Diagnosis and Management of Changing Vision
It happens to people every day, all over the world. They notice their childs changing vision at distance. They notice their children’s vision worsening in general. Their child may have reported blurry eyesight, but often the child isn’t aware. They sit by helplessly as the optometrist reads them the new, higher prescription numbers and grimace when it’s higher than expected. They ask the Doctor “how high will it go?” hoping for an answer yet knowing there is no way to predict. “What causes it, Doctor?” not getting any clear answer, just speculation regarding genetic factors interacting with the environment and vice versa. “What can we do, Doctor?” . The Myopia Institute wants parents to know myopia can be managed, but only through the care of eye doctors with clinical experience managing myopia and well versed in the latest peer reviewed research. Unfortunately, there are many unsavory characters out there pitching methods to manage vision change. Our Institute provides parental education and scientific data to back our claims.
Myopia is the condition most often associated with regular changing vision, although there are other reasons that we will discuss as well. The precise reason for changing vision in myopia isn’t known, but scientists, optometrists and ophthalmologists can agree that it is likely multifactorial. In most cases, scientists and doctors agree there is a genetic component. The environmental stimulus in most cases appears to be sustained near work. The physiological change that results in myopia is the axial elongation of the eyeball (eye getting longer). It is believed that two things happen as a result of sustaining vision at near that lead to myopia progression; (1) in some people, the sustained “pull” of the muscles that focus, or “accommodate” the eye for near is believed to gradually stretch the length of the eyeball and (2) studies in animals have shown that by focusing vision on objects directly in front of the eye and eliminating peripheral vision, myopia increases, so lack of use of peripheral vision is also thought to cause changing vision in myopia
Historically several methods have been used to attempt to address what we call “myopic progression”, or “myopic shift”. They include (1) under prescribing, or writing a prescription weaker than the full prescription, (2) Prescribing “Plus” for near – the equivalent of having a distance prescription and a near prescription, often achieved with bifocal or multifocal eyeglass lenses, (3) using cycloplegic eye drops, usually Atropine in a process known as “atropinization” which paralyzes the muscles that overfocus some eyes causing myopic creep, (4) prescribing hard or gas-permeable contact lenses which were suspected to help reduce change and (5) prescribing orthokeratology (OrthoK or Corneal Refractive Therapy), understood best as “vision braces”.
Many studies have been performed which demonstrate statistically which methods have the best chance of stabilizing changing vision due to progressive myopia. Overall, Orthokeratology (orthok) has been shown to have the greatest effect.. Orthokeratology is one of a class of therapies known as vision shaping treatments. OrthoK involves wearing orthokeratology lenses (ortho k lenses) during sleep, which gently reshape the surface of the cornea of the eye. Upon removal in the morning, clear vision is achieved which often lasts the entire day into the evening.
For hyperopia, or farsightedness, vision changes in a predictable method as people age. Young adults with great distance vision might notice the vision changing gradually over the years, and many people who didn’t ever need glasses for distance find a need when they are in their late 40’s or 50’s. Astigmatism generally changes in this manner as well, although certain eye diseases and conditions that affect the cornea of the eye may be culpable.
Presbyopia, or bifocal age comes about because of changes in the condition of the human lens. As we age (from the age of 11 on), the lens in the eye hardens. By the time we are in our mid forties, the lens is hardened to the point that the muscles responsible for focusing it can’t anymore, and gradually people are forced to add another element to their lenses to see multiple distances.
Options such as OrthoK, cornea refractive therapy including paragon crt (vision shaping treatment) are particularly helpful when seeking to improve eyesight in children, and reduce change in vision, specifically myopia in children and may, in some cases reduce the risk of children with myopia advancing to high myopia.
If you are interested in managing your vision or the vision of a loved one with nearsightedness, contact an eye doctor from our directory near you or read through our website to learn about other options for improving your eyesight.