Myopia Control for Children in Singapore

Myopia control is treatment that aims to slow how fast a child’s short-sightedness increases, rather than only correcting it with stronger glasses each year. The three options are low-dose atropine eye drops, myopia-control spectacle lenses, and ortho-K or myopia-control contact lenses. Each can slow progression, though none stops it.

Because the prescription is not the whole story. As short-sightedness increases the eye grows longer, and a longer, more myopic eye carries a higher lifetime risk of conditions affecting the retina. Ending up with a lower prescription is the point, not wearing thinner glasses.

One drop in each eye at bedtime. Atropine is an old eye medicine used at a far weaker concentration for this, and at that strength it does not usually blur near vision or make eyes light-sensitive the way the full-strength drops used for examinations do. It has been studied in children from the age of four.

They look like ordinary glasses and are worn the same way. The centre of the lens corrects the prescription for clear vision, and the area around it is made differently, which changes how light focuses in front of the retina. Your child does not have to do anything differently for them to work.

Orthokeratology, or ortho-K, is a rigid contact lens worn overnight and taken out in the morning. It reshapes the front surface of the eye while your child sleeps, so they see clearly during the day without glasses, and it also slows progression. It needs a child who can handle lenses and keep them scrupulously clean, and the fit is checked regularly.

There is no single answer, and it is chosen rather than ranked. It depends on your child’s age, their current prescription, how fast it is changing, whether they can manage a contact lens, and what the family can keep to every day. The one that works is the one actually used as directed. It is decided at the consultation and can be changed later.

There is no fixed starting age. It is usually begun once a child’s short-sightedness is found to be increasing, often in the early primary school years, and low-dose atropine has been studied in children from four.

Usually once the prescription has stayed stable for some time, often in the mid to late teens, as short-sightedness slows when growth ends. It is decided at a check-up rather than by age alone, because stopping too early can let the increase start again.

They can be used together in some children, for example drops alongside a lens. Whether that applies is a clinical decision made at the consultation and at the reviews that follow.

No. It aims to slow the increase. The prescription your child already has does not go away, which is also why starting earlier in the progression matters more than starting at a particular age.

Time outdoors is associated with less myopia developing in children, so it is worth encouraging, alongside breaks from close work. It is not a substitute for treatment in a child whose prescription is already increasing.

By repeating the measurements and comparing them: the prescription, and the length of the eye, which is what actually changes as myopia increases. Our myopia screening at The Straits Eye Community Clinic includes both, at $95.92 nett.

The treatment itself depends on which option is used, because drops, spectacle lenses and contact lenses are priced differently and are repeat purchases, so it is quoted at the consultation. A first consultation with Dr Audrey Pang is $174.40 nett at our Camden and Parkway East clinics, and the myopia screening at The Straits Eye Community Clinic is $95.92 nett.

Dr Audrey Pang, Senior Consultant Eye Surgeon, whose subspecialty is paediatric ophthalmology and strabismus, at Camden and Parkway East. At our community clinics, Dr Brendan Chin, Primary Eye Care Physician, also sees children for myopia control — it is one of his clinical interests.