We all are aware that Myopia has now become a matter of global concern. Being a widespread and costly eye disorder, affecting as many as 80–90% of young adults in some Asian cities. With such grim numbers, it’s more important than ever to prevent or control it. Thus, new strategies must be adopted in the treatment of myopia or near-sightedness.¹

Severe or high-grade myopia is associated with serious complications such as retinal detachment, macular degeneration, early cataract, and glaucoma and is also a leading cause of blindness.²

As people rummage through the internet looking for the best treatment of myopia, fact is that there is no permanent cure for myopia. Myopia can be corrected with corneal refractive surgeries, contact lenses or the most common of all, prescription eyeglasses. Wondering which lens is used to cure myopia? Concave lenses help correct the condition.

However, these measures do not cure the underlying cause calling for the need of simple, safe, and effective therapeutic modalities to prevent the onset and progression of the underlying cause which is axial elongation inside the eye.¹ Typically myopia begins during childhood ages 6 and 12 and tends to worsen or progress every few to several months until the late teenage years, However, the progression slows down or improves during young adulthood and plateaus by the age of 18 years.³ Even though it may seem like myopia may be improving, it cannot be reversed.

However, myopia can be controlled through many interventions like optical, surgical and pharmaceutical agents such as atropine drops that are available to retard its progression.

Apart from traditional ways to correct the refractive errors, latest methods to treat myopia are also available such as progressive addition lenses (PALs), peripheral defocusing lenses, overnight orthokeratology (Ortho-K), multifocal soft contact lenses, outdoor activities, and pharmacological agents such as atropine eye drops.⁴

Let us explore these latest treatments for myopia in detail:

Optical intervention – It includes use of lenses in the form of spectacles or contact lenses. They include Bifocal and multifocal lenses, peripheral defocusing lenses, defocus incorporated multiple segments or DIMS glasses or MSMD [Multi segment of myopic defocus]), contact lenses, progressive additional lenses. Bifocal and multifocal lenses- many studies have been done in past decades to determine its role when used in spectacles and are preferable options for kids with myopia. Peripheral defocussing lenses are available in both spectacles and contact lenses and study results are promising. DIMS provides clear vision and myopic defocus simultaneously for wearers at distance, intermediate or near objects simultaneously.4,5

Orthokeratology – these lenses are specially designed gas permeable contacts which are worn overnight and help reshape the cornea and temporarily correct low to moderate myopia by changing the shape of cornea. The patient is advised to wear the lenses overnight, which flattens the cornea and provides clear vision during daytime without any glasses or contact lenses.^4,5

Pharmaceutical intervention – This includes daily application of low dose atropine eye drops in the concentration of 0.01% which has minimal side effects compared to other concentrations of atropine preparations, as well as the same efficacy. Atropine has been known to mankind as a drug since long and its first use in treating myopia goes back to the nineteenth century. Various studies had been conducted all around the world to determine the correct concentration of atropine ranging from 1% to 0.01%. Although atropine is used in many countries in Asia for this purpose, it is rarely used in the USA and Europe due to its side effects. Additionally, pirenzepine, a drug which has been used since long to treat dyspepsia and paediatric endocrine disorders, can be used at a concentration of 2% (usually as a gel) to slow myopia progression.^2,4

Surgical interventions - Surgical interventions include laser corneal refractive surgery, intraocular lens implantation and implantable collamer lens can are established to effectively treat myopia but do not stop progression. Excimer Laser refractive surgeries include -

• Photorefractive keratectomy (PRK)

• Laser subepithelial keratectomy (LASEK) and

• Epithelial laser in situ keratomileusis (referred to as LASIK)

Amongst these, LASIK is the most popular option for myopia correction and is superior to PRK and can be used to treat up to -15 D but is recommended to correct up to -10D of myopia.⁶

Intraocular surgery – can be used to treat very high degree of myopia (more than -10D of myopia). Recent advances in surgical treatment include Fematosecond laser, and small incision ienticule extraction.⁶

Other latest surgical strategies to halt progression of high myopia include subscleral injection of mesenchymal stem cells and dopamine injection.⁶

Along with these medical interventions some lifestyle changes are helpful in controlling myopia progression to some extent. Measures like more time doing outdoor activites,4 restriction on screen time and limiting hours of near work are known to be effective in preventing the development of myopia and slowing its progression.

References:

1. Stell WK. A new angle on myopia therapeutics: Not just a fishing expedition. EBioMedicine. 2021 Mar 1;65.
2. Leo SW, Young TL. An evidence-based update on myopia and interventions to retard its progression. Journal of American Association for Pediatric Ophthalmology and Strabismus. 2011 Apr 1;15(2):181-9.
3. Subudhi P, Agarwal P. Myopia. InStatPearls [Internet] 2022 May 21. StatPearls Publishing.
4. Kaiti R, Shyangbo R, Sharma IP, Dahal M. Review on current concepts of myopia and its control strategies. International Journal of Ophthalmology. 2021;14(4):606.
5. Țone S, Niagu IA, Bogdănici ȘT, Bogdănici CM. Update in pediatric myopia treatment strategies. Romanian Journal of Ophthalmology. 2020 Jul;64(3):233.
6. Farooqui JH, Acharya M, Kekan M. Current trends in surgical management of myopia. Community Eye Health. 2019;32(105):S5.

FAQs

Q1. What is the best treatment for myopia?
Ans. As people rummage through the internet looking for the best treatment of myopia, the fact is that there is no permanent cure for myopia. Myopia can be corrected with corneal refractive surgeries, contact lenses or the most common of all, prescription eyeglasses.

Q2. What are the treatments for myopia control?
Ans. However, myopia can be controlled through many interventions like optical, surgical and pharmaceutical agents such as atropine drops that are available to retard its progression.

Q3. Which lens is used to treat myopia?
Ans. Wondering which lens is used to cure myopia? Concave lenses help correct the condition.

Q4. What is the latest treatment for myopia?
Ans. Apart from traditional ways to correct the refractive errors, latest methods to treat myopia are also available such as progressive addition lenses (PALs), peripheral defocusing lenses, overnight orthokeratology (Ortho-K), multifocal soft contact lenses, outdoor activities, and pharmacological agents such as atropine eye drops.⁴

Q5. Can myopia improve with age?
Ans. Typically, myopia begins during childhood ages 6 and 12 and tends to worsen or progress every few to several months until the late teenage years, However, the progression slows down or improves during young adulthood and plateaus by the age of 18 years.3 Even though it may seem like myopia may be improving, it cannot be reversed.