Over 21 and prescription still increasing? You maybe suitable for Adult Myopia (Progression) Management?

Myopia or short-sightedness causes blurred distance vision. It normally begins in childhood, being more common in children who have a myopic parent, although sometimes there is no family history. It used to be thought that the normal lengthening of the eye through childhood and teens, stopped on entering adulthood, as it was linked to body growth, we now think this may not be the case. More adults are finding their prescriptions are still increasing in their twentys, thirtys or  even older. Approximately one-third of myopia adults only develop myopia after 15 years of age.

A recent surveyed sample of Eye Care Professionals in the UK revealed that 39% of their myopic patients over the age of 21 had prescriptions that were increasing  by 0.50 dioptres per year. Given that the normal recall period for adults is 2 years, that means mearly 4 out 10 myopes will find their prescription changing by  a whole dioptre each time they have an eye exam, equivalant to going from 'normal' vision measured at 6/6 to 6/12 or a little worse, at this level most drivers would  fail the 'number plate test' and be liable to have their licence instantly revoked on the spot! 

This is a worrying public health issue, as increasing short sight due to a growing eye length is connected with a number of more serious eye problems in later life, such as retinal detachment, cataract, glaucoma & myopic macular degeneration. With every increase in myopia, the risk of developing these conditions increases. If the same mechanisim that drives increasing strengths of prescriptions in children continues in adults and the longer the prescription continues to increase the higher the risk of vision complications. Unlike paedatric myopia we don't, as yet, have as much evidence to have a firm conclusion, it remains not fully understood, but it is concerning. 

Is there anything I can do?

Parental history, ethnicity, environment (living indoors in cities) and spending longer each day on near tasks have all been linked to the onset and progression of myopia in children. With adult progressing myopia we have less data availble, other than it seems to be more prevalant than we used to expect. 

If the elongation theory of the eye in paediatric progressing myopia is true, and more and more evidence supports this, it could well hold true for adult progressing myopia, therefore interventions such as special myopia management contact and spectacle lenses may help slow these changes down. As Contact Lens Specialists we are pleased to say specific contact lenses, some already aproved for being specifically worn to help reading difficulty in later adult life, are prescribed by us.

As part of an Adult Myopia Management Programme you would be prescribed an over-night refractive treatment (ortho-k) or special daily disposable contact lenses with a view to hopefully slowing the rate of previous increases in your prescription. The application of these lenses for adult myopia management is in its early days, so it's impossible to be sure of a beneficial effect, if we wait, perhaps ten years for the science, we will know better, however ten years' of further increases in prescriptions will have taken place for many adults with short-sight by then!

How should I consider things?

If you would like to know more about about whether this is something that could be appropriate for you, please email one of us closest to you (please see bottom of this article). 

What happens next?

We will need to know your age and see your previous spectacle and/or contact lens prescriptions, we can discuss this by email before judging if you are one of the many myopes whose prescrition is continuing to progress. Then a discussion with will outline the next steps, this will start with a special eye exam where drops are used to measure the relaxed state of the eye. Following on from this you can consider special soft contact lenses.  

How does the programme work?

We may well want you to enroll you in an Adult Myopia Management Programme  where all the contact lens care and products needed are provided for a monthly fee. It would be logical to think any beneficial effect would be derived from wearing the lenses nearly every day, for most of the day, which is what a lot of contact lens wearers do already. It is vital all eye care is provided by a single practice, where the clinicians involved can communicate easily with one another, each having easy access to each others exam and test results.  

What are the charges?

The Adult Myopia Management Programme is not funded by the NHS. It involves a great deal of time with professional staff, this is included in the programme fees, however monthly payments are not too different to current daily disposable contact lens care plans. More detailed programme charges can be given on request.

What do I do next?

If you would like to contact us for non-urgent eye care discussions related to dry eyes or contact lenses you can  by email:

• Andrew D Price (Nantwich or Glossop or general enquiries) This email address is being protected from spambots. You need JavaScript enabled to view it.  
• Elizabeth Ralph (East Midlands and South Yorkshire) This email address is being protected from spambots. You need JavaScript enabled to view it. 
• Vanessa Uden (Surrey, Hants, Berks) This email address is being protected from spambots. You need JavaScript enabled to view it.
• Mr Ganeshbabu Mahalingam (West Yorkshire) This email address is being protected from spambots. You need JavaScript enabled to view it.

Personal portfolios can be found here: 

• Mr Andrew D Price FBDO(Hons)CL MBCLA 
• Mrs Elizabeth Ralph FBDO CL MBCLA 
• Mrs Vanessa Uden FBDO CL MBCLA 
• Mr Ganeshbabu Mahalingam MPhil PhD FCOptom FBCLA ProfHigherGlaucoma