[nhab-tech] Re: A Debatable Fix for Young Eyes.
- From: "Jan" <dmarc-noreply@xxxxxxxxxxxxx> (Redacted sender "janilovecarey@xxxxxxx" for DMARC)
- To: <nhab-tech@xxxxxxxxxxxxx>
- Date: Wed, 5 Nov 2014 08:39:27 -0500
I actually found it interesting.
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From: nhab-tech-bounce@xxxxxxxxxxxxx [mailto:nhab-tech-bounce@xxxxxxxxxxxxx]
On Behalf Of gosselin_louis
Sent: Tuesday, November 4, 2014 10:36 AM
To: nhab-tech@xxxxxxxxxxxxx
Subject: [nhab-tech] A Debatable Fix for Young Eyes.
Please note that this is not the most appropriate listserv for this article,
and is about Eyes, and not about computers or telephones. If anyone objects
to my posting of this article on this listserv, please let me know, and I'll
stop. It's just that I feel that it is a listserv that I feel will reach a
big number of people who might benefit.
Louis Gosselin
A Debatable Fix for Young Eyes.
NY Times Tuesday, 2014_11_04
By SINDYA N. BHANOO. BERKELEY, CALIF. -- Lilith Sadil, 12, climbs into an
examination chair here at the Myopia Control Center at the University of
California. 'Do you know why you are here? asks Dr. Maria Liu, an
optometrist.
'Because my eyes are changing fast,' Lilith says..
'Do you read a lot? Dr. Liu asks.
'Yes.
'Do you use the computer a lot?
'Yes.
Lilith is an active child who practices taekwondo. But like an increasing
number of children, she has myopia -- she can see close up but not farther
away.
Her mother, Jinnie Sadil, has brought her to the center because she has
heard about a new treatment that could help. Eye specialists are offering
young patients special contact lenses worn overnight that correct vision for
the next day.
Myopia has become something of a minor epidemic: More than 40 percent of
Americans are nearsighted, a 16 percent increase since the 1970s. People
with so-called high myopia -- generally, blurry vision beyond about five
inches -- face an increased likelihood of developing cataracts and glaucoma,
are at higher risk for retinal detachments that can result in blindness.
Exactly what is causing the nationwide rise in nearsightedness is not known.
'It can't be entirely genetic, because genes don't change that fast,' said
Susan Vitale, an epidemiologist at the National Institutes of Health who
studies myopia. 'It's probably something that's environmental, or a
combination of genetic and environmental factors.
Some research indicates that 'near work' -- reading, computer work, playing
video games, and using tablets and smartphones -- is contributing to the
increase. A recent study found that the more educated a person is, the more
likely he or she will be nearsighted.
A number of other studies show that children who spend time outdoors are
less likely to develop high myopia. But no one is certain whether the eye
benefits from ultraviolet light or whether time outside simply means time
away from near work.
Beyond corrective eyeglasses and contact lenses, there has been little
parents can do for nearsighted children. Now optometrists like Dr. Liu are
offering a treatment called orthokeratology -- ortho-k, for short.
Myopia occurs when the eyeball elongates. Ortho-k contact lenses apply
pressure to the cornea, flattening it. After wearing the lenses all night,
patients have clear vision that lasts for one full day, after which the
cornea returns to its natural shape.
The lenses have been around since the 1940s but caught on only recently in
the United States, partly because of long-term clinical trials demonstrating
that they may slow down the progression of myopia. A 2012 randomized
clinical trial in Hong Kong, for instance, followed children for two years
and found that the rate of growth of the eyeball in those wearing ortho-k
lenses was 43 percent less than those who wore glasses.
Ortho-k is not just for children: adults can wear the lenses too, but the
long-term benefits are limited. Because myopia tends not to progress after
patients reach their early 20s, the lenses are not really preventive, Dr.
Liu said.
'The younger the eyeball, the more capable it is of changing shape,' she
said. 'So early intervention is better.
But some clinicians are skeptical of the lenses and worry that the risks may
not be worthwhile.
'The studies do show that it seems to slow the progression, but it's not a
slam dunk,' said Dr. David Hunter, an ophthalmologist at Harvard University
and Boston Children's Hospital. 'Especially in young children, where the
risk of infection is high.
Young patients may not be diligent about cleaning lenses properly and
regularly to prevent bacteria growth, he said. One recent report in the
journal Clinical and Experimental Ophthalmology found that infections from
ortho-k lenses led to corneal scarring and permanent vision loss in four
children in Australia.
Dr. Hunter does not prescribe ortho-k lenses to his patients. As an
alternative, he sometimes prescribes atropine drops, which also have been
shown to slow myopia's progression in children. But there is reason to be
wary of the drops too: They can cause loss of near vision and light
sensitivity, requiring patients to wear sunglasses when outdoors.
Perhaps most important, Dr. Hunter said there was no research that tracked
children long enough to show that either ortho-k lenses or the drops
significantly reduce the severity of myopia by adulthood. Patients who use
the lenses and drops may end up just as myopic as adults who do not, he
said.
'I'm not convinced that it's enough of a difference,' he said. 'And
generally, the idea that you're putting these in to squish the corneas at
night is not something I'm comfortable with.
Dr. Hunter and other clinicians said that the best and easiest step a
concerned parent could take was to reduce children's time in front of
computer, phone and television screens -- and to send them outside to play.
Back in the center, Dr. Liu's assistant does a few tests on Lilith and
determines that her corneas are fairly steep, making her a good candidate
for ortho-k.
Dr. Liu tells Mrs. Sadil it will cost about $1,000 to fit the lenses and
$250 to buy a pair that will last a year. Mrs. Sadil decides to begin in
January.
She wears thick glasses herself. 'I would have done anything to not be so
nearsighted,' she said.. PHOTO: Maria Liu performed tests on Lilith Sadil to
see if she would be a good candidate for ortho-k lenses. (PHOTOGRAPH BY
SINDYA N. BHANOO).
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