high myopia glasses vs contact lens

[RICK2014]

My son has high myopia -8.75 at age 10 and has been under pediatric opthomologist care for yr. I just switched to contact lenses for him for better vision. I just want to know if wear soft contact lenses vs glasses can have negative impact on his progression of myopia. My opthomologsit seems fine with my decision going for contact lenses but am still bit worried.
Any suggestions welcome.Thanks.

[John C Hagan III, MD, FACS, FAAO]

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[flossy93]

Here is an overview from late 2012 from Review of Optometry about various techniques in slowing childhood progression of myopia:

http://www.revoptom.com/content/c/37770/

Regarding Dr. Hagan's comment about drops, this article mentions the following regarding the class of drugs including atropine - these are called Anti-Muscarinic drugs and in general they cause pupil dilation and can also paralyze the focusing muscles surrounding the eye's natural lens:

"Anti-Muscarinic Therapy:  A recent review that included 23 clinical investigations of myopia treatments in children found that anti-muscarinic medications (eye drops) had the largest positive effects for slowing myopia progression.18 At one year, children receiving pirenzepine gel, cyclopentolate eye drops or atropine eye drops showed significantly less myopic progression compared with children receiving placebo.18

In Singapore, researchers used topical atropine on 400 myopic children ages six to 12 years. The treatment was found to be well tolerated and effective in slowing the progression of low and moderate myopia and ocular axial elongation in Asian children. The mean reduction of myopia in the atropine-treated eyes was 0.03 +/- 0.50D, while there was progression of myopia of -0.76 +/- 0.44D in the placebo-treated eyes.19

Although this intervention appears to be somewhat effective, it is not a first-line treatment in our office due to the potential side effects that are encountered by anti-muscarinic medications.18" [end excerpt]

Some of the side effects fo these eyedrops are glare and loss of focusing ability due to the enlarged pupil and relaxed focusing muscles.  Patients using this therapy need extra protection from UV exposure such as sunlight, as more light can enter the eye due to the dilation.  UV light can cause harm to structures inside the eye.

I also read an interesting study about a caffeine extract, 7-methylxanthine or 7-MX, that was tested by Dr. Klaus Trier in Denmark and his colleagues  for its potential to slow myopia.  His study showed it to be effective in children but to my knowledge there is no one outside of that country (and perhaps no other doctor even in Denmark) prescribing it.  

You may find the study interesting to read although please be aware there hasn't been adoption of this method of myopia control anywhere outside Denmark that I have found, which gives me pause given the epidemic of childhood high myopia occurring in many countries:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802512/

Also please take note that the study found once the patients discontinued taking the 7-MX supplement, their eyeball elongation resumed.  Dr. Trier describes their concept of use of 7-MX as a supplement children could take it until age 18-20, when eyeball elongation typically slows on its own.  But again, I've never found any online reference to other studies of 7-MX effectiveness.

There was one adult patient on this board living in the US who went to great lengths to obtain 7-MX to try for his own high myopia.  He later told me that he stopped taking it after a time because it was too difficult to obtain.

[John C Hagan III, MD, FACS, FAAO]

Yes ask about bifocals, atropine eye drops, ortho-K contacts lens and there is one other eye drop used to slow down myopia progression but the name escapes me at present. Also an hour or more of outdoor play has been shown to be helpful

JCHJ MD

[RICK2014]

Thanks Dr.Hagan, Seeing his progression over the years I am really worried. I just made appointment with one of pediatric opthomologist in UIC chicago who we will be seeing in 2 wks.I hope that will help me guide in some way to try any treatment plan for this myopia progression. I always had his complete eye exam yearly but looking for something that can slow or stop the progression. Any suggestion for me to ask or be aware during my appt.
Thanks again

[John C Hagan III, MD, FACS, FAAO]

I would suggest you make an appointment with the pediatric ophthalmologist at one of the Chicago area  medical schools.

JCHMD

[RICK2014]

thanks for reply so soon. my sons opthomologist has seen him since he was 5 when he got his first pair of glasses. i asked her about atropine ,bifocal and ortho k but according to her nothing will help as he has long eye ball.
i am very concerned and want to try some thing but would definately need professional guidance , any suggestions regarding doctor in chicage who practices in high myopia in kids cases, any suggestions.
i would definately look into pediatric myopia control clinic, i wont mind traveling if that will help my son.
thanks again.

[flossy93]

It's great your son is old enough to use soft contacts rather than glasses.  They do provide much better vision than glasses for high myopes, particularly with peripheral vision.  Be sure he practices good lens hygiene as directed by his doctor.

In addition to discussing with your son's ophthalmologist the therapies noted by Dr. Hagan, you may find the following link useful.  It's the website of a new pediatric myopia control clinic that was opened in the last year at UC Berkeley in northern California:

http://www.caleyecare.org/myopia-control-clinic

Your profile indicates you are in Chicago, so I don't anticipate you will visit the clinic directly.  But you may find some of their web content and links helpful.  Best of luck to you and your son!

[John C Hagan III, MD, FACS, FAAO]

vision is better with contact lens. Soft lens lens will likely neither cause progression nor restrain myopia progression.   Ask your peds ophthalmologist about the use of atropine and bifocals and Ortho K contacts

JCH MD