After 13 Years, Our Approach to Myopia Control

Myopia Tsunami That Started in 2000….

I practiced optometry for 10 years in Port Huron, Michigan since my graduation from the Michigan College of Optometry in 1993. In this small town, I examined  few kids and lot more adults in any typical given day.  When I opened up my practice in here, Metro Detroit,  in 2003, that picture changed. I saw proportionality of kids with myopia jumped some what.  In early 2000, the surveys from Asian countries showing their myopic kids population were increasing substantially.

Who is to blame???

Even if every one saw increasing number of myopic kids, no one was pointing finger at electronics and books but the “genes” . If gene was only thing to blame then it must be mutating because , as you know, population as whole is becoming more myopic in every country. Still, even today some doctors think that gene is only cause for the myopia!

What Happens when eye worsens??

If you are looking for scientific explanation, here is the link.  Simply put, when eyes get tired from too much near work,  focus of retina goes back of retina and that makes eyes grow longer. As an eye ball gets longer, myopia worsens.

What Should We Do??

Back in old days, my parent let me roam with my friends out side all day until dark. Incidentally, I am much less nearsighted than my studious younger relatives!  Big study from UK concluded ” Kids who spent more outdoor activity had later onset of myopia and had less progression”.  Ya~, it ‘s no brainer when you are out playing soccer it is hard to play iPhone games. It is easy to say to limit the near work. But in this hyper competitive world, it is impossible to limit the near work.

What other Options are there?

The primary goal of myopia control is putting the image of eye in front of retina. There are many ways to achieve that goal but hard to sustain every day. After 13 years of providing myopia control, we became more practical.

Here are my list ( least to most effective in order):
1)#4: Bifocal glasses– all  lined or no line bifocal eyeglasses- Not much effective, Blurry Dizzy, hard to get used( ask 50yr old uncle Jack about his)
2)#3: Bifocal/multifocal Soft Contacts-daytime wear ( good luck putting that thing in the busy school morning)- Better result than glasses.
3)#2: Bifocal/multifocal Hard(RGP) contacts– more flexible on astigmatism. Easy on & off, clear vision but least comfortable.
4)#1: CRT(ortho keratology)– Wear at night only, best preventive effect, good daytime vision, easy to put in & out on even uncooperative young kids.
I do not recommend Atropine related eye drops because unknown long term side effect on young kids.


Myopia control is not one dimensional process. Kids need to spend less time on books and electronic screens. Parents,  try to get the CRT(Ortho-K (night contact lenses)) for your kids  if it’s possible. The less effective soft bifocal (multifocal) contact lenses can be a substitute  if CRT is not possible. The least effective bifocal eyeglasses can be the last option if every thing else fails.

And, Moms !  Don’t sign up too many lessons. Here is what my patients are saying.