More And More For Kids - Orthokeratology
So we always want better for our kids than we have right? We want them to have straighter teeth than we do,we want them to make more money than we do, we want them to be better athletes than we are, we want them to be smarter than us, and the list goes on. There is one thing though that I think we all want to be better at than our kids and that is being nearsighted. I can’t see my hand when it’s 6 inches in front of my face, do I want that for my children? Heck no! I want to be the most nearsighted person in my family hands down. But what do you (the parent) do when the eye doctor tells you year after year that your child’s eyes have changed and they need new glasses with thicker lenses (and new contacts if they wear them). What do you do when your number is -6.00 or -7.00 and your third grader is already -3.50 or -4.00 or even higher?
Well, many eye doctors would tell you to get the stronger glasses because there’s nothing we can do and the child needs to see clearly. After all, kids are too young for LASIK which by the way is surgery and besides, nearsightedness (myopia) won’t kill them. Or the one that drives me crazy is something like, ‘Well, I’m nearsighted and I turned out alright’ (YES, SOME DOCTORS ACTUALLY SAY STUFF LIKE THAT)!
Well, as it turns out, there is increasing evidence-based scientific study showing ways of slowing down or even stopping myopia progression in children! There are several methods being utilized by the progressive eye doctors out there who aim to not only keep their pediatric patients seeing clearly, but also improving the quality of their lives. By decreasing high myopia, we also can decrease certain associated risks of major eye health problems. For instance, high myopia is a risk factor for glaucoma, floaters and retinal detachments.
So, how do we accomplish this? It turns out that the application of contact lenses seems to be better than glasses when trying to slow down increasing myopia. Not just ordinary contact lenses though, special lenses. The most special (and probably the coolest) lenses are Orthokeratology lenses. Ortho what you say? Ortho from the Greek meaning straight, kerato meaning cornea. The science of straightening corneas then. Another way of saying this is changing the shape of the cornea to produce clear vision. Here’s what an OrthoK lens does to the cornea: *** A rigid lens is placed on the eye causing a redistribution of corneal tissue. Tissue is neither eliminated nor added, therefore the treatment is safe, non-permanent and modifiable. When the lenses are removed, the new shape is maintained for anywhere between 24-72 hours. What this means is that you can see clearly after the lenses are removed for a day or more. Ready for the best part? You wear the lenses overnight while asleep. 7-8 hours of sleep can correct your nearsightedness during the day so you can be free from daily wear contacts or glasses! Oh, by the way, you can see with the lenses on, but the treatment works best when you’re asleep. There is no permanent change, so the lenses need to be worn each night (in some cases every other or every third night). But is it safe? Haven’t we optometrists been yelling at our patients to stop sleeping in their lenses because it is unsafe? Actually, we yell at our soft lens wearing patients because they not only sleep in their lenses, but then wear them all day too so there is no time they are lens free. This can cause corneal swelling, irritation, inflammation, infection and oxygen deprivation. Plus soft lenses are sticky. Germs love sticky surfaces. OrthoK lenses are rigid and not sticky. In fact many deposits and germs are repelled by them. Also, they are not worn for the 16 or so hours you are awake. This makes them a safer alternative. I would be remiss to fail to mention that any contact lens, be it soft, rigid, overnight or daytime-only can cause problems to the eye and cornea. Proper care helps mitigate problems as does decreasing the frequency of wear. Again, that’s why we love lenses worn for half the time of traditional daytime wearers. There have been many studies proving the safety of OrthoK lenses. In fact, the FDA approved OrthoK as safe for patients of all ages!
Another contact lens modality being used to help slow down increasing myopia is soft bifocal daily wear lenses. (Coopervision Proclear Multifocal lens depicted). They work on the principle that the central 2-3 millimeters of the lens gives clear distance vision and the rest of the lens is weaker. Studies show that the smaller treatment area helps slow down the rate of change. That’s why regular soft lenses and glasses just don’t work as well for controlling myopia. It is a similar treatment to OrthoK which also gives maximum correction in the central part of the cornea and less in the peripheral part.
But what if your child cannot (or will not) wear any form of contact lens? For better or for worse, not everyone can tolerate a lens on their eye. There are now some early studies looking into using very low concentrations of atropine to help control myopia. Atropine is an eye drop that in higher concentrations can cause pupil dilation and inability to focus for near, but those side effects are all but eliminated in the new weaker concentrations. There will be more to add on this subject in the near future I suspect.
So, in summary, the question is not which modality do you chose, the question is, what options have been presented to you? In this modern age of health care, offering one hundred year old methods without any options seems a bit, well, old fashioned.
So the next time your kids need stronger correction, you might want to ask what else can be done. Hopefully, you will maintain your position as the leader of the myopes in your family!
This wealth of information was originally published here: https://greatvisioncare.wordpress.com/2012/05/28/more-and-more-for-the-kids/
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