HomeAnswersOphthalmology (Eye Care)myopiaMy son has a nearsighted prescription. Will it increase?

Diagnosed with spherical powers in eyes,How to control the progression of myopia?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At May 11, 2018
Reviewed AtFebruary 8, 2024

Patient's Query

Hi doctor,

My son is 5.5 years old, and he has been diagnosed with spherical powers of -3.5 and -4.0 in both eyes respectively. I am tensed considering his age. The local doctors say that the power will increase with age. How much would it increase? And are there any means to control it?

Hi,

Welcome to icliniq.com.

Your child has myopia and usually, minus spherical number increases with body growth and age. However, it is very difficult to predict how much it will increase nor are there any means to prevent it.

He needs to wear his glasses constantly for maximum visual improvement, and there is a need for regular six monthly eyes check up.

Patient's Query

Hello doctor,

I will ensure constant wear of glasses, but I would like to know how to control the progression of myopia with age. I have read somewhere that Atropine drops are effective. Where is this available? I also heard that ortho-k lenses are useful, but I am not able to find it near my place. I know that no doctor can answer how much will the myopia progress, but I am still worried. Also, I have heard that LASIK cannot be done if power crosses -8. So, what are the other options in the future?

Hi,

Welcome back to icliniq.com.

Atropine drop treatment is an option, but to initiate that treatment, you need to have significant progression of myopia. Your child has just started using glasses. There is no documentation of progression of myopia.

  • There is a possibility that his refractive error might not change or will change very insignificantly, in such a case, Atropine treatment would not be warranted. You need to contact a pediatric ophthalmologist in your area, who will discuss this treatment plan with you.
  • LASIK is possible up to -10 D. However, if the refractive error is high, there are other options available in the form of ICL (Implantable Collamer Lenses), which can completely correct the glass number.

Patient's Query

Hi doctor,

Thank you for replying. I understand your point. I should wait for 3 to 6 months to recheck the power. However, in automatic refraction power, it was -4 or -4.5, but the doctor started with -3.5. My current doctor said that my child has childhood myopia and that she is suspecting amblyopia, as both the eyes have almost same power. I was not suspecting that, so I showed it another doctor. That doctor also told me to wait and watch for a month and then think about patching. But, the first doctor told to start patching immediately. I am so confused. Are there any side effects of Atropine? If I start using them now, is there any harm?

Hi,

Welcome back to icliniq.com.

  • There is no need to start patching immediately. Let the child start using glasses on a constant basis. If the vision does not show improvement even after two months of wearing glasses, then consider patching. There will be no harm if you wait for 1 to 2 months before you start patching. Just ensure constant wear of spectacles.
  • There are side effects of Atropine. You cannot use it on your own. You have to use it under the guidance of an ophthalmologist. The type of glass needs to be changed for atropine therapy. Please do not start without consultation.

Patient's Query

Hello doctor,

I am a bit inquisitive, and you may be irritated with my questions. I am sorry in advance for that. The doctor who has told to start patching has given a power of -3.5 and said the vision is 6/18. Another doctor has given powers of -4 and -4.5, and she has told to wait a month after which she will review and tell about patching. As per here test also, the vision was 6/18. If the myopia is not progressive, do you think by the time he turns 18 or 20, the minus power will not change much. I mean it will increase with age, but should I worry too much or I can be at peace. I have not slept properly for last seven nights. Can a person with -6 or -7 can lead a normal life, and contact lenses can be worn by a child of which age? Lastly, I want to know about ortho-k lenses for overnight use? I have heard it stops the progression of myopia. Which company lenses are best for eyes? I am very worried about the future and wants some assuring words.

Hi,

Welcome back to icliniq.com.

I cannot comment on the glass number, as the child has to be personally evaluated for that. However, there is no point in under correction if at all it is done. The child needs to be given full refractive correction. Patching, as I have already said, can be started after 1 to 2 month of constant spectacle wear.

  • If the myopia is nonprogressive, then the power would not change much. In either case, even if the myopia is progressive, there is not much cause for concern. You need to change his glasses according. We need to ensure that the child achieves 6/6 vision, irrespective of the power of the glasses.
  • Irrespective of the refractive error, the child can lead a normal life, provided his vision is good (6/9 or better). Contact lens can be used at any age, provided the child is mature enough to handle them properly.
  • I never advise ortho k lenses, so I am not the right person to tell about it. You need not be worried about the progression. The child will be as normal as any other child. The only difference will be he would need to wear glasses, which again can be completely corrected after 18 years of age with refractive surgeries.

Patient's Query

Hello doctor,

Thank you so much. Your words have calmed my nerves a bit. One thing is clear vision is more important than power, and I will work with my doctor on that. How will I know if the myopia is progressive and if it is progressive, how much is the yearly progression generally? I know you cannot answer or give a correct prediction, but being a doctor, you have an idea. If it is progressive, then what is the line of treatment to delay the progression? Should some normal activities of the kid be restricted or limited, like reading books?

Thank you for your patience.

Hi,

Welcome back to icliniq.com.

  • Whether the myopia is progressive or not will be ascertained on follow-up visits. If refractive error increases every six months, then it is progressive. Generally, the yearly progression is between 0.75 to 1.0 DS, but this varies in children.
  • If it is progressive, then you can start on Atropine treatment therapy. Normal activities like studying and reading books should not be restricted. It is a good idea to decrease the screen time like mobile or computer games. Reading in dim light has to be avoided. Adequate illumination has to be present while reading.

Patient's Query

Hello doctor,

I visited a doctor today, and he also told me that six monthly checkup has to be done to see if it is progressive or not. Hence, after few days, we would be putting correct power, as he is getting used to the glasses now. The doctor here has also advised against patching. I thank you for all your support. The doctor has told he will also think about Atropine after the first checkup. I hope constant wear of glasses should protect progression and hope that wearing constantly will not put a strain, as I have read somewhere that wearing glasses of minus power increases the power further. I hope it is false.

Hi,

Welcome back to icliniq.com.

Constantly wearing will not put any strain on the eyes. In fact, it will decrease the strain on his eyes and will enable him to see clearly. Let us hope for the best.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Chandrashekhar Kale
Dr. Chandrashekhar Kale

Ophthalmology (Eye Care)

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