Nearsighted Kids – Time for a serious talk about managing myopia

By Richard Casselli, ood 

My name is Richard Casselli and I am an Optician and board-certified contact lens fitter in practice since 1974. Since 2017 I have worked with Dr. Daryan Angle and Dr. Daniela Bugescu, IRIS Optometrists in Waterloo at our location on King Street.

As parents we want to do what’s best for our kids. Since vision is one of our most important senses, children should have their vision assessed as early as possible. Optometrists recommend children have their first eye examination at around 6 months. Along with checking eye health and development during each eye exam the optometrist will be looking for signs of myopia, a vision condition that affects about 30% of Canadians, begins in childhood and continues to worsen up to the persons 20’s when it “stabilizes” or stops progressing.

What is Myopia  

Myopia is often called nearsightedness because objects in the distance like signs are blurry, while a book in hand is clear.  Myopia occurs when the eye is too long or too sharply curved, causing light to focus in front of the retina instead of on its surface.  Like other vision issues, without eye examinations, myopia can easily go unnoticed in children who may not know what is missing in their vision. 

If either parent is myopic, there is a greater chance the child will also be nearsighted and at an early age.  With the increase of handheld screens for fun and learning and a decrease in outdoor activity, nearsightedness numbers are rising.  Yes, gazing at flying baseballs, birds, the sign on a bus that’s a block away and constellations are good for kids’ eyes! 

My child needs eyeglasses, what’s the problem with that?

Children’s eyes grow until they are about 18. Along with the need for stronger lenses yearly or more often due to prescription changes glasses for kids isn’t always easy. They break during sports and play, fog in the winter and go missing in the bottom of a book bag or locker. More seriously, if myopia progresses to over -5.00 diopters, there is an increased risk of retinal detachments, retinal tears, glaucoma, macula layer separation and other eye disease.

Twenty years ago, I began my Orthokeratology practice 

During my career I placed a lot of glasses on little faces, and while those glasses corrected their vision, they didn’t prevent the myopia from progressing.  Nor do the regular contact lenses worn by tweens and teens.  In fact, while they resolve the blurred vision, these corrections can actually cause the eye to become more myopic.  With the higher risk of unmanaged myopia, I want to provide young patients an opportunity to prevent or slow down myopic progression by using orthokeratology or “OrthoK” for short.   

What is Orthokeratology?

OrthoK is a therapeutic rigid contact lens designed to gently re-shape the cornea while the patient is sleeping. That’s not a typo, the patient only wears the lens at night during sleep. In the morning the lens is removed and vision is near perfect or better for the entire day, without the need of eyeglasses or contact lenses. When the patient is ready for bed, the lenses are reinserted and the process starts all over again.

Since OrthoK lenses address the image focus on both the centre of the retina and the periphery, they resolve image defocus and that reduces the elongation of the eyeball.  Remember, elongated eyes are why myopia occurs.  Orthokeratology can’t reverse nearsightedness that has already developed but it can slow down or even arrest further progression.  We start as early as 6 years old.  The earlier treatment is started the better the outcome.  For kids OrthoK is therapeutic, and they will age out of the process with better vision and healthier eyes, sometimes leaving corrective lenses behind.  Adults with myopia, even though their vision has stabilized, can enjoy temporary cosmetic benefits of OrthoK. 

Some frequently asked questions: 

Is OrthoK therapy safe?  

Yes, even safer than soft lenses.  Rigid gas permeable lenses required in OrthoK therapy have been used safely since the 60’s.  Today’s RGP’s are designed to allow even more oxygen to pass through to the eye making them comfortable and safe. 

How do you get children to wear them? 

I have become very good at working with kids and parents to achieve OrthoK results. Kids are much easier to deal with than adults.  I can count on one hand the number of kids over the last 20 years that were unable to get them in.  Usually, for the younger ones, the parents help out to start until the child learns to do it themselves.  I have lots of 6-year-olds putting in their own lenses.  

Can I use my extended coverage? 

OrthoK lenses are billed under contact lenses. If you have optical coverage that includes contact lenses you will be able to use it towards the costs of OrthoK lenses. 

Should you wish to have your child or yourself assessed for Orthokeratology, the consultation is free. Please call 519-725-3937 to book an appropriate appointment. We can talk about what’s involved and how we can work with you and your child to get what’s best for their vision.

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