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OHSU Casey Eye Institute focuses on nearsightedness

Myopia Management Program offers comprehensive care to treat increasingly common, vision-threatening condition
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Amanda Dieu, O.D., FAAO, FSLS, right, checks the eyes of pediatric patient Melody Redfield, 10, of Albany, Oregon, at the OHSU Casey Eye specialty clinic. The OHSU Casey Eye Institute’s Myopia Management Program provides comprehensive care for nearsightedness, which causes objects in the distance to appear blurry and can lead to serious vision problems if left untreated. Treatment options include dual-focus contact lenses, prescription eyeglasses and low-concentration atropine eye drops. (OHSU/Christine Torres Hicks) 
Amanda Dieu, O.D., FAAO, FSLS, right, checks the eyes of pediatric patient Melody Redfield, 10, of Corvallis, Oregon, at the OHSU Casey Eye specialty clinic. The OHSU Casey Eye Institute’s Myopia Management Program provides comprehensive care for nearsightedness, which causes objects in the distance to appear blurry and can lead to serious vision problems if left untreated. Treatment options include dual-focus contact lenses, prescription eyeglasses and low-concentration atropine eye drops. (OHSU/Christine Torres Hicks) 

A comprehensive program at Oregon Health & Science University’s Casey Eye Institute is helping manage nearsightedness, a vision-threatening condition that is expected to affect about half of the world’s population by 2050.

Nearsightedness, also known as myopia, is when people can see close-up objects clearly, but objects in the distance are blurry. The condition occurs when an eye grows into an oblong shape instead of a sphere. This causes images to focus in front of — instead of precisely on — the retina, light-sensitive tissue in the back of the eye. Spending more time outdoors can help prevent nearsightedness.

Margaret Overstreet, O.D. , smiling (OHSU)
Margaret Overstreet, O.D. (OHSU)

“Nearsightedness is increasing worldwide as people spend more time indoors and in front of screens,” said Margaret Overstreet, O.D., an assistant professor of ophthalmology in the OHSU School of Medicine and a pediatric optometrist at the OHSU Casey Eye Institute. “Not only are kids needing to get glasses sooner, but also people with nearsightedness have a higher risk for developing other eye conditions, such as glaucoma, cataracts and retinal detachment — severe cases of which can cause blindness.”

To help stem the rising tide of nearsightedness, the OHSU Casey Eye Institute last year established its Myopia Management Program. Through the program, Overstreet and other providers help children manage myopia with prescription eye glasses and special contacts or eye drops.

Protect eyesight during screen time

Follow the 20-20-20 rule for screen time:

  • Every 20 minutes
  • Take a 20-second break
  • Look at least 20 feet away

In 2019, the FDA approved dual-focus contact lenses to slow the condition’s progression in kids between the ages of 8 and 12. Some insurance plans don’t cover these special contacts, but a $100,000 commitment from Portland philanthropists Mike and Tracey Clark enables the OHSU Myopia Management Program to provide low-income patients contacts and related care for free.

Pediatric eye providers have long recommended bedtime use of a low-concentration form of eye drops. OHSU is involved in ongoing research to pinpoint the exact concentration that best controls nearsightedness, while also minimizing temporary side effects like light sensitivity and blurry vision.

Managing myopia early

The children of adults with nearsightedness are more likely to develop the condition.

Amanda Dieu, O.D., FAAO, FSLS, smiling
Amanda Dieu, O.D., FAAO, FSLS (OHSU)

“A decade ago, myopia management methods were limited and not as widely used, but research and technology advancements have made many more treatment options available today,” said Amanda Dieu, O.D., FAAO, FSLS, an assistant professor of ophthalmology in the OHSU School of Medicine and an optometrist at the OHSU Casey Eye Institute. “Unfortunately, most of the adult patients I see are not aware that special contact lenses and eye drops can both slow myopia progression and eye growth. I hope that eye care providers and pediatricians can change that.”

Owen Ni holding his name sign at a college event. The OHSU Casey Eye Institute’s Myopia Management Program helps Owen Ni, 13, of Lake Oswego, manage his nearsightedness. Being able to see clearly enables Owen to enjoy both school and summer camps, including the youth program that enabled him to stay at a college residential dormitory. (Courtesy of Jun He)
The OHSU Casey Eye Institute’s Myopia Management Program helps Owen Ni, 13, of Lake Oswego, manage his nearsightedness. Being able to see clearly enables Owen to enjoy both school and summer camps, including the youth program that enabled him to stay at a college residential dormitory. (Courtesy of Jun He)

Jun He of Lake Oswego is one of those parents. Her own mother had poor eyesight, but He didn’t experience a significant decline in her own vision until a few months before her now 13-year-old son, Owen Ni, was born. Knowing nearsightedness can be inherited, she watched for vision changes in her son.

“Owen became nearsighted when he was around 8 years old, and I immediately brought him to the eye doctor,” He said.

The OHSU Casey Eye Institute team initially recommended that Owen use glasses during the day and eye drops at night. Later, Owen swapped glasses for contact lenses. Currently in seventh grade, Owen is now able to play soccer thanks to his well-managed eyesight.

“He knows my story and understands how important it is to wear his contacts and use his eye drops,” He added. “Being able to see clearly helps Owen feel more confident in school and enjoy camps during the summer.”

Nearsightedness can also affect academic success. Children who have uncorrected myopia can fall behind in school because they can’t clearly see things in the front of the classroom.

“To help children receive timely treatment for nearsightedness, I encourage parents to schedule their children for a myopia exam with an ophthalmologist or optometrist,” Dieu said. “Routine eye exams are particularly important when other members of the family have myopia, or when parents notice their children working on assignments closer to their face.”

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