Myopia is the clinical term for nearsightedness. Nearsighted eyes see nearby objects clearly, while objects far away are blurry without glasses.

In order to see clearly, the eye uses the cornea (the clear window in the front of the eye) and the lens inside the eye to adjust the focus of the light entering the eye. The clearest images are seen when light is focused accurately on the back of the eye (the retina). If the eye is too short or too long, the ability to accurately see the world decreases because the cornea and lens cannot focus the light onto the back of the eye. Myopia usually results from the eye being too long.

Just like feet get bigger and children get taller, the nearsighted eye tends to get longer over time. This means nearsighted children often need to get stronger glasses every year as their eyes continue to grow.

Researchers are not sure exactly what causes myopia, but it is understood that genetics play an important role. Studies have shown that if a child has one parent who is nearsighted, the child is twice as likely to develop myopia than if neither of the child’s parents were nearsighted. If the child has two nearsighted parents, the child is over five times more likely to develop myopia.

Environment also seems to play a role in the development of nearsightedness. Research has found that more time spent outdoors may protect against nearsightedness; factors like circadian rhythm (internal biological clock) and parents’ education level may also play a role.

Myopia causes far away objects to look blurry, but the blurry vision can be corrected with glasses, contact lenses or refractive surgery. There may also be ways to control the growth of myopia.

Myopia treatments have been shown to reduce a person’s myopia by up to 60 percent, which could reduce the need for wearing glasses or contact lenses. Myopia has also been associated with common vision-threatening conditions like cataracts, primary open angle glaucoma and retinal detachments. The risk of developing these conditions depends on the severity of the myopia; therefore, reducing a person’s myopia could also decrease his or her chances of developing one of these vision-threatening diseases.

MiSight® 1 day Contact Lenses:The MiSight® 1 day daily disposable contact lens is currently the only FDA approved treatment in the United States for slowing the progression of myopia. The MiSight® 1 day contact lens, which is supported by CooperVision’s Brilliant Futures program, was found to slow the progression of myopia by 59% during the study that supported this product’s approval. UAB is one of the first clinics in the United States to be certified to use this product. Dr. Pucker is also one of the trainers for the doctor certification program.

Corneal Reshaping Contact Lenses: Corneal reshaping contact lenses are worn during sleep and are removed in the morning. They temporarily change the shape of the cornea so that a person can see clearly all day long without glasses or contact lenses. They are also thought to slow myopia development because they bend light that enters the eye in a beneficial way. Corneal reshaping contact lenses have been shown to reduce myopia progression on average by about 50 percent.

Non-FDA Approved Myopia Control Soft Bifocal Contact Lenses: Soft bifocal contact lenses also are thought to slow myopia by bending light that enters the eye in a beneficial way. These lenses have been shown to reduce myopia progression on average by about 50 percent.

Atropine: These eye drops are taken in each eye before bed. It is currently not known how this medication slows myopia development, but low concentration (0.01% to 0.05%) atropine has been shown to slow myopia progression by about 60 percent without significant side effects as with higher concentration atropine (such as increasing pupil size or decreasing near vision). These eye drops are also sometimes used in combination with the above contact lenses to better slow myopic progression.

The scientific community does not yet fully understand how long people should be treated with myopia prevention methods, but the general consensus is that people should be treated until they are at least in their mid-teens or longer.

Contact Lenses: Children (ages 8-12 years) and teens (ages 13-17 years), both of which are age groups that are commonly fitted with contact lenses, are at an equally low risk for developing contact lens-related problems or being noncompliant. Children and teens are able to wear their contact lenses for a similar amount of time each day. In addition, both groups feel that contact lenses improved their social acceptance, appearance, ability to play sports and overall satisfaction with their vision correction.

0.01% to 0.05% Atropine: Low dose atropine is considered to be safe for children. Low dose atropine has been shown to work without increasing pupil size or decreasing near vision dramatically, side effects that are seen with full strength atropine (1%). In fact, only 8 percent of children complained of having problems with low concentration atropine, and glasses can reduce these symptoms if it is harder for the child to read or if the child is more sensitive to lights.

The MiSight daily disposable contact lens is currently the only United States Food and Drug Administration (FDA) approved treatment in the United States for slowing the progression of myopia. Evidence in the scientific literature suggests that other types of contact lenses and eye drops also slow the progression of myopia; however, they are not currently FDA approved for controlling myopic progression. Nevertheless, these options are approved for other purposes such as correcting blurry vision.

The UAB School of Optometry, which operates UAB Eye Care, has researched myopia control for more than 20 years. Studies conducted by the School’s Pediatric Optometry Services have been funded by the National Institutes of Health, which is the federal government’s research branch.

One NIH-funded study, the Correction of Myopia Evaluation Trial, included the UAB School of Optometry and three other sites in the U.S. The 469 participants were aged 6 to 12 years old when they enrolled in the study. After 14 years, 118 of the original 133 UAB participants (89 percent) were still returning to UAB to be studied. The UAB School of Optometry had the highest recruitment rate and highest retention rate for one of the longest research studies on a single group of children with nearsightedness.

A second NIH-funded study, the Collaborative Longitudinal Evaluation of Ethnicity in Refractive Error, included UAB and three other U.S. sites. The study examined an ethnically diverse group of 4,927 children aged 6 to 14 years old over the course of 15 years to learn more about the development of nearsightedness.

Through these long-term, longitudinal studies conducted at the UAB School of Optometry, the world has learned:

• Nearsightedness tends to grow between ages 7 and 16.
• Nearsightedness tends to grow at a rate of about 0.50 diopters per year, which is the approximate amount that requires new glasses to noticeably improve vision.
• Once discovered, nearsightedness tends to grow for about nine years.
• Nearsightedness stops growing by age 18 for about 75 percent of children; however, about 4 percent of children will still see myopia growth at age 24.

Because of its success in research, the UAB School of Optometry is one of 10 sites selected in the U.S. to conduct another NIH-funded study of nearsightedness, this time using 0.01% atropine.