How eyes are changed when myopia progresses

When eyes are worse in myopia, the length of eye ball grows longer as of squash on vine. Physically growing longer makes impossible to reverse changes in my opinion.

Myopia is commonly measured in terms of prescription strength in diopters for optical corrections. Recently, axial length of eyeball measurement (biometry) is used to verify objectively changes in elongation of eyeballs.

Most common question about myopia is if it can be fixed with laser surgery such as LASIK. Any refractive surgery -like LASIK – can only replace optical corrections such as eyeglasses and contact lenses. Elongated eyeball will stay elongated because any optical corrections which includes all refractive surgeries and implants will not reduce elongation.

Second common question is any exercise can be done to reverse myopia /elongation. I am not aware of any studies indicating efficacy of any exercise to reverse elongation.

Because of irreversible nature of changes, we recommend our patients to recheck in 3 months to catch early rather than late to intervene axial length changes.

Fighting against Myopia

Since we provide myopia control / prevention services in 2004, we saw gradual increase of effective tools for the fight. Myopia progression measuring tools became more accurate and objective , such as biometry ( measurement of eye ball length.. LensStar, IOL Master ), topography (measurement of eye shape.. OPD Scan, Pentacam..). More management tools are in our disposal such as Ortho-K lenses ( CRT, Moonlens, Dream lens and GOV, softOK) , Soft multifocal lenses ( Mysight, Multifocal Lenses) and atropine eye drops. These tools can be optimized for each patient’s needs and conditions. But still none of above method has 100% efficacy. However, combining multiple strategies can produce much better results. If you are interested learning more about, make an appointment with Dr. Youn to find out what might be the best strategy for your case.

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.

What is Myopia Prevention?

childmyopiaMyopia, nearsightedness, is the  most common eye problem among young children. The number of children having myopia is increasing rapidly in U.S. and world wide.  Most of myopia starts at school age then gradually progresses each year. Generally, the younger the age myopia starts, the worse the eyes get when they reach adulthood. Myopia increases the risk of retinal problems, such as detachments, holes and breaks, and glaucoma,  as a person gets older.

The goal of myopia prevention is to reduce the speed or stop the progression  to avoid a high degree of myopia. There are a few clinically proven methods that have shown to  prevent or slow down the progression. Some methods are more effective than others and can be determined based on each individual patient’s needs.  It is the best to have your child examined before deciding on what to do on prevention. It is very helpful to know family history of myopia as well as old prescriptions to determine rate of change.

We offer free screening for myopia prevention. Please call us at 248-332-0200 to set up an appointment.