About Gold Coast Myopia Control
Gold Coast Myopia Control was established in 2014 as a specialty division of Envision Optical, a locally owned optometrist with 4 locations across the Gold Coast and Tweed. Focused on preventative eye health and wellness, optometrist Andrew Bowden was frustrated that for
Andrew Bowden - Envision Optical Director
hundreds of years vision care for myopia had not changed: check eyes every year or two and make stronger glasses or contact lenses if you get worse. In his twenty years in practice he had seen certain patients that were more susceptible to getting worse with their myopia, and certain signs that would help indicate who they might be. He also was alarmed by ongoing research that showed the incidence of myopia was increasing greatly and that modern life with less outdoor time and high amounts of close work especially on screens like PC’s, phones and tablets was contributing to this. Most eye care professionals approach myopia the same: make stronger glasses.
Gold Coast Myopia Control Center is dedicated to the concept of assessing the risk factors and lifestyle factors contributing to your myopia and seeking preventative approaches to minimize future disease and symptoms.
As you’ll learn, proven treatment approaches exist that can reduce the rate of progression by up to 80% and in individual cases halt progression of the condition. At the Gold Coast Myopia Control Center, we offer a comprehensive suite of myopia control treatment options, and the ongoing management and monitoring to maximize the success of your treatment program. Stronger glasses are NOT the solution. We utilize the scientifically proven testing protocols and treatment programs that are used by the worlds leading myopia control scientists and treatment centers.
What is Myopia?
Myopia — or shortsightedness — refers to poor distance vision but clear near vision. This happens when the eyeball grows too long in relation to the power of the eye’s lenses. The light rays then focus at a point in front of the retina, rather than directly on its surface. Myopia usually appears in childhood. The condition does run in families, but some children are becoming shortsighted even though their parents have no vision problems. That means genetics is not the only contributing factor.
What are the symptoms of Myopia?
Shortsighted people have difficulty in seeing distant objects clearly. They find it hard to read road signs and scoreboards and to play ball games. Recognising people in the distance may be a problem for many shortsighted people. Often a person will not realise that they cannot see clearly but an eye examination will reveal the problem.
How can I tell if my child is shortsighted?
A complete eye test is the only sure way of determining whether your child’s vision is normal. Some clues to myopia in a child are:
- Screwing up eyes to see distant objects
- Difficulty reading the blackboard at school
- Poor posture while reading
- Lack of interest in playing outdoor games
Does Myopia get worse?
Myopia typically progresses rapidly, increasing every year through the teenage years. Current research has confirmed two clear facts:
- The younger the age of onset, the faster the likely progression
- The higher the prescription at presentation, the more likely your child is to develop high myopia
- Older patients generally progress more slowly and in lower amounts
Myopia prevalence: It’s becoming an Epidemic
The increase in myopia cases is worryingly high across the world.
- There are approximately 1.4 billion people worldwide with myopia. This is estimated to reach 2.5 billion by 2020
- 93% of 18 year old girls in Taiwan are myopic
- 70% college graduates in Singapore are myopic
- Up to 78% of 15 year old girls in urban China are myopic
We have not missed out close to home, either:
- In Australia, 30% of Australian school leavers are myopic — and this percentage is on the rise
- Myopia (shortsightedness) is increasing around the world, with many calling it an epidemic. In the US for example the prevalence of myopia has increased markedly in the last 30 years – from 25% in the early 1970s, among those aged 12 to 54 years, to over 40% now. Australians show similar trends. Aside from the burden of needing spectacles or contact lenses to function normally, patients with myopia have a much higher risk of blinding eye disease later in life.
- 23% of the world population is myopic, 2.7% high myopia: by 2050 43.4% with myopia and 10% with high myopia
Why it matters: Progression and associated risks
Adult-onset myopia (developing after 20 years of age) can progress over time, though youth-onset (before 20 years) generally shows more aggressive progression which continues until the eye stops growing. Typical sufferers are highly dependent on expensive, high-powered glasses or contact lenses and require frequent replacements as the condition escalates.
All levels of myopia increase the chance of these blinding conditions:
| Prescription Range | Condition | Risk Increase |
|---|---|---|
| -1- -3 -3.0- -6.0 -6.0 – -8.0 | Retinal detachment | 3.1x 9.x 21.5 |
| <-3 >-3 | Glaucoma | 1.77 2.46 |
| -1- -3 -3.0- -6.0 -6.0 – -8.0 | Myopic Macular Degeneration | 2.2x 9.7x 40.6x |
| -1- -3 -3.0- -6.0 -6.0 – -8.0 | Cataract | 2.1x 3.1x 5.5x |
These risks escalate as the level of myopia increases. Myopia maculopathy, a progressive condition causing holes in the retina due to over-stretching, is the fourth most common cause of visual impairment in the UK ahead of diabetic eye disease.
Studies show the risk factor for eye disease due to myopia is comparable to the risk of cardiovascular disease due to untreated high blood pressure. The risk for glaucoma and cataract due to myopia compares to the risk of stroke from smoking over 20 cigarettes per day. For retinal detachment and myopic maculopathy, myopia carries a risk far in excess of any identified population risk factor for cardiovascular disease. Given that higher levels of myopia entail a higher risk of these conditions, halting this progression can broadly prevent a significant level of blindness.
Why would you take the risks above with your eyes or your children’s eyes?
Who is at risk of developing Myopia?
- An early indicator is if level of hyperopia is less than age normal
- Parental myopia: 3x risk for one parent, 6x risk if both parents myopic
- Asian ethnicity
- Time spent outdoors: < 1.5 hours per day
- Time spent on near work: More than 2.5 hours per day (outside of school)
Who is at the highest risk of progression?
- Early age of onset: < 9yrs old
- Higher myopia on initial presentation
- If current progression is more than 1.00D per year
- Family history of myopia: one parent 3x, two parents 6x
- East Asian or South East Asian ethnicity
Important prevention measures we can take
1) Outdoor activity
- Spending more time outside has been shown to decrease the likelihood of developing myopia, and slows down its progression in those who already have myopia.
- Recent studies in Brisbane school children show that spending 2 hours per day outdoors can protect against myopia development.
- The benefits of being outside do not appear to be related to sports or physical activity, but rather the exposure to higher light levels.
- Try to find ways to increase the amount of time you spend outdoors on a daily basis, such as walking to school, walking the dog, or sitting outside at lunch time.
- Although being outside is good for your eyes, it can be damaging too. Make sure you always use a hat, sunscreen and sunglasses when you’re outdoors.
2) Near Work
- There is evidence that the amount of near work children perform can influence myopia development and progression.
- Make sure you take a break for 5 minutes every 30 minutes when reading, studying, drawing or playing handheld or computer games.
- Try not to sit too close to your work when reading or writing, use the distance from your shoulder to your elbow as a guide.
- Balance your reading time out by spending an equivalent time outdoors (e.g. if you read a book for one hour, spend another hour that day outside).
- Make sure that when you’re reading or studying you are in a well-lit room, or have plenty of light on your page.
- Smart phones are popular for children and teenagers’ texting, social media, reading and games - but too much screen time is linked to myopia, can cause dry eyes, and increase risk of eye damage and diseases in adulthood similar to UV damage
- The blue-white bright light from tablets and phones can damage long-term eye health and affect sleep – while there are no guidelines yet on how much to limit a child’s overall time spent on screens, these devices should be avoided by children and adults for three hours before bedtime
Key Questions
At this stage there have been no long-term studies published that satisfactorily answer this question, however clinical experience suggests that the child must continue with the myopia control procedure until the end of their teenage years. Alternatively, when the myopia has been shown to be stable for an extended period of about four to five years, then consideration can be given to discontinuing the treatment.
Yes. Myopia control is not about curing myopia – its function is to prevent the myopia from getting worse.
If my child still needs to wear correction after the treatment, what is the point of myopia control?
Quite simply, to ensure your child’s degree of myopia does not become higher. Restricting the myopia to a relatively small amount means less dependency on glasses and less risk of developing the sight threatening eye diseases outlined earlier.
What can you do?
- Ortho-k
- Bifocal SCL
- Artmost SCL
- Esophoria and accommodative lag
- Outdoors and nutrition
Prescribing standard spectacle lenses or contact lenses will give clear vision today, but will do nothing to slow or halt the progression of myopia. You will require frequent lens updates and will be put at risk of sight-threatening problems in the future. The lengthening of the eye which causes myopia cannot be reversed, making it absolutely critical to control myopia sooner rather than later. The good news is, evidence shows that certain treatments can slow and even halt progression.
Ortho-K for Myopia Control
– Corneal Topography Scan
Research shows a 32%-100% slowing in the rate of myopia progression through using ortho-K; most reports suggest a 50% average. Results at Envision Optical over the last 15 years and other practices in Australia and NZ show almost complete halting of myopia progression in some patients.
When myopic eyes are corrected with conventional spectacles and contact lenses, light entering the eye centrally will focus at the retina; however, light entering off centre will focus behind the
– Orhto-k Lenses
retina. This is thought to stimulate lengthening at the back of the eye as the retina tries to reach the focal point behind the eye, worsening the condition.
Ortho-K lenses can slow this growth by changing the shape of the eye surface, allowing central light to focus accurately at the retina and off-centre light to focus in front of the retina. The retina will no longer attempt to elongate.
Atropine drops
Atropine drops have been used for many years to control myopia; however, until recently they have been prescribed at a normal concentration of 0.5% – 1%. Atropine at this concentration causes loss of focusing in young children for near tasks and dilates the pupil significantly, leading to extreme light sensitivity.
Studies over the last decade have found that much lower concentrations of atropine, such as 0.01%, have a comparable reduction in myopia progression, without any noticeable effect on pupil size or near-focusing. For example the ATOM2 study showed the myopia control effect of 75% reduction for the 1%, 0.5% and 0.1% concentrations and 65% reduction with 0.01%. Studies have told us that 0.02% is the highest concentration of atropine that shows no significant change to near focussing or pupil size in children, and has no reported allergic side effects.
It was initially thought that as atropine drops paralyse the focusing muscles of the eye, this was the reason for the myopia control. Our understanding now suggests that the atropine molecule affects a receptor in the choroid or sclera of the eye, signaling the eye to not elongate excessively.
Atropine drops need to be instilled nightly and can be combined with Ortho-K therapy to maximise the myopia control effect. Visual and general side-effects are highly unlikely at 0.02% concentration. Atropine drops will need to be specially formulated at a compounding pharmacy as they are not readily available at concentrations below 0.5%.
Multifocal Soft Contact Lenses
Certain types of multifocal soft contact lenses have been used to try to control myopia, with success rates of a 40-70% reduction in progression. Multifocal soft contact lenses are typically used by patients 45+ years old to improve their near vision. These lenses have a clear central distance focal zone surrounded by a stronger near focus ring to give peripheral focus myopia control. There are conventional multifocal and myopia control specific designs available. In 2017, Gold Coast Myopia Control became accredited in the prescribing and supply of MiSight myopia control contact lenses which have demonstrated an almost 70% reduction in the rate of myopia progression over three years in published data.
Esophoria and Accomodative Lag: Spectacle lens options
As mentioned previously normal spectacles offer no myopia control benefit. In some individuals that are already a progressing myope and patients that show a near esophoria (tendency for their eyes to turn in more than required when reading) or an accomodative lag (a child’s eyes do not focus enough on a near task they are looking at) then progressive addition spectacles lenses (normally used for older patients who cannot focus on near print) may offer some myopia control benefit.
Theses near vision conditions are only detected by specific near point testing protocols that are not part of most standard eye examinations. A comprehensive assessment of your binocular vision function is conducted by our optometrists. Studies are varied but suggest an average reduction of myopia progression in the range of 37% with progressive/multifocal lenses.
How can I prevent or slow myopia?
- Catching early signs of myopia before it fully develops can help slow onset and progression
- Children should not spend more than 2.5 hours a day – in addition to school time – on close work such as reading, homework or screen-time
- When using a computer, ensure it is properly positioned to avoid eye strain and take breaks every 20 minutes by looking across the room for 20 seconds
- Outdoor sport and play of at least 90 minutes a day can reduce the risk of myopia – looking at your tablet or phone when outside doesn’t count!
- There is evidence to suggest that exposure to outdoor light is beneficial in slowing onset and progression of myopia – but UV protection is still important so wear sunglasses and a hat
Resources
| Resource | Link |
|---|---|
| Myopia Profile | www.myopiaprofile.com |
| Myopia Prevention and Control | www.myopiaprevention.org |
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Practice Locations
Contact Information
If you prefer, you can contact your local store directly – We have 4 optometrist locations on the Gold Coast:
Address:
Shop 19,7 Classic Way
Burleigh Waters QLD 4220
Opening hours:
Mon to Sat – 9.00am to 5.30pm
Thurdays – 9.00am to 7.00pm
Phone: 07 5593 7844
Fax: 07 5522 0078
Email: treetops@envisionoptical.com.au
Address:
4/33-35 Corporation Circuit,
Tweed Heads South NSW 2486
Opening hours:
Mon to Sat – 9.00am to 5.30pm
Thursday – 9.00am to 7.00pm
Phone: 07 5524 9659
Email: tweed@envisionoptical.com.au
PO Box 2136
Burleigh BC QLD 4220
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