyedrops – One method that has been very effective in slowing myopia progress is the use of atropine. This is very common in Asia, but has been more slowly adopted in the US. 
  10. Avoid myopia scams – Finally, beware. There are some websites that promise to reverse or eliminate myopia with special glasses or exercises. Some of these sites charge as much as $9,000(!) for their services. While these sites may sound informative and scientific, they are purely scams and cannot deliver what they promise. Ask your doctor (see #3), instead of spending money on these.  

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