Chong Jing (M/10) came for an eye examination, complained of blurred vision at far. Mother, Ms Sally notices that he squints his eyes always recently.
He has worn his current spectacles for about 9months with power of:
R: -3.00/-2.50×180
L: -2.75/-3.25×170
New power is:
R: -5.00/-2.75×180 (6/6)
L: -4.75/-3.25×170 (6/6)
Chong Jing’s shortsighted power(or myopia) has increased 200 in both his eyes in less than a year. If there is power increment of 075 a year, it is considered a red flag already. Now not only we want to correct the power, we also want to monitor and to control myopia so that we can slow the rate of power progression. Having higher eye power means that the eye is at higher risk of eye pathology in myopia such as myopic macular degeneration, retinal detachment.
For children who have power increase, we will bring you through myopia control management. There are many options available in myopia control, namely (not in any specific order):
1. Spectacle myopia control lens
2. Soft contact lens that you wear during daytime (MiSight)
3. Hard contact lens that you wear to sleep or Orthokeratology
4. Atropine eye drop (to be monitored by eye doctor/ophthalmologist)
5. Combination treatment from above
The choice is yours to make. We will explain all the above strategies in myopia control and parents will decide whether to go for spectacles lens / contact lens / eye drop, to undertake an option that you think is best suited for your child. Mum and Dad know our child best. If power increment is a lot, we will advise to do combination treatment.
Ms Sally would like to continue with spectacle lenses for her son, so we prescribe Myopilux Max as his power increment is very high. We also advise that he goes for Atropine eye drop.. to do a combination treatment to bring the power progression under control the best we can. Also, these contact lenses are safe to be used for kids as they are FDA approved. For kids who are active in sports, perhaps contact lens is a great option. Together with all proper visual hygiene in place, golden rule 20-20-20 rule, proper posture & workdesk ergonomic, enough lighting, hold material away at arm length, 2 hours of outdoor play every day.. all these work hand in hand in arresting myopia progression.
Myopilux Max (or executive bifocal) is spectacle lens with a horizontal line at centre of lens. With the horizontal line, Chong Jing will be aware of the line, to know that the portion above the line will be used for his far vision. The portion below the line will be used for his near vision, the portion that works in controlling the progression of his myopia. What we know now is that myopia increases due to excessive near work. When we see our phone, this image from near target will fall behind our retina(screen of our eye) which will stimulate eyeball to elongate. In a long run, continuous stimulation to elongate will lead to increase of myopia. What the bottom portion of the lens does is to let the image fall back in front of our retina, to prevent having the stimulus to elongate, so that we can slow/stop the progression of myopia. With the horizontal line as guidance, this ensures compliance in using the lenses, hence better effect of myopia control. Another feature in Myopilux Max is that it incorporates prism in the lens itself to help relax the eye (reduce convergence) when they do near work.
The same thing goes with no line/multifocal myopia control lenses too. The top portion of lens is to see far clearly while the bottom part of lens is used to see near and this bottom portion is to control power progression as well. With these multifocal myopia control lenses, we need to ensure that our kids use the bottom part of the lens when they see near, to fully utilise the effect of myopia control. So, proper posture is very important to ensure he/she is using the bottom portion to see phone/read in order to maximise myopia control.
What we will do is that we want to see Chong Jing every 3 months, to see him frequently to monitor his power progression and to reinforce proper visual hygiene. For example, if he were to come back 3 months later with power increase of 050, then we know combination treatment is required. If he comes back 3 months later, still having same power, then we know he is doing fine with this executive bifocal myopia control lens.
Thank you Ms Sally & Chong Jing for your trust & support!????