Ask the Expert with Dr. Thanh Mai, OD – Part Two


Our new expert Q&A series invites you to sit in on conversations with myopia experts who are sharing their insights to help parents like you make the best decisions for their kids’ vision health.

Today, we’re talking about myopia control with Dr. Thanh Mai, an Optometrist at Insight Vision Center Optometry in Southern California. If you missed part one of our conversation with Dr. Mai, you can read it here.

In this conversation, Dr. Mai explains when to think about myopia control for kids, he discusses treatment options, and provides tips for what you can do to help with your child’s myopia at home.

What do you want parents to know about myopia?

I think parents should know that an ounce of prevention is worth a pound of cure. So simply just correcting blurry vision with a pair of glasses in today’s day and age, knowing what we know about the condition of myopia, is no longer enough. Because we know kids, once they are myopic, they just get worse.

I would also want parents to know that the number of kids who need glasses today, especially after COVID, has gone up dramatically. We’re thinking it might double than just in the last 20, 30 years from when parents were growing a up. So, it’s become a big problem. I want parents to understand that it’s a big problem, but by finding out if there is a problem with their child first, and preventing from getting worse, that ounce of prevention is worth a pound of cure.

Take home points

  • Kids, once they are myopic, are likely to get worse over time.
  • Glasses are not enough to slow down myopia.
  • Parents should find out if their child has myopia first and then work to prevent it from getting worse.

When should parents start to think about myopia control for their child?

Nature is the best eye doctor, something about being outdoors, playing with three-dimensional objects, not looking at screens—that can actually stop myopia in the first place.1 So even if your child is less than one year old, I would plan a myopia control plan where you just spend more time outside. For instance, make that part of your daily routine where, you know, you should be outside for the sake of your children’s eyesight.

Take home points

  • Spend more time outside for the sake of your children’s eyesight.

What are the different treatment options for myopia control and children?

Right now, the biggest ones, the most widespread, are optical treatments and eyedrops. It’s the primary way of controlling myopia right now with pharmaceutical drugs. [Topical eye drops are being studied to treat myopia, but are not FDA approved for this use.] The other optical treatments involve special contact lenses. Some you wear during the daytime, some you even sleep with at nighttime called orthokeratology. And we’re even making special glasses with special optics that can also control myopia.

Take home points

  • There are different myopia treatment options.
  • Your eye doctor can help you select what’s best for your child.

Will these myopia management options be uncomfortable for my child?

No, absolutely not. And we have kids as young as even my own son. He’s six-years old. So, I practice what I preach. I do it on my own kids, my nephews and nieces, and any little one I know that has myopia.

Take home points

  • Based on Dr. Mai’s experience, myopia control treatment options are well tolerated.

How should I expect my child’s vision to change during myopia management?

The goal is not to change your vision. It’s just to slow it down or stop it from getting worse. That’s the goal. And in most of the cases, when I talk to parents about it, I say, if they can see better with this treatment, that’s just the side benefit. By doing special contacts lenses, like the soft multifocal lenses or the overnight lenses, that can also correct vision as well. But for children, the main reason why we do that is to prevent them from getting worse during that critical period of time when their eyes are still growing.

Take home points

  • The goal is to treat the eyes from getting worse during the critical time when kids’ eyes are still growing.

What are some of the hurdles you’ve seen with your young patients who are going through myopia treatment?

For some of these young kids it’s new, just like anything, any child, I’ve got two young kids. And when you’re introducing something new, they’re just a little bit scared because they’re not sure, maybe they aren’t given control of the situation for instance. So, at the office, we’re very easy. We let the kids actually be in charge more than the parents because we know if we let the kids be in charge, then they’ll actually follow through and the success rate is much higher. So, we try to always empower them by explaining the reasons why and ask them if they’re on board.

Take home points

  • Empower kids by explaining the reasons why and ask them if they’re on board.

How long does myopia treatment take?

With myopia management, the good news is that once you become an adult, usually in your twenties, you should not be progressing very much in terms of your myopia. With or without intervention, it should be fairly stable. Some people still progress, but for the most part you’re fairly stable. So, it doesn’t have to be for a lifetime. I would definitely start the moment you find out that your child has myopia. And you should consult your eye doctor to get regular eye exams to check for that. That’s also measuring something we call axial length, which is the length of eye eyeball. But usually again, treatment’s not for life, just until their twenties. As far as how long it takes, every treatment is different.

Take home points

  • Myopia treatment doesn’t have to be for a lifetime.
  • Start the moment you find out your child has myopia.
  • Get your child regular eye exams to check for myopia.

What can you do as a parent at home to help with myopia?

As a parent, the first thing you can do is more outdoor activity.2 Especially if your child doesn’t have myopia yet, because the best thing you can do is prevent it. So that we don’t have to have this conversation. But I understand that myopia is happening, and it’s going in epidemic proportions. When it does happen, I would see a doctor, and I would just have them measure a few things. Of course, check the prescription for glasses. That’s typically done—check how the vision is on an eye chart. We call it visual acuity. But also make sure the doctor is measuring something we call axial length. How long are my kids’ eyes? And that’s the biggest indicator of how we treat and monitor the progression of myopia, how long the eyeball is.

Take home points

  • Encourage more outdoor activity.
  • Have an eye doctor look at:
    • Prescription for glasses
    • Axial length, the length of the eyeball

Is there anything else you want parents to know about myopia?

I want everyone to know a few things:

  1. If a child has myopia, it, unfortunately, gets worse.
  2. Myopia is a big problem for these little kids. More and more kids have myopia today than ever before in the history of humanity. And unfortunately, it’s only getting worse. And COVID has made it even worse than before. And then before it was already getting bad based off of our addiction to digital devices and shortage of lack of outdoor activity. So, it’s just thrown gasoline on to the fire.
  3. If kids do develop myopia, I want every parent to know that so much more can be done than just simple vision correction. Very simple options. Patients love it. Very easy to implement and it’s a win-win for the parent and their children.

In part one of our conversation with Dr. Mai, he explains why children develop myopia, he talks about why glasses are not enough, and focuses in on why we want to slow down eye growth in kids with myopia. Part one is very helpful if you just learned your child may be nearsighted (has myopia).

Read Part OneRead Part One Arrow

Tags: myopia, myopia management specialty, optometrist

  1. Wu, Pei-Chang, Ophthalmology, 2013, 120;1080-1085
  2. Wu, Pei-Chang, Ophthalmology, 2013, 120;1080-1085