Myopia control treatment can be stopped when myopia stabilizes and cease to progress. Learn at what age it happens in general and what to consider after the cessation.Â
Â
After embarking on the journey to control myopia with your kid and possibly seeing some initial success, some of you, like me, may start wondering how long the myopia control treatment will be or when it is appropriate to stop. To answer the question, we will need to understand when myopia stabilizes.Â
The risk factors for myopia are both hereditary and environmental. A meta-analysis study showed children with one myopic parent are one and a half to two times (1.5 to 2x) more likely to develop myopia and up to three (3) times if both are myopes. And the key environmental risk factors include less time outdoors, increased years of education, and near-work activity levels, such as reading and screen time.Â
In a normal eye, babies are born hyperopic or farsighted. And within the first year, then slower later, their eyes' axial length growth matches the focal length of the cornea to the retina, which is called emmetropization.
In a study conducted in the US, among 4,512 ethnically diverse, school-aged children, the age-normal hyperopia among the non-myopic children was +0.50 D or less for ages 7 to 8 years, +0.25 D or less for ages 9 to 10 years, and emmetropia for age 11 years. Â
In myopia, the growth of the eyes, or the elongation of the axial, doesn’t match the focal length and overshoots emmetropization. In fact, studies found that the abnormal axial length growth seemed to appear the year or even up to three (3) before myopia onset. Â
When does myopia stabilize?Â
Myopia can begin at any age, but most start at the school age of 6 to 14. Even though there is no firm consensus on when myopia stops progressing, a key myopia study in 2013 found that the mean age at myopia stabilization was 16 years, with the following breakdown:
- Age 15 years, 48% had stable myopia
- Age 18 years, 77% had stable myopia
- Age 21 years, 90% had stable myopia
- Age 24 years, 96% had stable myopia
Furthermore, the study also indicated African Americans tend to stabilize at a slightly younger age, 13.8, than other ethnic groups.   Â
In other words, it may be appropriate to stop myopia control treatment in only half of the myopic children when they reach 15, but most at 24 years old.Â
Interestingly, a study published in 2014 indicated that less near-work activity but not outdoor exposure seems to be associated with stabilization of myopia.
What do you need to know when stopping myopia control treatment?
Work with your eye doctor when stopping myopia control treatment, especially if ceasing early.
If your kid is using atropine, atropine cessation may need to be tapered over time to reduce the risks of refractive errors rebound. Switching to single vision glasses or soft contact lenses from Ortho-K or myopia control contact lenses/glasses may also result in some discomfort initially and require some adaptation.
Since myopia control treatment prevents myopia from worsening, the cessation of the treatment after myopia stabilizes means the refractive errors may still need to be corrected. You may want to discuss with your eye doctor the different correction options, for example, glasses, contact lenses, laser, or other treatments.
Furthermore, some myopes, after reaching their 20s, will continue to progress by at least one diopter over a decade. Closely monitor for any vision changes or symptoms of myopia progression and discuss with your eye doctor about eye exams, especially following cessation.    Â
Takeaways
Ideally, myopia control treatment should continue until your kid’s myopia stabilizes, between 14 to 24 years old for most. If your kid’s myopia stabilizes with high myopia, 5 to 6 D, they should monitor their eyes more closely throughout their life due to their increased risks of developing other eye diseases secondary to high myopia.Â
Myopia management is a relay race, and myopia control treatment is the first runner. For many of us, the time to pass the baton is when our kid becomes an adult.
Â
Â
Want to stay connected on the newest happening? Join me @
Facebook group:Â www.facebook.com/groups/myopia/Â
Pinterest board:Â www.pinterest.com/clearsightcorner/Â Â
Â
Comments