Ortho-K contact lenses for 7YO DD

[EssCee]

I'm really worried about DD's change in vision over the past 6 months. So, just trying to investigate all the options available - including Ortho-K lenses.

In November 2018, it was a surprise to find out that she needed glasses (prescription: -0.5, -1.5) for the whiteboard/TV, etc. But, she was happy enough to wear them.

6 months later, her prescription has changed to -2.5 in both eyes.

She has her new glasses, but she's not happy with wearing them all the time, and they do make her look a little different. I'm worried that it'll affect her confidence - this morning, she didn't want to get out of bed for school and she looked sad when looking in the mirror. Both very out of character and really so sad for me to see.

Both DH and I are both quite badly short-sighted, so there's a big genetic component.

Does anyone know much about ortho-K lenses as a way to slow down the progression of myopia? And how effective they are in replacing glasses? Have you tried them for your own DC?

Thank you in advance.

My daughter started with ortho-k lens when she was nearly 10. Like you we were worried about the rate of decline in her prescription - from -0.5 to -2.5 in 1 year - basically a new pair of glasses every 4 months!

It took her months to get used to putting them in and we stopped for a few months as she was finding it so traumatic. Then she just decided to try again and now pops them in in a couple of seconds and wakes up with perfect vision.

You need a really good optician who has experience of them - if you're near SW London I'll give you details of ours as they've been amazing with her. I think they've had kids from 8 years old but possibly younger.

It's £50 a month but honestly so worth it. Our opticians is now seeing kids who've worn them for years and are stopping as there's no real need to continue past age 16 apparently - prescriptions don't change so much by then.

Pm me for details if you want.

Hi @ElleEmDee that sounds really positive. The negatives sound like a faff, but definitely worthwhile.

@mateysmum - Thank you VERY much for this. Did it take long for your DC to get used to the discomfort of the hard lenses?

Hi @deedar - Thank you so much - that rate of decline sounds just like my daughter’s. It's reassuring to read your experience and I'm thinking that it does sound like a good option.

I've just spoken with a local independant optician that offers Ortho-K and Misight lenses - anyone have any experience of Misight? They're myopia control soft lenses.

It didn't take long for DS to get used to the discomfort as it just feels a bit funny for the short time between putting them in and going to sleep. It's partly about knowing that's how they are meant to feel. DS still says he can "feel" them and won't wear them for long after getting up. They are not the same as normal hard lenses which is what I wear all day every day. It might take a little while for a 7 year old to get used ti inserting them.
I do agree with ElleEmDee that the only small downside is that if you can't wear them for a day or two you can be a bit stuck as you can't just have a pair of glasses there as your prescription will drift over a couple of days. DS has a really old pair, but he's never actually had to use them - partly because his eyes have not deteriorated as much as they otherwise would have. This also means that if in the future he wants to consider laser eye surgery, this is likely to be more effective as his myopia will be less.
DS has had no eye health problems and as he is checked so frequently if there were any issues I'm confident they would be picked up quickly.

Sorry, never heard of Misight. sounds like they are daytime lenses.

Hi OP. I too am very short sighted, my 'good eye' is -11.5, my 'bad eye' is -15. I too have got progressively worse over the years, my 'bad eye' was always rubbish but sadly my 'good eye' seems to be catching up. I've worn glasses from age 4, from when I was 8 I wore a soft contact lens in my bad eye along with glasses to give me the best vision in both eyes (I got double vision whilst wearing glasses with the full prescrisption for my bad eye). At age 17 I was prescribed gas permeable lenses, which I have worn since. They are much more practical than glasses, although not what I would describe as comfortable. They didn't stop my prescription from getting worse, although my contact lens prescription has not changed for the last 4 years now which I can only put down to me taking lutein every day... could your daughter try a lutein supplement, her Dr or optician would probably be able to suggest an age appropriate dose for her? Tbh, I wish I'd got the gas permeables and went on lutein at 8, it may have helped my vision to deterioriate less.

OP I have quite high myopia and think it’s great you are looking into this, my vision just got worse and worse throughout my teenage years and now as an adult I worry a lot about retinal detachment, I’ve been told not to go on rollercoasters and things which whilst not a major trauma, is a bit rubbish as a young adult. Even without changing any behaviour it is something I worry about day to day. I’d absolutely do the same for my child in your shoes.

Following with interest will post my experience later am out at the moment

Paediatric nurse here. I've looked after several teenagers, who have nearly lost their eyesight because they didn't look after their contact lenses properly. 7 is far to young for lenses. And also to be worrying about their appearance.

I know it seems really young @Toddlerteaplease - but it's the rate of progression of myopia that I'm really worried about. If she stayed at -2.5, I don't think I'd be too bothered at all, but that's not going to happen.

Eye infections are obviously concerning though, so you're right to point it out.

@munchbunch12 - Fingers crossed your eyes have become stable now. Mine too, they went through years of just seemingly getting worse every year or so. It's not nice (understatement), and I'd like to avoid this for my daughter, if possible. I don’t know about lutein. Did your doctor or optician recommend this to you?

@ stayhomeclub I try not to thinking about things like retinal detachment! The optician that I spoke to today said that if I can keep her prescription below -4 then it would increase her chances of ocular health in the future.

My brother is an optical technician at a very prestigious practice and wears the ortho overnight lenses himself. He loves them and feels they have made such a difference. He’s an adult, but as part of his job he teaches young children to wear and look after contact lenses. I’m pretty sure he told me he was able to teach a 7y/o to use them. Hygiene is obviously very important as I’m sure you’re aware. I understand what you mean that it’s not just an alternative to glasses, it’s about actually correcting vision.

Paediatric nurse here. I've looked after several teenagers, who have nearly lost their eyesight because they didn't look after their contact lenses properly. 7 is far to young for lenses. And also to be worrying about their appearance.
With respect you’re a paediatric nurse, not an paediatric ophthalmologist or an optometrist so your area of expertise and advice isn’t based on any clinical experience other than a few teenagers who weren’t responsible enough to look after their lenses.
7 is young but it’s actually an ideal age to start myopia control, considering that a myopic eye is at more risk of significant pathology including retinal detachment, glaucoma and maculopathy it’s something that needs to be looked into seriously.
Contact lenses do increase the risk of infection and require a degree of maturity in handling and caring for but if I had a child who was in a similar position i’d be looking into ways to manage it.
Find yourself a good optometrist OP, ortho-k will be relatively more expensive as the chair time involved is more, Boots are launching Mi-sight at the moment although you can probably get them from any good optometrist.

@EssCee regarding lutein, I think I first read an article about it in a magazine, then asked my optician (who said he and his dw both take it), and then it was mentioned on 'Trust me I'm a Dr'. Michael Moseley is normally sceptical of food supplements/vitamins but iirc he thought lutein was worth taking. It may be your daughter can get it from her diet if she eats a lot of leafy green veg. Sorry I don't know how to attach a link, but this tells you a bit more about it www.bbc.co.uk/programmes/articles/1f4vsRpHghwGWZcSvRN72xM/can-i-improve-my-eyesight
The only thing that's changed for me in the last 4 years is I've been taking a lutein supplement, up to then my prescription was getting stronger each year, or at best every 2 years, so I put it down to the lutein...

I tried hard lenses once. Never again! The pain...

@mari50 The independent optician I spoke to this morning mentioned about Mi-sight, and potentially trying her on those first as they’re easier to get on with (and less likely to frighten her off the whole thing), although she does swim so that’s my concern as they’re soft lenses. Are you an optometrist or someone with experience of these lenses, and know about Mi-sight versus Ortho-k?

I've been wearing Ortho-K for about 5 or 6 years now, for me they're brilliant. I was having problems with daily disposables getting dry and hated the faff of needing prescription sunglasses etc when I wore my specs.

The big advantage is that once they've settled down (takes a few days where the vision deteriorates a bit towards the end of the day) I pop them in at night, take them out in the morning and have crystal clear vision all day. They also mean no worrying about swimming etc. My lenses have really 'taken' now over the years so I can skip a night from time to time with no deterioration in my sight (eg overnight flight, if I'm totally knackered and can't deal with the faff or I put a lens in and it doesn't feel quite right).

The big risk is that you have to be scrupulous with lens cleaning, hygiene etc. A lot of the risks of contacts are reduced as you have them in for a lot less time each day etc however you do have to clean them properly and take good care of them. The other downside is that if you you can't wear them for a few days then your vision will deteriorate and it isn't as easy as going back to your glasses. Once you have them you are pretty much committed to them as a routine for the foreseeable future.

I'm not sure how it would work with a 7 year old. I would imagine you would have to supervise cleaning every morning to make make sure they are being treated properly.

You mention you and your dh are short sighted - what kind of glasses behaviour do you model for your dd. Do you wear them all the time and/or are positive about them when you have them on. When DS needed glasses DH took to wearing his a bit more rather than lenses and reigned in the moaning about his glasses (he got a new pair which he is happy to wear - he hated his old ones). DS now 14 happily wears either lenses or glasses and doesn't mind either.

Hello,
I’m an optometrist and used to fit ortho-k in my previous position. It’s about £250 for initial fit and approx £45 per month thereafter. You wear them solely overnight so great for sports, swimming etc. Ortho-k only works for prescriptions up to -6.00 so if you decide to do ortho-k later it may be too late if the prescription has already progressed past that. If -2.50 at age 7 then it’s likely your DC is going to end up with a pretty chunky Prescription.

Compared to MiSight ortho-k has the best results in terms of slowing progression of myopia in research.

Comfort wise MiSight will be more comfortable but ortho-k are only uncomfortable for the first week or so, eventually your eyelids get used to them (just ask long term rgp wearers). Also rgps aren’t uncomfortable if you close your eyes when wearing them, and that’s when you’re wearing them - in your sleep! Ortho-k lenses can be worn during the day like a normal rgp lens if DC forgets to put them in the night before.

As to 7 years being too young, there’s no age limit on contact lenses, and ortho-k is designed to slow myopic progression which happens in childhood and particularly the teens. Believe it or not, children actually tend to be our most compliant patients when it comes to contact lenses. Children are used to following set rules and routines even if they don’t fully understand them. It’s the adults who always push their luck! And with parents checking on them, hygiene is generally very good with our child patients. Ortho k is only worn overnight so approx 8 hours a day whereas a soft lens like MiSight will be in the eye all day approximately 12-14 hours of the child tries to avoid wearing specs. Less wear time = more oxygen to the cornea = better for the eye.

Basically, if my child had that prescription at that age, I would ortho-k.

Thanks @RockNRollNerd, great to hear your experience. My DH wears his glasses more than me - he spent a lot of money on them. I'm less keen on mine and only tend to wear them at the end of each day (but definitely don't moan about them in front of DD).

I would also start with the ortho-k, you can always try the MiSight if she doesn't get on with the ortho-k.

Thanks SO much @Smiling89 - really good to read your thoughts about Mi-sight versus Ortho-K. Do you have any links that I can read up on, please?

And, yes, understanding that she’s -2.5 at aged 7 is the reason why I’m worried about how her vision is going to be in the future. How common is this prescription for 7 YOs? And do most parents worry about that?? I feel like my worrying has gone through the roof on this.

-2.50 at her age is not that common, most myopes don’t really start going short-sighted until 8 or 9. So -2.50 at 7 isn’t a good indicator. Even being -1.00 increases the risk of retinal detachments, tears, myopic degeneration, glaucoma.... there’s a long list, all conditions that aren’t easily fixed. The higher your prescription the higher the risk of these conditions. It’s not just ‘having to wear glasses’ - it’s a health concern too. Then there’s the cost of thinner lenses, restrictions in terms of which frames you can wear to reduce thickness/weight etc, the fitting of frames (the tiniest error in measurements and you can’t see through them as you should).

I’ve probably got a few research papers/articles somewhere, I’ll have a rummage...

Using one myopia calculator produced from research, then it’s estimated at age 17 your DD could be -6.00 approx if just specs. With ortho-k or misight then approx -4.25/-4.50 at age 17. Fairly similar results between ortho-k and misight, in this study, which compared just these two methods. That’s just the closest study I have to hand, there’s more with varying results.