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How to Treat Near-sightedness in Adolescents and Adults

Myopia, commonly known as near-sightedness, is a condition in which people have difficulty seeing objects in the distance clearly. In progressive myopia, the near-sightedness often begins in early childhood and worsens through adolescence.

During childhood, myopia is typically treated with glasses in younger children and, in some cases, contact lenses in older children and teenagers. Refractive surgery, such as LASIK, is generally reserved for adults.

What Causes Myopia

Many patients and families inquire about why progressive myopia occurs and want to know ways to slow down myopia progression. The precise mechanism of myopia progression is unknown. There is a genetic component to myopia, so it is more likely to occur if there is a family history of near-sightedness.

How to Treat Myopia

Treatment for progressive myopia is aimed at slowing the rate of progression since the prevention of myopia is not possible. Treatments attempting to slow myopia progression have included optical treatments (e.g., bifocal glasses, contact lenses), pharmacologic methods (e.g., atropine eye drops), and environmental factors (e.g., outdoor time).

Some optical treatments (e.g., multifocal soft contact lenses, bifocal glasses) are used to allow the eye to relax from focusing to see at near in an attempt to slow down myopia progression. Orthokeratology attempts to reduce myopia progression by changing the peripheral focus of the eye and uses a rigid gas permeable contact lens every night to reshape the cornea (the clear, front part of the eye),. The FDA has recently approved the MiSight contact lens that attempts to slow myopia progression by inducing peripheral myopic defocus. Risks with contact lens wear include corneal abrasions, ulcers or infections, and scarring that can lead to vision loss.

Studies in Asian children using “low dose” (0.01 percent) atropine eye drops were more effective at slowing myopic progression, with fewer side effects (e.g., light sensitivity, blurred near vision) compared to higher doses of atropine. This treatment requires daily use of eye drops. These findings require studies of children of all backgrounds before they can be widely recommended for use in all myopic children.

Evidence also suggests that increased time spent outdoors during childhood may reduce the progression of myopia in children and adolescents.

The Future

While multiple treatment options have been researched, a general consensus on the best approach is lacking since definitive evidence is unavailable; progression can recur after stopping the treatment; and there can be significant side effects and risks as with any treatment.

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