According to a 2015 journal article in Adolescent Health, Medicine and Therapeutics by Molly J Smith and Jeffrey J Walline, we can slow the progression of myopia in children by controlling it properly. We had the chance to learn more from optometrist Ken Tong and hear his recommendations.
Raising a kid who has myopia? You’re definitely not alone. Myopia (or nearsightedness) in children is more common than you think, especially in Singapore. The country has often been labelled as the “myopia capital of the world”, with 65% of the children here being myopic by Primary 6.
While the situation is worrying, not all hope is lost. The good news is that there are ways to control myopia effectively, with many eyecare professionals in Singapore who are ready to help. We had the opportunity to speak to one of them, Ken Tong, an optometrist who’s also President of the Singapore Optometric Association. Read on to find out what he has to say about the various myopia control treatment options for children, as well as how to find one that suits your child best.
Thanks for speaking to us, Ken. Can you briefly tell us what are the major drivers of childhood myopia in Singapore?
The main causes of myopia development can probably be attributed to high frequency of near vision work, insufficient sunlight or outdoor time, and genetics. In the context of Singapore, we observe that it’s mainly due to excessive screen time and, to a certain extent, long hours spent on reading and writing.
Last but not least, genetics also play a big role in myopia development. For example,: the risk of a child developing myopia is significantly higher if one parent has myopia. This risk is doubled if both parents are myopic.
How can we prevent myopia in children? Are there any early warning signs that parents can spot?
Early intervention is key to preventing myopia from developing and progressing in children. The earlier we detect myopia or pre-myopia, the better our chances of slowing its progression. Parents can look out for signs such as:
- Their child being unable to see objects, like an approaching bus’ number or text written on their class’ whiteboard;
- Regularly squinting their eyes or frowning their eyebrows while reading;
- Turning or tilting their heads sideways when looking at an object.
However, it’s also worth noting that these signs may not be obvious when a child is in the early stages of myopia. As such, sending your child for regular eye checks with an eyecare professional is very important. I recommend that children between the ages of five and twelve to get eye checks once every six months. This is the period where children usually experience rapid growth, which is also the time when their visual acuity can change quickly.
Can myopia be ‘cured’, and is it possible to manage it via natural means?
Unfortunately, myopia cannot be ‘cured’ or reversed. But, it’s possible to slow myopia progression through effective treatment plans; – this is what we mean by myopia control.
You can manage myopia ‘naturally’ by reducing its major drivers, such as screen time and near work time. Spending more time outdoors, like playing sports, is encouraged as well. Parents can also follow the 20/20/20 rule, which is to remind kids to look further than 20 feet (6m) for more than 20 seconds after 20 minutes of near work or screen time.
These are good eye health habits that we can practise as we go about our daily routine. However, doing these alone isn’t sufficient to control myopia. I would recommend that parents get their children to practise these good habits in conjunction with myopia control treatment options prescribed by qualified eyecare professionals.
Who are the eyecare professionals parents can go to for professional advice on myopia control for kids?
Optometrists are the best eyecare professionals to go to for detecting myopia in young children. This is because the Optometrists and Opticians Board (OOB) guidelines specify that only optometrists, not opticians, can perform degree checking for children under eight years old. Optometrists’ services are easily accessible; you can find them in clinics, hospitals, and optical retail stores. In fact, parents can refer to the OOB register to look for a qualified optometrist who’s nearest to them.
Are there optometrists who specialise in myopia control? Is it worthwhile for parents of myopic children to go to them instead?
Yes, there are optometrists who specialise in myopia. I highly recommend that families with myopic children seek eye care advice and treatment from these specialists. Not only do they have experience with myopic patients, but they also have specialised equipment to provide personalised myopia control strategies and monitoring.
Now, we have a question that’s on every parent’s mind – are myopia control treatments expensive?
The cost varies as it depends on the treatment option that best suits the child. Myopia control treatment options include spectacles, soft contact lenses, ortho-k lenses, and prescriptive eye drops. For example, a single purchase of a set of myopia control spectacles may cost more than a pair of soft contact lenses. Parents also have to factor in the possibility of their child’s degree increasing rapidly if myopia is not managed effectively.
In my opinion, there’s no specific treatment option that’s better than the rest. The best treatment option for myopia control is just one that suits a child’s needs.
Can you give us some examples of how you prescribe suitable treatment options based on a child’s needs?
Myopia control soft contact lenses, like ACUVUE Abiliti 1-Day, are suitable for children with low to mid myopia, children who regularly participate in physical sports, as well as children who dislike wearing spectacles.
I have had a young patient whose myopia increased rapidly in six months. This was caused by his infrequent spectacle-wearing. Similarly, the myopia condition of another young patient of mine, with only one myopic eye, worsened as his compliance with spectacles wasn’t great since visual needs were relied on the eye with perfect or better vision . In cases like these, soft contact lenses that allow for full-day clear vision while being glass-free are more effective in correcting their vision and controlling their myopia progression.
Aside from myopia control soft contact lenses, ortho-k lenses like Abiliti Overnight have shown success in myopia control for children. I’ve prescribed ortho-k lenses for a patient who’s active in water sports, as this allows for all-day spectacle-free clear vision. Not only does this suit his lifestyle, but the lenses have also successfully controlled his myopia. His condition has been stable for many years.
These are just cases that I’ve worked on. Parents should always consult their optometrist on the most suitable treatment options for their children as every child has unique needs.
Thank you for this informative session! Last but not least, is there anything else you would like parents of children affected by myopia to know?
Like I mentioned, it all boils down to finding one that suits your child’s needs. As optometrists, our duty is to keep parents well informed about the available treatment options so they can opt for one that best suits their child. We invest in specialised equipment, and constantly update ourselves with the newest research and studies so we can provide the best standard of care to families in Singapore. Having said so, myopia management requires families to work together with clinicians to ensure the prescribed treatments are effective.
Thank you for your time, Ken!
You can help your child manage myopia effectively by getting them a comprehensive eye check with an optometrist. Book an appointment with your nearest optometrist today.
This post is in partnership with ACUVUE Abiliti.
