Myopia Control Case studies
Myopia Control Case studies at Lynne Fernandes Optometrists
Following popular request, here are clinical details regarding three of our myopia control patients here at LFO. If you’re concerned about your child’s sight book an eye examination with us. Sight tests are free on the NHS for children under 16. Or if you would like to know more about the Myopia Control Programme, visit http://www.lynnefernandes.co.uk or call your local practice.
This patient first attended for an eye exam in 2015 aged seven showing signs of hypermetropia (longsightedness) which was stable at +0.50DS in both eyes on his annual review in 2016. Both parents were myopic (each around -3.00DS to -5.00DS). In 2017, the child presented with a myopic prescription of -0.75DS in both eyes. The mother of this patient is an optometrist and was eager to start myopia control at it’s first onset given her own history of myopia. Myopia control options were discussed at this appointment and both parents were happy for MiSight soft daily disposable lenses to be fitted. Two insertion and removal lessons or “teaches” were required for the patient to be fully confident in doing this at home themselves. The patient was reviewed at one week, three months and now regular 6 month intervals. The prescription has changed by only one step or -0.25 in almost exactly one year since we first started the control programme.
"I have been wearing contact lenses for almost a year as part of the myopia control scheme. I'm wearing lenses because both my parents are short-sighted so by the time I was eight I was already in glasses. I decided to wear contact lenses because there is less risk of my eyes getting more and more short – sighted. It took a while but now I've mastered putting them in and it takes about a minute to pop them in and out. Putting contact lenses in looks a bit strange but it doesn't hurt at all, and they're comfortable to wear all day. Having lenses is less of a fuss because you don't have to worry about where your glasses are or remembering to put them on." Charlie, 9yrs old.
This is one of our first myopia control patients. They presented in 2014 at the age of 7 with -0.25DS in both eyes. One parent is myopic (approximately -3.00DS in both eyes). Eleven months later they returned complaining of a deterioration in the clarity of their distance vision. The prescription on this occasion was found to be -3.25DS in the right eye and -3.75DS in the left eye. The child was prescribed their first pair of spectacles and was asked to return three months later. At this appointment the prescription had changed to -4.00DS in the right eye and remained at -3.75DS in the left eye. Myopia control was still in its experimental stages in 2015 and as a result the only lens available to us that appeared to work was a monthly multifocal which was designed for adults over the age of 40 years old. Due to the significant visual changes this patient had experienced in just one year, the parents agreed that it was worth trying them. Bifocal glasses were also prescribed for use in the evenings or on a rest day from the contact lenses. Bifocals have been shown to have some effect on the progression but the research shows variable results and a lower overall effect on slowing myopia progression. There was no change in the prescription for 18 months! As research in the field developed, a soft daily disposable called MiSight was manufactured. Due to Lynne’s excellence and advocacy in myopia control, even in its early stages, Lynne Fernandes Optometrists was selected as a MiSight lens provider. In January 2018 the patient was refitted to these more appropriate lenses as the prescription had deteriorated by -0.50DS. It will be interesting to follow this progression now that we are using the MiSight lenses.
This child’s first prescription was issued in 2014 at age eleven. Children presenting at this age with problems seeing the board is very common. Most short-sighted people remember their prescription changing significantly in their “tweens”. On this presentation, the right eye was -1.00DS and the left eye was approximately -0.50DS. Just twelve months later, the prescription had increased to -2.50DS in the right eye and -2.00 in the left eye. It was at this appointment that we decided to fit myopia control lenses. At the time the MiSight lenses did not exist so we fitted monthly multifocal lenses. After another twelve months the prescription had increased but at a slower rate than before. This was in March 2016 and you can see from the two graphs that the prescription has remained quite stable since with a much slower rate of progression than before myopia control.