How young can we start management? How long do I have to continue management for?
At this time, management options are most often prescribed when myopia (near-sightedness) first presents. Myopia tends to progress fastest when children are young while their bodies are growing quickly, and then will slowly plateau over time. Starting management as soon as possible once myopia has presented gives the best opportunity for a larger, cumulative effect over the years of progression.
A management option could be initiated at any age, as long as it is appropriate for that specific child’s age, maturity and individual circumstances.
Time outdoors, reduced near work and a greater working distance while doing near work have all been shown to help delay the onset of myopia. In children that have strong risk factors, such as family history or ethnicity, of one day becoming myopic, it is very important that these lifestyle modifications be recommended with the goal of delaying the onset of myopia as much as possible.
As mentioned, children will progress the fastest at younger ages and one of the best predictors of becoming a high myope is an early onset of myopia.
There have been limited studies done looking at treating children that are hyperopic (far-sighted) with low dose atropine. This was effective in delaying the onset of myopia, but this is not a widely embraced management at this time in a clinical setting.