Faye at 400 Degrees! The Lowdown on Ortho-K, Myopia Spectacle Lens and Atropine

Faye's myopia was caught in July 2021. When we found out, she was already harbouring bad eyesight at 200 and 225 on her right and left eye respectively. [Read: Faye has myopia and we found out late] It came as a shock because she did not complain about blurry images or her inability to read the white board at school. It was also a heartache to learn that her degree was so high. 

Six months later, we received a collaboration opportunity to put Faye on an Orthokeratology programme. Short for Ortho-K, it is a contact lens technology that flattens the cornea while the patient is asleep allowing clear vision in the day. It is a hard lens to be worn overnight and I obviously had my concerns. I decided to bring Faye in for an eye-check and spoke to the optometrist to learn more about it. 

To my horror, her degree jumped quite significantly to 250 and 350 on her right and left respectively! A myopia intervention is crucial to maintain her eyesight! That is when I jumped into the research of Ortho-K, Myopia Spectacle Lenses and Atropine. 

She is seven years old!

We decided to make an appointment for the kids at Eye and Retina Surgeons to see Dr Elaine Chee. 

Allow me to give you some context on our decision. My husband has Coats disease, a rare eye disorder involving abnormal development of blood vessels in the retina which costed one of his eye. He was concerned if it could have been genetic and our children could be victims of Coats. Since he is a patient of Dr Ang Being Chong at Eye and Retina Surgeons since two years old, we decided to go back to the same clinic for consultation with an eye specialist. 

COATS DISEASE

It was very assuring to hear from Dr Elaine Chee that Coats is not genetic. That said, we agreed that we should check both Ewan and Faye for healthy eyes and eliminate all doubts that they may carry the same disease as daddy. 

The children had their eyes checked extensively with the regular Eye Chart Test, Computerised Test, 3D Tests and even a dilation procedure to check the back of their retinas. 

Faye's results at the clinic was worst than the one done at the spectacle shop. Remember her results was 250 and 350? It is now confirmed, at the clinic, that she is a 350R and 400L! 

That is an unbelievable jump of 200 degrees from six months ago! Dr Elaine was as concerned as us about her increment since Ewan and Faye share the same reading habits. For a basic, they read at every meal. We talked about their screen time usage and theirs are considered low with an hour usage a day at max [well, not when they had HBL of course]. 

Sigh... proof that no two children are the same. She is genetically more inclined to bad eyesight than Ewan.

ORTHO-K

Here is what I've learnt about Ortho-K from the optometrist at the spectacle shop and from Dr Elaine.  

Is there a possibility the lens might break if she rubs her eyes?

Optometrist: Yes. There is. If she sleeps face down or gets a little rough with her actions during sleep she may shift the lens and it might break too.  

That sounds dangerous! Wouldn't it tear her cornea? I am not sure if I'm able to accept any accidents that may occur.

Optometrist: We haven't heard of any cases yet but usually when it breaks, it doesn't shatter but more likely breaking into two. 

What is her responsibility if she does take this up?

Optometrist: She will have to be diligent in caring for her lenses, washing and keeping them properly day and night. 

I am not sure if she is mature enough for this. She is 7 going on 8. To be honest, I don't see her being able to responsibility clean her lenses diligently.

Optometrist: We have patients as young as 8 and we haven't heard any issues just yet. But of course it is up to her and her comfortability. She has to want to do this and we shouldn't force this upon the child. 

How effective is Ortho-K technology?

Dr Elaine: Very high! 90% in fact!

Is there a chance of infection?

Dr Elaine: Yes, I had to treat bad infection cases from the usage of Ortho-K. 

We dropped the idea to have Faye on the Ortho-K treatment because she was not ready. I showed her the contact lens and asked if she wanted to give it a go. She plucked up some courage to say yes but started to tear when we wanted to try it on for her. As long as she is not ready, I shall not force my opinions on her. Her comfortability is of utmost importance. 

Actually, I think I am not ready for her to do this either. The idea of having something foreign in her eye for a prolonged period of time i.e. overnight, sounds rather uneasy to me. I am concerned about eye infection which would cause long-term damage given her age. 

MYOPIA SPECTACLE LENS

I was introduced to the idea of a myopia-control spectacle lens which HOYA is promoting. It is called MiyoSmart. It sounds wonderful since it controls the deterioration of myopia. No contact lenses will be placed onto the naked eye because it sits on the spectacle frame like a regular lens! 

The downside is the cost. $500 for just a pair of lens! Although the pinch is real, I was ready to put this money down and have her spectacles upgraded to a MiyoSmart lens. 

A quick check with Dr Elaine and I changed my mind [again]. 

What do you think of myopia spectacle smart lenses in the market?

Dr Elaine: Firstly, they are very expensive. You have to take note that although you may be able to afford the first lens, Faye's degree may increase and you will have to change it again to suit her current degree. That is another S$500. Besides, studies have shown only 50% - 60% effectiveness. It is low compared to Ortho-K and Atropine which is 90% effective. 

Decision made. No myopia-control spectacle lens until her degree sort of stabilises.

ATROPINE

Yes, I have heard of Atropine eye drops and as much as I am reluctant to start Faye on it because it is after all, a drug, we have begun this programme on her. It has been in the market for a long time and if Dr Elaine's children are on it, I trust my child will be in safe hands with Atropine. 

It is actually a medication to treat the symptoms of low heart rate and for dilation of the eye pupils before an eye examination. Research has shown that with appropriate amount of Atropine, it can also slow down the rate of myopia. 

We are required to put a drop in each of Faye's eye every night to relax her eye muscles. The effects of this relaxation will last not only for the night while she sleeps but also in the day when she wakes. Her sight will be slightly blurred and sunlight could become extra glaring for some children. 

While one set of spectacles had been sent in for degree correction with normal blue-light lens, I am considering to change the lens of her second pair of glasses to a transition lens to help her combat the sun glares in the day. 

A bottle of Atropine costs about $12 and is meant for a month's usage. 

We will also be eye-dropping ASEA in the day for her [if you know what it is, you will know its claims and benefits]. 

LENSKART

We are back at Lenskart to adjust the kids lens. Remember to check your kids every 6 months! I had totally forgotten that the kids are still under Lenskart's Gold Member one-year warranty, which meant they get to change their lenses for free this time round! 

CHANGING EYE HABITS

How to ensure the increase of myopia doesn't escalate too much with proper eye care? Here are some of our recommendations!

1. Use Reading Light: I only started reading light when I first found out about Faye's myopia six months ago. I didn't think it was necessary since we always read in the day and never lying down on a bed. I guess daylight wasn't good enough. Nor were the lights overhead sufficient to keep their eye muscles from straining. Stress on the eye muscles is the start of myopia. Reading lights are very expensive and that is why I had been procrastinating for years. I hope to turn the lessons I've learnt to save your children from bad eyesight. So do take heed! 

We use 3M P1709 [please purchase only from 3M directly or official distributers]. It protects eyes from strain with up to 80% glare reduction. This light has 7-level brightness control from cool white to warm white and has a sand for smartphone charging too!

2. Take Breaks: Whenever the children do their homework, break time was either cartoon time or reading time. It was a mistake we made and did not realise how it added to the strain in their eyes. We only thought how important it is to take regular breaks from studying but did not know how to do it better. You see, after 30 minutes of eyes on assessment books, it is important that their eyes should take a break by engaging in far "work" instead of another "near" work activity. "Near" work includes reading storybooks and watching TV right? So in the end, the kids did not take any eye breaks at all! In fact, they have been using their eyes for "near" work for hours! Plan your children's breaks properly.

3. More Outdoor Play: Until COVID-19 happened, we used to spend most of our time outdoors exploring the island. This activity had been cut because it is such a hassle to mask-wear wherever we go. We need to bring this back in a safe manner to help our children slow down the deterioration of their eyesights.  

I cannot stress enough how important it is to have your children's eyes checked since HBP no longer offers free eye checks in school. It is now parents' responsibility to ensure our children's eye health are being taken care of. 

Please do not try to delay these eye check-ups in fear to learn the truth. Sometimes, it is a necessity and it doesn't make our children any less than who they already are. It actually helps them see life with better clarity and their world could be a more beautiful place to live in. 

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