Charlotte Contact Lens Institute

Myopia Management

Providing Custom Options for Each Child to Slow the Worsening of their Vision

Myopia Management
Specialists in Charlotte

Where Advanced Technology Meets
Compassionate Care

Myopia, or near-sightedness, is a common problem among children due to excessive near work (more schoolwork and digital device use), decreased outdoor time, and genetics. Myopia impacts not just the vision of children, but also their self-esteem, as well as their overall mental and physical well-being.
One of the main focuses of the Charlotte Contact Lens Institute is the treatment of myopia progression, and our doctors are truly passionate about myopia management. It’s easy to see why, when considering the dramatic improvements in vision, and overall health that the prescribed myopia management treatment has on her patients.
The number of children with myopia has dramatically increased over the past 10-20 years. Fortunately, the number of treatment options and the success of treatment options has also dramatically improved. Our doctors lecture at conferences and meetings nationwide on the topic of myopia management and they are well-versed on the latest myopia management techniques, procedures, and research.

Looking for More Information on Myopia Management?

Myopia (also known as near-sightedness) is when close-up objects look clear but distant objects are blurry. Myopia is a common problem among children due to excessive near work (more school-work and digital device use), decreased outdoor time, and genetics. Myopia can decrease the quality of life of children by decreasing school performance and self-confidence1-2. Some studies cite a higher prevalence of mental health problems in children with myopia2.

At young ages, myopia can advance quickly – yielding decreased functional vision when without vision correction and requiring reliance on glasses or contact lenses to function. Myopia management can help to decrease these progressive & concerning vision changes to allow your child to reach their full potential.

One common question from parents of myopic patients is “Why have I not heard about myopia management treatment until now?”  The short answer to this question is myopia is becoming increasingly more common in children, as compared to previous generations.  One reason for this is the increased amount of “screen” time, but there are other contributing factors as well. 

Genetics are a key risk factor for myopia, with the condition being particularly prevalent among Asians. Just over 45 years ago, around 25% of Americans aged 12 to 54 were affected by myopia. However, a 2009 study revealed a significant increase, with about 42% of this demographic experiencing nearsightedness, nearly doubling the prevalence in three decades. Looking ahead, researchers estimate that by 2050, around 5 billion people globally will have myopia, which would constitute approximately half of the world’s population. If myopia were a fatal disease, it would be termed an epidemic, highlighting the dramatic rise in its occurrence.

The good news is over the past 10 or so years there has been a dramatic increase in the research on myopia.  Over the past few years, there have been new FDA-approved myopia treatment options that have become available, and there have been dramatic improvements in the success of myopia management treatment options.

In summary, if you haven’t heard much about myopia, you’re not alone.   If you are considering myopia management treatment options for your child, we are available for a free phone consultation and can be reached at (704) 800-5230 or hello@charlottecontactlens.com.

There are three main options to help slow the worsening of a child’s vision, including:

  • MiSight daily – daily disposable myopia control contact lenses (more info here
  • Orthokeratology – (also known as ortho-k, orthok, or OK) contact lenses (more info here)
  • Atropine – which is an eye drop that is taken nightly.

There are many considerations to determine which option best suits your child, such as the child’s prescription, maturity, motivation, outdoor time, various types of sport involvement, and after/in-school activities.  Often, atropine may be prescribed in conjunction with specialized myopia management contact lenses to further slow myopia progression.  During a myopia management consultation, our doctors will work with the parent(s) and child to determine the best myopia treatment option.

There are so many great options we have for myopia management. Using the three main myopia management options of orthokeratology, MiSight (FDA approved daily lenses), and atropine, nearly all prescriptions can be treated. The doctor will meet with you and your child to determine what option fits best with your child’s lifestyle – including hobbies, school performance, and future goals.

  • This is a normal concern for most parents. According to multiple studies, children are safer contact lens wearers than their adult and teenager counterparts5,6,7.
  • Starting myopia management at a younger age provides greater long-term benefits for the child.
  • Myopia progresses aggressively from ages 6-9, so starting early is key to preventing large prescription changes from occurring, ultimately keeping myopia as low as possible.
  • Contact lens wear has also been found to improve children’s self-esteem4.
  • The doctor will schedule multiple follow ups to ensure optimal ocular health and continual guidance on how to care for and handle the contact lens.

During the initial examination, the doctor will perform the following:

  • Refraction – To assess the most up-to-date prescription
  • Ocular Health Exam – To evaluate ocular health and candidacy for various myopia management treatment options. The front and inside of the eye will be examined thoroughly.
  • Topography – To evaluate the unique shape of the cornea and determine the best fit for a contact lens solution.
  • Binocular Vision Assessment – To assure that both eyes are working in synchrony.
  • Meibography – All contact lens wearers will have their meibomian glands evaluated (important glands to help keep contact lenses hydrated and comfortable), as well as basic tests to assess for dry eye syndrome.

For new contact lens wearers, there will be a contact lens application and removal class. This class will also include instruction on how to properly care for contact lenses and overall hygiene during contact lens wear. The lessons do not end here. Children are constantly quizzed on their skills and learnings.

There will be an additional 1 week follow up to assist with potential difficulties with contact lens wear, as well as an additional ocular health examination to assure great eye and contact lens compatibility.

 

An Introduction to Orthokeratology (Ortho-k)

  • Orthokeratology contact lenses are a great option for children that do not want to wear glasses or contact lenses during the day.
  • Orthokeratology lenses allow children to see and experience the world like children that never needed glasses or contacts! Orthokeratology contact lenses are worn only at night and act as night-time retainer lenses. They will correct the child’s vision to see great during the day, while slowing the progression of myopia.

More Info

  • Countless studies have demonstrated great efficacy and safety of orthokeratology9,10,11. Orthokeratology is often the contact lens of choice for children that are active in sports, love to swim, or simply do not want to deal with the hassle of glasses or contacts during the day.
  • An added benefit is that the contact lens will never leave home, so parents have the ability to monitor how the child is caring for their lenses, assure good hygiene, etc.

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  • Orthokeratology works through fluid hydraulics. The lens rests on the tear layer of the eye. The anatomy of an orthokeratology contact lens allows the tear layer of the eye to shift fluid within the cornea which temporarily results in a shape change of the cornea. This shape change of the cornea functions to allow the child to see clearly when the lens is removed, and also changes the way light comes into the eye to slow the progression of myopia. Often, the shape change can last more than 24 hours, but the child is still encouraged to wear the lens nightly.

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An Introduction to MiSight

  • MiSight daily disposable contact lenses are the only FDA approved contact lens specifically
approved for myopia control12. Other options, such as orthokeratology, are FDA approved for myopia correction, but through studies have been shown to effectively reduce myopia
progression.
  • MiSight contact lenses are worn during the day and slow the average myopic progression by 59% 6,12.

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  • During the 6 years FDA clinical trial, there were no adverse events6,12. Clinical trials found that children wearing these lenses experienced great comfort and handling ability with applying and removing lenses 6,12. At the end of a 6-year period of wearing MiSight contact lenses, 23% of the children showed complete stability of myopia!

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  • These contact lenses look and feel like a traditional contact lens but have special optics integrated within the contact lens that prevent abnormal elongation of the eye, and as a result, slow myopic progression.

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An Introduction to Atropine

  • Atropine is an eye drop that is taken nightly to help slow myopic progression. It is compounded to low-doses for myopia control, specifically 0.05% at Charlotte Contact Lens Institute. This is the best dose for myopia control outcomes and safety. Often, atropine is prescribed for children that are not quite ready for contact lenses or as an added treatment for children with aggressive myopic progression. Glasses will need to be worn during the day. Low-dose atropine slows progression by over 50% 13.

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  • Low dose atropine drops are typically tolerated very well by children. Some side effects may include light sensitivity and near vision blur13. If these side effects occur, they usually last up to around two weeks. If children experience these side effects longer, the dosage will be decreased.

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  • Atropine is thought to slow myopic progression by acting directly on the layers of the eye that grow abnormally during the myopic process.

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Why Choose Charlotte Contact Lens Institute
for Myopia Management in Charlotte?

The Team

The team at Charlotte Contact Lens Institute have experience with offering myopia management treatment for hundreds of children, and are experts in options for myopia management.

Advanced Technology

Our office is one of a few practices in the country that is equipped with the Pentacam AXL Wave and Optovue Solix OCT, which greatly aid in managing myopia and monitoring progression over time.

Unlimited Answers

We allow for enough time for thorough comprehensive exams, and plenty of time for answering questions. No rushing in and out here.

We Focus on Myopia

Myopia Management is one of our two key focuses of our entire practice. We receive referrals from many different doctors in Charlotte because we specialize in myopia management.

Access to the Doctor

Our doctors are available to answer questions you have after your exam, and will make sure you have the information needed in order to ensure the best possible outcome.

Affordability

We keep our overhead costs low and offer very competitive prices as a result. We have monthly payment options available and also accept CareCredit™, HSA, & FSA.

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Summary

Our doctors are nationally recognized for their expertise in myopia management, including ortho-k, and MiSight. Our doctors regularly present at both local and national meetings and conferences, where they share their knowledge and insights to audiences of 10 to hundreds of doctors.

MiSight and ortho-k are the most recommended options for myopia management, and atropine is also prescribed in some situations. One of the benefits of visiting Charlotte Contact Lens Institute is the amount of one-on-one time with the doctor, which allows for plenty of time to ask questions and evaluate all possible options.

Citations for Scientific Reviews on

Myopia Management

  1. Modjtahedi, Bobeck S., et al. “Reducing the global burden of myopia by delaying the onset of myopia and reducing myopic progression in children: the Academy’s Task Force on Myopia.” Ophthalmology 128.6 (2021): 816-826.
  2. Huang, Juerong, et al. “Myopia and Depression among Middle School Students in China—Is There a Mediating Role for Wearing Eyeglasses?.” International journal of environmental research and public health 19.20 (2022): 13031.
  3. Hu, Yin, et al. “Association of age at myopia onset with risk of high myopia in adulthood in a 12-year follow-up of a Chinese cohort.“ JAMA ophthalmology
  4. Dias, Lynette, et al. “Myopia, contact lens use and self-esteem.“ Ophthalmic and Physiological Optics 33.5 (2013): 573-580.
  5. Chalmers RL, Wagner H, Mitchell GL, et al. Age and Other Risk Factors for Corneal Infiltrative and Inflammatory Events in Young Soft Contact Lens Wearers from the Contact Lens Assessment in Youth (CLAY) Study. Invest Ophthalmol Vis Sci 2011;52:6690-6.
  6. Chalmers, Robin L., et al. “Adverse event rates in the retrospective cohort study of safety of paediatric soft contact lens wear: the ReCSS study.” Ophthalmic and Physiological Optics 41.1 (2021): 84-92. 
  7. Chamberlain P, Peixoto-de-Matos SC, Logan NS, et al. A 3-Year Randomized Clinical Trial of Misight Lenses for Myopia Control. Optom Vis Sci 2019;96:556-67. 
  8. Chua, Sharon YL, et al. “Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children.“ Ophthalmic and Physiological Optics 36.4 (2016): 388-394.
  9. Bullimore, Mark A., et al. “The risks and benefits of myopia control.“ Ophthalmology 128.11 (2021): 1561-1579.
  10. Bullimore, Mark A., and Noel A. Brennan. “Myopia control: why each diopter matters.” Optometry and Vision Science 96.6 (2019): 463-465.
  11. Si, Jun-Kang, et al. “Orthokeratology for myopia control: a meta-analysis.” Optometry and Vision Science 92.3 (2015): 252-257.
  12. Chamberlain, Paul, et al. “Long-term effect of dual-focus contact lenses on myopia progression in children: a 6-year multicenter clinical trial.“ Optometry and Vision Science 99.3 (2022): 204-212. 
  13. Yam, Jason C., et al. “Three-Year Clinical Trial of Low-Concentration Atropine for Myopia Progression Study: Continued Versus Washout Phase 3 Report.”