Myopia, or nearsightedness, is a common vision condition where distant objects appear blurry because the eye focuses light in front of the retina instead of directly on it. This condition usually results from the eyeball growing too long from front to back. When the eye elongates excessively, it increases the risk of serious eye health issues later in life, such as retinal detachment and glaucoma. The focus of treatment is therefore not just to correct vision, but to actively control this axial elongation to protect long-term eye health.
Optical Devices for Progression Control
Specialized optical devices are designed to address the underlying cause of myopia progression. Unlike standard corrective lenses that only focus light clearly on the center of the retina, these devices manipulate how light falls on the peripheral retina. The goal is to create “myopic defocus” in the periphery, which acts as a signal to the eye to slow its growth.
One category includes specialized spectacle lenses, such as Defocus Incorporated Multiple Segments (DIMS) or Highly Aspherical Lenslet Target (HAL) technology. These lenses have a clear central zone for sharp distance vision, surrounded by an array of tiny lenslets that introduce a controlled amount of plus power, creating a blur in front of the peripheral retina.
Peripheral defocus contact lenses, often soft multifocal or dual-focus designs, use a similar principle but are worn directly on the eye. They feature alternating zones for distance correction and treatment zones with added power, which create the necessary peripheral defocus. Another highly effective option is Orthokeratology (Ortho-K), which involves wearing rigid, gas-permeable lenses overnight. These custom-fitted lenses gently reshape the cornea while the person sleeps, providing clear vision during the day without correction. The temporary corneal reshaping creates a peripheral myopic defocus, which is the mechanism believed to slow axial elongation.
Low-Dose Atropine Therapy
Low-dose atropine is a pharmaceutical intervention, typically administered as eye drops once daily, used to slow myopia progression. The most common concentrations range from 0.01% to 0.05%, significantly lower than the concentration historically used to dilate the pupil. The 0.05% concentration often shows a favorable balance of efficacy in slowing axial elongation and minimal side effects.
The precise mechanism by which low-dose atropine works is not completely understood, but it is thought to act on muscarinic receptors in the eye that regulate growth signals. Some research suggests it may involve increasing the release of dopamine in the retina, a neurotransmitter linked to inhibiting excessive eye growth. Low-dose therapy is generally well-tolerated, with common side effects being mild, such as slight sensitivity to light or minor blurring of near vision. Because this is a prescription medication, it requires consultation and regular monitoring by an eye care professional specializing in myopia control.
Environmental and Behavioral Modifications
Modifying daily habits and environment provides a non-invasive way to manage myopia progression. One of the most impactful changes involves increasing the amount of time spent outdoors. Research suggests that children should aim for at least 90 to 120 minutes of outdoor time per day. Exposure to natural, bright light is believed to stimulate the release of dopamine in the retina, which acts as an inhibitor to the eye’s axial elongation.
Natural light exposure also encourages the eye to focus on objects at different distances, providing a break from the sustained focus required for close-up tasks. Limiting prolonged and intensive near work is another critical behavioral adjustment. When engaging in activities like reading, homework, or screen time, it is beneficial to maintain a healthy working distance, generally about an elbow-to-knuckle distance from the face.
Incorporating regular breaks is important to reduce strain on the focusing muscles of the eye. A simple and widely recommended strategy is the “20/20/20 Rule”: every 20 minutes spent on near work, look at something 20 feet away for 20 seconds. These consistent changes in visual hygiene support the treatments prescribed by an eye care professional and offer an important layer of preventative management against the worsening of nearsightedness.