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Earlier Orthokeratology fitting for more effective myopia control

Orthokeratology Society of Oceania - Wednesday, August 16, 2017

Myopia (short-sightedness) has been recognized as a global public health concern. Clinicians, researchers and scientists are currently examining the mechanisms of myopia progression, how we may address risk factors and slow/halt these changes in the eye.

Recently, Professor Pauline Cho’s research has shown that myopia control treatment for children at a younger age halved the risk of rapid progression in fast changing myopia. (1) Orthokeratology are suitable for children, adolescents and adults, however this study showed that the ideal age to commence Orthok for myopia control benefits is 6 to <9 years old. (1) Older children including adolescents also demonstrated reduced myopic progression and slower eyeball growth, for those with fast progressing myopia (1)

“For all three groups, mean axial elongation of the right eyes was slower during ortho-k treatment compared to the spectacle-wearing phase but the young children showed the fastest elongation in both phases of the study,” Professor Cho stated. (1)

Children in the 6 to <9 years old bracket demonstrated a reduction from 86% to 43% progression, and children 9 to <13 years showed a drop from 17% to 0% myopic progression, when changing from spectacle to Orthok lenses. (1) No adolescents showed fast progression in glasses or Orthok lenses. (1)

Orthok may be used to correct for myopia in adults as well, however research is needed to investigate its role in slowing progression. (1)

The take home message is that optometrists and clinicians should discuss myopia control options with all progressing myopic children, and keep in mind the potential rapid progression in early childhood. This discussion should include a shared-care decision plan between the child, parents and optometrist; addressing risk factors such minimal outside time, extensive near-time & close working distances for near-tasks, and optometric myopia control options including soft multifocal contact lenses, Atropine eye drops with optical correction and Orthokeratology. (2-4). Patients wishing to commence Orthok, should be referred to an Ortho-k fitting optometrist.

- Natalie Buckman, OSO Guest Board Member

(1) http://www.optometry.org.au/blog-news/2017/8/16/start-ortho-k-early,-study-urges/
(2) Scott A. Read, Michael J. Collins, Stephen J. Vincent; Light Exposure and Eye Growth in Childhood. Invest. Ophthalmol. Vis. Sci. 2015;56(11):6779-6787. doi: 10.1167/iovs.14-15978.
(3) Bao J, et al. Near tasks may worrsen myopia in children. Optom Vis Sci. 2015;doi:10.1097/OPX.0000000000000658.
(4) Huang J, Wen D, Wang Q, et al. Efficacy comparison of 16 interventions for myopia control in children: a network meta-analysis. Ophthalmology. 2016;123:697–708. [PubMed]