Binocular Vision status also influences the development of myopia. If someone has an inward posture of their eyes (not an eye turn, but an esophoria) they are at a significantly higher risk of increasing the myopia rapidly. One needs to be extremely careful about prescribing minus lenses in these cases as they “eat up the minus” at an unbelievable rate. There are also cases of exophoria (outward posture of the eyes) and intermittent outward eye turning (most will see this at the end of the day). These people use the prismatic effect of the minus lens to help hold their eye posture inward so they do not need to do it themselves. The myopia increases in these cases as their eyes become “lazy” in wanting to go outward again. So, increasing the power of the lens, increases the prism effect and voila, you no longer have to “work” to hold your eyes inward.

When I see these cases, I recommend vision therapy. Vision therapy provides the necessary, meaningful opportunity for individuals to choose to use different tools in holding their eye posture together. In these cases, and in the cases above where the anti-fatigue lenses are used, vision therapy can be very beneficial in slowing down the development of the myopia. Vision therapy works very much in incorporating the entire body to align the vision. It incorporates posture, peripheral awareness, and increases a person’s ability to get out of their overly “focal” state and this is the mechanism in which vision therapy can help.

Vision therapy, offered at our Burlington optometry practice, is often also called behavioral optometry and there are psychological components that create myopia as well. Intense stress, anxiety, trauma can create myopia as well. I have had cases where a child has been +0.75 (farsighted, the perfect buffer prescription to prevent myopia…one does not want zero prescription at distance. +0.50 to +0.75 is ideal) at distance and seeing 20/20 uncorrected in both eyes and having a sudden change into myopia practically overnight, anywhere from -1.50 to -4.00. These cases have reported bullying at school, severe anxiety, sudden loss of a loved one, and head trauma. These cases benefit from vision therapy and very careful prescribing of the myopia as this is often functional, and not permanent.

For more information on myopia control, call us at 905-319-1066.

Ergonomics and environment are factors in slowing down the development of the myopia. Having a proper working distance to your near-work is essential. Holding reading materials too close stresses your focusing and convergence system and thereby increasing the myopia. Harmon’s working distance (for each person, that is the knuckle of their hand to their elbow) has been shown to be the most beneficial working distance. Using a slanted desk helps with the proper body and eye posture to reduce strain. Taking breaks from near work every 20 minutes and looking at distance to relax the accommodative (focusing) system of the eye is important. If the distance is blurry when doing this and it takes time to clear up, you are at risk of increasing the myopia.

It is strongly advised to get outdoors and look at distances in a three-dimensional space (looking at a lake, trees, mountains…looking at a television does not qualify). Myopia increases in areas that have winter and where people spend more time indoors (constricted spaces). In my schooling, the evidence had shown that farmers did hardly developed myopia at all. This statistic has now changed with the introduction of technology. People in academia had a higher rate of myopia. So these statistics indicate that increased amounts of near-work, looking at objects too close to you, increases your risk of myopia. We can all see the unique postures people use to view their cell phones.

For more information on myopia control, call Dr. Patricia Fink Optometry at 905-319-1066.

So what do we know that can help? Anti-fatigue lenses have been shown to help in some cases. What this lens does, is creates a thinning of the bottom portion of the lens so that the distortions of a minus lens (the edge thickness is greater in a minus lens and studies have indicated that this distortion increases myopia) when looking downward is removed. It also creates a zone of “less minus power” which is beneficial when looking at near tasks. You see, many people will have distance glasses to correct their blur at distance. They then wear them all the time even though they can see fine at near without them. Within a year they need a stronger prescription, not necessarily due to “normal” progression of myopia, but due to the fact that the brain likes the nearsightedness to help with near work and putting on the distance glasses as messed that up. The brain adapts and puts the nearsightedness back in place.

This is where the whole concept of wearing the glasses makes your eyes worse. Well yes, wearing glasses for the wrong purpose may do that. The glasses were meant for distance, not near work. So, for those cases of myopia where this is the mechanism of action, the anti-fatigue lenses are amazing. We are fortunate now that we have anti-fatigue contact lenses as well. The amount of the anti-fatigue lens needs to be carefully measured. If it is too much or too little, it will not stabilize the myopia. Zeiss myovision lens is also a great lens to slow down myopia in this category.

What is another way to slow down the development of nearsightedness? Wearing contact lenses has shown to slow it down. Why? Still a discussion point. Some believe the feeling of the contact lens on the eye sends signals to the rest of the eye to slow down the axial elongation. Some feel that the minus lens distortions are eliminated and it opens up the peripheral vision. Some specific lenses, like ortho-k, are retainer hard contact lenses that you sleep in overnight which reshapes your cornea to eliminate myopia. These need to be worn nightly and are best for powers under -3.50. Long range studies indicate that this method doesn’t actually slow down the development of the myopia, however patients that use this method, love it as they are free of glasses or contact lenses throughout the day.

For more information on myopia control, call us at 905-319-1066.

Myopia control is creating a big buzz in the world currently. Myopia is another word for nearsightedness, and the incidence of nearsightedness has suddenly leaped up across the world. When I entered optometry school in 1995, the percentage of myopia in the population was approximately 30%, while it is now 40% and predicted to affect 50% of the population by the year 2050! That means 5 billion people in the world will have some form of myopia.

The World Health Organization has indicated that this in now an epidemic and needs to be studied and controlled. Thereby “myopia control” is the new buzz.

Before we go into why this is such a concern, it is important to appreciate what myopia is. Having myopia indicates that you can see things which are nearby, but are unable to see clearly at distance.

To treat myopia, Dr. Fink will prescribe a minus lens in order to diverge the light so it can hit the macula (central viewing portion of the retina). Although many studies and much research has been conducted in myopia, the actual process is not fully understood. Some believe too much close-work creates it. Some studies indicate that elongation of the eyeball creates it. Maybe it’s genetic. There has been no one proven mode of action to explain myopia or it’s progression.

So why do we care? Why do we care if the prescription is a -1.00 vs a -12.00? Well, the higher the prescription, the higher the risk of retinal disease and glaucoma. Once the eye exceeds the power of -3.50, the risks go up significantly. This is why everyone, including the WHO, is interested in “controlling” it, as the cost in not only treating these additional diseases is a concern but also the impact these conditions have on the individual, their quality of life, and on the entire economic structure, as these individuals will no longer be able to continue in their employment. There are also costs to employers that need to modify the work space and the costs to healthcare, as not only the surgeries and treatment cost money but also low vision services if vision cannot be rescued. The impact that myopia has is frightening and unless you are aware of the dangers an increase in power can create, you may not be invested in also doing everything possible to slow down the development of myopia.

Stay tuned for more in this series. For more information on myopia control, call us at 905-319-1066.

Here I am with my new glasses. Let me tell you my journey. I was significantly nearsighted which began at age 10 with a -2.00 prescription that was -4.50 -1.00 x 180 by the time I finished optometry school. I had laser vision correction in 1997 and 1999 (yup, both eyes at separate times as I had my son in between operations and can’t have laser when you are pregnant or lactating). By the time I was in my early 40s I knew I should be in reading glasses to preserve my distance vision however all the reading glasses and progressives gave me headaches and eyestrain until I went to Phoenix and had a binocular vision assessment done by Dr Robin Lewis who prescribed me a +0.37. Holy comfort. It was great. I wore it for near work until I was 50. Then it became uncomfortable again.

Now my right eye was blurry for distance yet both eyes clear for near. Very strange for someone in their 50s. A new binocular assessment by Dr Manny Singh at my office determined a minimal distance prescription in my left eye with an anti fatigue lens at near. It was very strange for the first 20 min. My stomach was upset, my right eye ached. Then 45 min in things started to click. I saw better for distance and near work was easier.

Will keep you all posted as my week progresses. I’m also back to taking vision therapy sessions once per week to improve my visual performance.

Did you know that 86% of Dry Eye Disease (DED) involves the lid margin and that 5 minutes of sustained heat to the lids is the first treatment whether your DED requires expression, biofilm clearance, antibiotics, anti-inflammatories or anti-allergens?

Did you know that regular warm compresses do not provide this?

Did you know that the Bruder mask was created and designed by an optometrist to have the correct contour, bead density, and bead composition (important for proper moisture release)?

Now you know.

For more information don’t hesitate to contact our dry eye specialist in Burlington, Ontario .