As discussed in Part 1 and Part 2, Myopia Control Treatment slows down the progression of myopia (nearsightedness) by 50%, which has huge eye health, financial, and lifestyle benefits for your child. We will now discuss the 3 different treatment options, and the pros and cons of each.
Atropine
The first treatment option that showed consistent effectiveness in slowing down the progression of myopia was low dose atropine. ATOM 1 Study1, published in 2006, was the first large scale clinical trial that proved the atropine is effective in slowing the progression of myopia in children. This was followed up by the ATOM 2 Study2, which confirmed the results and proved that low dose atropine (0.01%) was equally effective and less visual side effects than full strength atropine 1%. These 2 studies were paradigm shifting, as it was the first proof that we could have an impact on how much myopia a child would develop.
Then, in 2018, the LAMP Study3 evaluated different concentrations of low dose atropine, and concluded that 0.05% atropine was slightly more effective than 0.01% atropine without an adverse effect on vision-related quality of life. In summary, low dose atropine appears to slow myopia progression by about 50% with little to no visual side effects, depending on the atropine concentration.
Orthokeratology
Think of these contacts as retainers for the cornea. OrthoK lenses are only worn at night, where they temporarily reshape the cornea before being removed upon waking up in the morning. This provides the patient with clear vision for the entire next day without having to wear contacts or glasses. Approved by the FDA in 2002, these lenses have been safely used in children and adults alike. More importantly, the improved optics of the cornea is theorized to decrease the signal the eye receives to grow excessively long, thus slowing down the progression of myopia. This has been found to slow the progression of myopia by about 50%4. This option is best for kids who have low amounts of astigmatism.
Multifocal Soft CLs
These lenses create a similar optics to orthokeratology, but done using soft multifocal contact lenses worn daily instead of a hard lens worn at night. These lenses are very similar to lenses adults wear after age 40 to achieve simultaneous distance and near vision without the need for reading glasses. This is typically the first option for more mature kids due to ease of use and similar efficacy. This treatment option also slows the progression of myopia by about 50%5.
What is the most effective Myopia Control method?
In Summary, all 3 of the above treatment options slow down the progression of myopia by around 50%. There is not one option that I favor more than others. During our Myopia Control Evaluation Exam, we will talk about your child’s lifestyle, maturity, and glasses prescription, and decide together which is the best option for your family.
References:
1. W. Chua, V. Balakrishnan, D. Tan, Y. Chan, ATOM Study Group; Efficacy Results from the Atropine in the Treatment of Myopia (ATOM) Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3119.
2. Chia A, Lu QS, Tan D. Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2: Myopia Control with Atropine 0.01% Eyedrops. Ophthalmology. 2016 Feb;123(2):391-399. doi: 10.1016/j.ophtha.2015.07.004. Epub 2015 Aug 11. PMID: 26271839. https://www.aaojournal.org/article/S0161-6420%2815%2900675-2/fulltext
3. Yam JC, Jiang Y, Tang SM, Law AKP, Chan JJ, Wong E, Ko ST, Young AL, Tham CC, Chen LJ, Pang CP. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology. 2019 Jan;126(1):113-124. doi: 10.1016/j.ophtha.2018.05.029. Epub 2018 Jul 6. PMID: 30514630. https://www.aaojournal.org/article/S0161-6420(18)30285-9/fulltext
4. Lee, Yueh-Chang et al. “Effect of Orthokeratology on myopia progression: twelve-year results of a retrospective cohort study.” BMC ophthalmology vol. 17,1 243. 8 Dec. 2017, doi:10.1186/s12886-017-06394. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721542/
5. Multifocal Contact Lenses Slow Myopia progression in Children. National Institutes of Health News Release. August 11, 2020. https://www.nih.gov/news-events/news-releases/multifocal-contact-lenses-slow-myopia-progression-children