The fact that myopia is linked to genetics is not disputed. However, genetics alone would not be enough to account for the rising incidence of myopia, and it’s now believed that environmental factors also play a role. Whatever the reasons for the rise of myopia, there have also been advances in its treatment. According to Australian behavioural optometrist Jacqueline Gattegno, reducing the progression of myopia is a real possibility – provided that intervention happens soon enough.

Myopia Control Treatments

Jacqueline says that contrary to popular belief, Myopia is a childhood problem. “It’s related to an increase in the axial length of the eyeball which results in poor focus on the retina. The progressive lengthening of the eyeball occurs during growth, with the eyes generally stabilising around the age of twenty. If myopia’s progression is to be slowed, treatment must occur during this time,” says Jacqueline. “Various non-surgical, drug-free methods have been explored, with the greatest successes coming from orthokeratology and the use of peripheral defocus lenses.”

Atropine drops appear in a lot of the research literature, but Jacqueline isn’t convinced that their use should be attempted or that they will result in the best possible outcomes. “There are side-effects,” says Jacqueline, “and the drops only seem to offer myopia control benefits during their first year of use. Following excellent results in early trials, it’s now widely believed that atropine drops don’t have sufficient long-term benefits to justify their use. Orthokeratology is drug-free and it works. There’s no reason to use a drug-based treatment.”  

Efficacy of Orthokeratology in Myopia Control

Studies support Jacqueline’s confidence in orthokeratology for myopia control, and the treatment itself is remarkably simple. Optometrists carefully map the eye and then create hard contact lenses that gently mould the cornea to allow for better light focus on the retina. The lenses aren’t worn by day. Instead, they’re worn during sleep, and the eye maintains the correct shape during waking hours.

Research shows that orthokeratology, or Ortho-K, can slow the progression of myopia in children by 36 to 56 percent. “It’s known that the higher the level of myopia in people of any age, the greater the risk of certain ocular pathologies that can lead to vision loss,” says Jacqueline, “so reducing myopia in childhood not only offers a good chance of better vision during adulthood, but may even prevent conditions like retinal detachment and age-related blindness’ later on.”

Myopia Control at Home

There’s at least one other therapy that can help children in slowing the progression of myopia – and parents can practice it for free at home. “Tell the kids to go and play outside,” says Jacqueline. “There have been some remarkable studies that have shown that just spending more time outdoors reduces the risk of rapid myopia progression. There was a measurable reduction in axial elongation and myopic shift during trials in Asia, and some experts even theorise that reduced time outdoors might be at least partially to blame for the myopia epidemic that’s currently being witnessed.”

It’s Time the World Started Talking About It

Jacqueline believes that the combination of orthokeratology and a healthy, active lifestyle can make a difference in combating the rise of myopia but is concerned that myopia control isn’t more widely talked-about. “Many parents have never heard of ortho-K or myopia control. They know about glasses and contact lenses, and they bring their children to get prescription eyewear. That provides an opportunity to tell them about treatment options, but it isn’t ideal.”

“Myopia control should be headline news. It’s exciting. The benefits are beyond price. It’s time the world started talking about it because we’re rapidly heading towards a situation in which half the world’s population is myopic with high myopes facing further risks to their vision,” concludes Jacqueline.

Smart Vision Optometry clinics are located in Sydney. Book a Smart Vision Comprehensive Vision Skills Assessment or Advanced Eye Health Test for any child or adult by calling the Bondi clinic (02) 9365 5047 or the Mosman clinic (02) 9969 1600, alternatively book an appointment online.

Written and syndicated by: YDMA News, YDMA Group

Studies Show that a Higher Percentage of Myopic Children do Well at School

The results of a 1958 study are tantalising. US-based researchers reported that children with myopia are inclined to have a higher IQ. Czech, Danish, and Israeli researchers were among those to corroborate the finding. This may seem like an open-and-shut conclusion, but nothing is ever as simple as it seems.

Related research showed that myopic children, regardless of IQ, tended to do better at school. With this piece of information to digest, it might seem that studying harder, better results, and myopia are all linked.

Long hours of study can certainly cause eye strain, this can lead to elongation of the eyeball which is myopia. Additionally, there’s a clear link between too much time spent indoors and myopia, indicating that the absence of natural light is also a problem for studious children.

However, researchers were alert to the question of whether higher IQs and myopia were related, and their investigations continued. Subsequent studies published in 2004 and 2006 by Professor Seang-Mei Saw and colleagues concluded that children with myopia really did tend to have higher IQs regardless of how much time they spent reading and studying.

Why Myopia and IQ are Linked

Given that research had shown the link between Myopia and higher IQ regardless of time spent hitting the books, the next question to address would be why children with myopia tended to have higher IQs. Unfortunately, the answer to that remains a matter for scientific speculation.

Professor Saw and her team of Singaporean researchers observed that there might be a link between the genes determining a predisposition to myopia and a higher IQ with the same sets of genes influencing both traits at once. They added the thought that genes affecting eye size and growth, which are linked to myopia, may also influence neocortical size, a factor which may be associated with IQ.

Many Kids with Myopia Can Live Without Glasses

“There seems to be a grain of scientific truth behind the myth that smart kids wear glasses,” says Jacqueline, “but advances in myopia control may change that. Already, children who are developing myopia are going without glasses or contact lenses. They are seeing perfectly thanks to orthokeratology, a non-surgical treatment that uses night-time wear of hard contact lenses.”“They reshape the cornea, not only eliminating the need for day-to-day correction for myopia, but also its progression. This type of treatment is already widely used. It is to be hoped that in time, there will be further advances in this field, and that children all over the world will have access to myopia control treatments. As a result, children with a predisposition towards myopia may not have to live with short-sightedness and may not need corrective eyewear at all. That will certainly be a happy ending.”

Smart Vision Optometry clinics are located in Sydney. Book a Smart Vision Comprehensive Vision Skills Assessment or Advanced Eye Health Test for any child or adult by calling the Bondi clinic (02) 9365 5047 or the Mosman clinic (02) 9969 1600, alternatively book an appointment online.

Written and syndicated by: YDMA News, YDMA Group

The Gift of Sight: How Eyes and Brain Work Together

Sight begins in the eyes. But it doesn’t end there. The brain is needed to process and interpret data from the eyes. It’s not a simple process. One part of the brain conjures up an image based on the data it receives from the eyes. Other parts of the brain interpret it. The gift of sight involves much more than just the eyes. Gary Rodney, a behavioural optometrist and an expert in the field of myopia control guides us through a complex process that is often taken for granted: seeing.

The Brain’s Role in Vision

It all begins when a person decides to look at something. A part of the brain stem known as the “pons” tells the eyes to move towards the object, setting the surprisingly complex process that is vision into motion.

The brain is clearly divided into lobes, and the first part of the brain to process visual information is the occipital lobe which is situated at the back of the brain. The occipital lobe’s role in vision is proven and not just a matter of conjecture. When people suffer damage to this part of the brain as a result of illness or injury, they may experience visual disturbances, or even lose their sight completely.

There’s a difference between having an image and understanding it, and the occipital lobe can’t help with the latter. Instead, visual information requires further processing, and different parts of the brain do the work.

Visuospatial cognition takes place in the parietal lobe. This part of the brain is the seat of depth perception and helps with the coordination of movement based on data such as direction and distance. Reaching for, and successfully grasping an object, for example, requires several pieces of information. Recognising the object is a good start, but if it is to be handled, its location in relation to the body is a vital piece of information.

But recognition doesn’t take place in the parietal lobe. For that, the temporal lobe must contribute its share to the process of vision. It’s the seat of memory and it’s able to turn an image into something that’s recognisable based on prior experience.

Until quite recently, experts believed that the frontal lobe wasn’t involved in processing visual information, but it’s now believed to have a rather important role. The theory is supported by information from MRI scans that showed frontal lobe activity during the performance of certain visual tasks.

It’s believed that this part of the brain “focuses” on specific objects. To illustrate this, imagine a room full of various objects. A person is looking for his or her car keys, but plenty of other things are in view. The frontal lobe might be the part of the brain that helps with spotting those car keys among the clutter of other objects in view.

Super-Quick Communication Through a Neural Network

In order to transfer information from the eyes to the different parts of the brain that use and interpret visual information, a super-fast information highway is needed. The retina of the eye has special light-sensitive cells called rod and cone cells. When light strikes one of them, it sends a nerve impulse through the optic nerve to the occipital lobe which processes the information to make up part of an image.

But the image is without any meaning until the occipital lobe is able to match it with a memory. If there’s no match, this part of the brain will store it as a new memory, or it will still retain the memory, if only temporarily, categorising it into understandable information that can be used like “Oh that’s where the car keys are!”

It’s remarkable how quickly this all happens. Some researchers have equated the “speed of sight” as being equivalent to that of a good Ethernet connection, but that’s rather conservative as estimates go. It can be even faster. It’s theorised that the brain prioritises information and works a little more slowly when it deems information less than vitally important, saving its top speed for urgent data – like that obtained from rapidly approaching objects.

Behavioural Optometry: When Eye Tests are About More Than Just Eyes

With so much more than eyes involved in vision, it should come as no surprise that some optometrists do much more than just test the physical ability of the eyes to see clearly. “There’s a lot more to vision than just seeing,” says Gary. “That’s why behavioural optometrists test for visual skills as well as visual acuity. When visual skills need to be developed, it’s more than just a matter of prescribing glasses, but proven therapies can often help with vision problems that go beyond mere eyesight.”

For more information on vision therapy and how it works, or to book an appointment, visit the Smart Vision website: Optometrists Sydney: Optometry Services For Children and Adults | Smart Vision; for specific information about Myopia treatment and prevention visit Myopia Prevention: Solutions, Control And Treatment In Sydney; and for detailed information about Myopia Treatment visit Orthokeratology In Sydney: The Non Surgical Alternative.To book an appointment for a thorough eye check-up, click here or Call the Bondi clinic on (02) 9365 5047 or the Mosman clinic on (02) 9969 1600.

HEAR: Gary Rodney Interviewed By David Wood Ultra106five.com

Lockdowns Could Cause Spike in Myopia Endemic

Rodney, a fellow of the International Academy of Orthokeratology and Myopia Control, says there’s good reason to be concerned that lockdown regulations could push the curve of the Myopia epidemic still higher. It’s already one of the most prevalent eye problems affecting the children of the 21^st century, and contributes to the likelihood of eye diseases like glaucoma, macular degeneration, and possible blindness in the elderly.

“The lockdown stay-at-home lifestyle may succeed in slowing the spread of the Covid-19 pandemic. But it could spike the Myopia epidemic’s curve by increasing prevalence and speeding up its progression. It’s taking children’s focus away from certain activities and shifting it to others, some of which have long been identified as possible causes for increasing myopic progression,” Rodney said.  

The vision impairment is caused by refraction errors in the eye which cause light to focus in front of the retina rather than on it, resulting in blurred distance vision. It usually develops in early childhood, because of genetics or lifestyle factors and gets progressively worse until it levels sometime in the late 20s, and can cause major eye problems later in life.

And as there is no cure for the potential damage caused by elongating the eyeball and stretching the retina, treatment has been rapidly expanding to control progression. This has led to an increasing number of options to stop this from happening, Rodney said.

Large Screens vs The Great Outdoors

“By stopping children from going to school, and preventing them from leaving the house to see friends, or spending much time outdoors, lockdown regulations have caused children to spend more time inside. And they are spending a lot of it watching TV, studying online, or making long calls or sending lengthy messages on their mobile devices simply to keep in contact with friends,” Gattegno said.

While understandable in young people who felt trapped, Gattegno said these activities worked against some of the most important aspects of myopia management, which prioritize spending at least 2 hours a day outside, and restricting access to screens.

According to Rodney, another lockdown risk is that it could interrupt treatment that’s already underway and achieving positive results. Missing scheduled appointments or falling behind in the program due to the lockdown could undo, and even reverse, what has so far been achieved.

Actions Needed to Manage Myopia Epidemic

Rodney said both parents and optometrists can go a long way towards lessening any lockdown after-effects and helping prevent the possible spike in the myopia curve. Parents need to keep a close eye on their children’s activities, monitor screen time, and watch carefully for any signs of shortsightedness. These include sitting too close to the TV, closing one eye or holding books very close when reading, eye rubbing, and frequent headaches.

If concerned, parents should have their children’s eyes tested as soon as possible. This can be done during lockdown at optometry clinics like the Smart Vision clinics in Sydney, which have instituted Covid-19 safety measures, or left for soon after the lockdown is over.   

Broader Vision of Myopia Needed

Rodney says it is vital that optometrists broaden their approach to testing and treating children with Myopia both as a norm, and even more so in the post-lockdown period.

“Single vision spectacles which have to be changed and strengthened regularly, are simply not enough, even for the mildest of myopias . Single vision spectacles or contact lenses are shown now in research to be the WORST thing you can do to contribute to the eyes getting worse and the corresponding increased potential of age-related blindness.There are a wide range of new treatments available, including the special night-time oxygen-permeable corneal lenses used in Orthokeratology. This is having positive results in 100% of cases in slowing the progression of myopia in children in our practice,” Rodney said.

Smart Vision Optometry clinics in Sydney focus on providing eye care for a number of vision problems with particular focus on children and myopia, and on determining the best treatment for each case. Visit the Smart Vision website: Optometrists Sydney: Optometry Services For Children and Adults | Smart Vision to find more information provided by the Smart Vision behavioural optometrists and for information on the precautions applied during COVID-19.

Click here to book an appointment online or Call the Bondi clinic on (02) 9365 5047, or the Mosman clinic on (02) 9969 1600.  

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