Coming to Canada soon? FDA authorizes first eyeglass lenses to slow nearsightedness in children in the US

A growing body of research suggests that when the quality of an image that the eye’s peripheral retina receives is manipulated – such as through a lens – that may slow eye growth, said Dr. Jeff Walline, professor of optometry at The Ohio State University.

In children with myopia, the eye grows too long, and this causes the image projected on the retina to be poorly focused when they look at a distance. The retina is a layer of tissue at the back of the eyeball that converts images into nerve signals that are sent to the brain, and the peripheral retina is the outer portion, which gives us side vision.

The idea is that “the whole retina regulates eye growth, but we need to provide the central retina with clear vision, so we put the signals to slow eye growth in the peripheral retina,” said Walline, who was not involved in the development of the newly authorized eyeglass lens.

However, some questions remain. “What exactly about that signal that the eye is specifically paying attention to, that results in the slowing of growth, that’s the part that we’re still trying to better understand,” said Berntsen, who has collaborated with Walline on various studies.

The exact aspects of a visual image that the retina processes to regulate eye growth remain complex and elusive, Berntsen said, but with better understanding can come better treatments.

“It’s really an important area of research because it affects so many people: 1 out of 3 people in the United States is nearsighted,” Walline said.

“When those people become adults, there’s a greater risk of sight-threatening complications,” he added. “We’ve got to do what we can when they are children, when myopia is developing, to try and reduce those risks far later in life.”

Myopia can cause “changes in the eye that lead to an increased risk for comorbidities down the line,” Berntsen said. “It is a disease. It’s important that we view it as that.”

Some of the complications that may come with age include an increased risk of glaucoma, which damages the optic nerve, and myopic maculopathy, or loss of central vision. There is also a higher risk of retinal detachment, in which the retina detaches from the back of the eye. All of those complications can lead to permanent vision loss, even with glasses or contact lenses.

In the future, simple eyedrops could be used to delay the onset of nearsightedness in children, which in turn can reduce those risks, Walline said.

The next frontier in nearsightedness

Walline, Berntsen and their colleagues have received $25 million in grants from the US National Institutes of Health to test whether daily drops of atropine could be effective as a way to delay the onset of myopia in children ages 6 to 11, before they even start to experience vision problems. Atropine is a drug sometimes used to dilate pupils during eye exams, and it works by relaxing muscles in the eye.

“We’re trying to delay the onset of myopia, because the later in life that you become myopic, the less myopic you are as an adult, and the less risk you have of those sight-threatening complications,” Walline said.

“It’s the first time in the United States that we’re looking at trying to treat children before they become nearsighted. We’ve always waited until after,” he said of the eye drops. “This is the new next great thing, because not only can we delay the onset, but literally, the moment they become nearsighted, they’ll already have a treatment to slow the progression of nearsightedness.”

When a child first becomes nearsighted is when their vision is changing the fastest and their eye is growing most rapidly, Berntsen said, and that would be the optimal moment to slow progression if possible.

“We know from longitudinal studies that a child’s myopia is progressing the fastest when you first see that they become nearsighted, so treat now,” he said.

Walline said that by routinely measuring a child’s vision, doctors can identify who may be approaching nearsightedness and therefore who may benefit from the eye drop treatment.

“We just measure their prescription, and when they’re close to that myopia cliff, they then have a 90% chance of becoming nearsighted by eighth grade,” Walline said.

“So we can do a good job of predicting who will become nearsighted, and then we’ll give the treatment to only them,” he said. “Hopefully we can have a bigger effect than we’ve had just by treating it after onset.”

Berntsen said that most often, children don’t even notice or realize that they may be experiencing vision changes and may be nearsighted, but that moment is the most critical for administering treatment.

“It’s a gradual change in vision. In fact, most kids don’t realize that they’re not seeing well, they just think, ‘Oh, this is how everybody sees.’ And it’s usually a vision screening where it is first noted that there is a problem,” Berntsen said.

The eyedrops could serve as another option for those children.

“It’s very helpful to have options, because there are kids who won’t want to wear glasses. There are kids that want contact lenses, and there’s some that don’t want to touch a contact lens. There’s some that don’t want any of the above, and that’s sometimes where the eye drops come in – if a kid won’t wear their glasses or contacts, even though it makes them see better,” Berntsen said. “That’s where having a range of things is really helpful from a treatment and management standpoint.”

For more CNN news and newsletters create an account at CNN.com