Putting the Brakes on Myopia Progression

Myopia, or nearsightedness, is a growing problem in the United States and around the world. Research suggests 30 to 40 percent of adults in Europe and the United States and up to 80 percent in Asia have myopia. It usually develops in children around age 8 and continues to progress until age 15 or 16.

While myopia is common and often corrected with glasses or contact lenses, moderate to high myopia is associated with serious vision-threatening side effects, including early cataracts, detached retinas or increased prevalence of glaucoma. When this occurs, it is called degenerative myopia or pathological myopia.

Researchers at The Ohio State University College of Optometry and the University of Houston College of Optometry are currently involved in a study sponsored by the National Eye Institute to determine how well the progression of nearsightedness and growth of the eye in young children can be slowed, simply using commercially available soft bifocal contact lenses.

The BLINK Study, led at OSU by Jeffrey J. Walline, OD, PhD, associate dean for research at The Ohio State University, is a clinical trial in which 300 children aged 7 to 11 years will wear regular single vision contact lenses or one of two bifocal contact lenses. The progression of their myopia will be monitored over a three year period.

“Our secondary goals include finding out if a stronger reading power slows the progression more than medium reading power and to determine factors that lead to the best control of eye growth so that we can maximize control in the future,” says Dr. Walline.

“The BLINK Study fits center distance contact lenses on patients to focus some light in front of the seeing part of the eye, likely slowing the progression of myopia,” adds Amy Keller, OD, staff optometrist at Nationwide Children’s Eye Clinic. “The results of this study have the potential to change our contact lens fitting practices forever.”

If the use of contact lenses slows the progression of nearsightedness significantly, fitting near sighted children with soft bifocal contact lenses could potentially become the standard-of-care.

“Children as young as 7 years are capable of independent contact lens wear,” Dr. Walline says. “I think realizing that fact and knowing contact lenses may be able to slow the progression of nearsightedness will help physicians and ophthalmologists to counsel patients and their parents about nearsightedness, because about 15 percent of children are nearsighted by the time they reach high school.”

In fact, while the medical community waits for the results of the clinical trial, some optometrists are offering the treatment to patients based on the growing body of evidence showing these lenses slow nearsightedness in children. For example, a study from a team in Hong Kong showed the lenses slowed myopia progression by 25 to 46 percent, while a previous study from Dr. Walline and colleagues showed a 50 percent reduction in progression.

“The contact lenses we are using in the BLINK Study are commercially available today, and many, but not all, optometrists know they slow the progression of nearsightedness in children,” Dr. Walline explains. “I think doctors ought to tell all nearsighted children and their families about myopia control.”

Dr. Keller agrees, “There are definitely situations where this approach is an excellent choice. As a pediatric optometrist, I have many patients who have an increase in their myopic prescription every year.  If we could slow this progression, I believe this could be greatly beneficial to those patients.”

According to both Dr. Keller and Dr. Walline, contact lenses in general are safe for children in this age range. Contact lenses also provide a variety of other benefits for the wearer, including improved self-confidence and greater flexibility with sports and other physical activities.

“There is little additional risk with contact lens wear, as long as the patients don’t sleep in them,” Dr. Walline says. “Not all children will want to wear contact lenses, but they ought to be told about the opportunity because contact lenses offer a variety of visual and non-visual benefits.”