Multifocals for Myopia?

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Multifocals Improve Myopia, According to Study

A study funded by the National Institutes of Health revealed that children wearing multifocal contact lenses to slow myopia progression retain benefits even after ceasing their use as teenagers. This follow-up study to the BLINK trial from 2020, which showed the efficacy of high-add peripheral-focusing multifocal lenses in slowing eye growth, addressed concerns about potential accelerated eye growth post-discontinuation. Findings indicated that upon stopping multifocal lens wear, eye growth returned to age-expected rates, with a slight increase in eye length but no significant deviation from standard growth patterns.

The study had participants wear high-add contact lenses for 2 years, followed by 1 year of single-vision lenses, to assess the effects of treatment discontinuation. Results confirmed that after discontinuing multifocal lens wear, axial eye growth normalized, maintaining the myopia control benefits. Participants who initially wore high-add multifocals retained shorter eye lengths and less myopia than peers who switched to high-add lenses later, suggesting the importance of early intervention.

David A. Berntsen, OD, PhD, emphasized the safety of discontinuing myopia-control lenses without adverse effects on eye growth, and Jeffrey J. Walline, OD, PhD, highlighted the strategic benefit of fitting children with multifocal lenses early and continuing treatment through late adolescence to manage myopia progression. Unlike single-vision options, multifocal lenses not only correct distance vision, but also address the underlying issue of abnormal eye growth. With rising global myopia rates, early intervention is crucial to mitigating vision-threatening complications, such as retinal detachments and glaucoma. (Read more here.)

My Two Cents

This study provides more reason why every optometrist should consider offering myopia management in their clinic. As word makes its way out in the eye care profession about how effective soft lenses are in managing myopia (thanks to industry giants such as Justin Kwan, OD, from CooperVision), our ability to access beneficial technology continues to increase. After reading this study, I immediately forwarded it to many of my coworkers. Our pediatric patients who are at a high risk of myopia progression deserve to know all the options available to them!

OUTSIDE THE LANE

Life in Plastic … It’s Fantastic

A new study in Nature Medicine found that a human brain contains an entire spoon of nanoplastics upon autopsy. Brain samples collected in early 2024 contained more pieces of plastic than samples collected 8 years earlier.

The study found that cadaver brain samples contained seven to 30 times more “tiny shards of plastic” than their kidneys or livers, according to the co-lead study author Matthew Campen, professor of pharmaceutical sciences at the University of New Mexico in Albuquerque. He explained that the concentrations seen in the brain tissue of normal individuals, who had an average age of around 45 or 50 years old, were 4,800 mcg per gram, or 0.48% by weight, which is the equivalent of an entire standard plastic spoon. “Compared to autopsy brain samples from 2016, that’s about 50% higher,” he said.

It's still unknown what these plastics are doing to us, however. According to the article, microplastic particles are like little Trojan horses carrying thousands of chemicals found in plastics. Scientists also believe nanoplastics can interrupt cellular processes and deposit chemicals such as bisphenols, phthalates, flame retardants, heavy metals, and per- and polyfluorinated substances. (Read more here.)

My Two Cents

Please keep any plastic my son could be ingesting far far away. This is wild! I know the jury is out on whether these plastics are causing any damage to the brain; however, it’s scary to think about how much more plastic seems to be accumulating within our bodies. I’ll leave you with a little nugget buried deep within the article: More than half of all plastic ever made has been made since 2002, and production is on track to double by 2040. That’s per pediatrician and biology professor Philip Landrigan, MD, MSc, director of the Program for Global Public Health and the Common Good and the Global Observatory on Planetary Health at Boston College.

CAN YOU RELATE

I’ve never been called a fashion or fitness “trendsetter,” and if you know me, you will likely agree. I’m often behind the times in most categories. I only just discovered Hokas and Lululemon gym shorts. While most people start their fitness journeys on January 1st, I started a new program mid-February. Again, I’m behind most people.

I’ve been trying to get back to the gym for a few years after giving up CrossFit because my schedule didn’t allow it. (Oh, and I was years late getting into CrossFit. I joined when many “boxes” began to close down.)

As I contemplated all my beginnings and endings (and the failures that caused those endings), it became clear to me that it was because I needed someone to motivate me and create a plan for me to implement. I decided to spoil myself and hire an excellent personal trainer.

Although I haven’t even started my sessions with Chase yet, I am excited and motivated to begin. I know he will get me to where I want to be because he has already laid out his plan for me. From nutrition to workout regimens, to the daily expectations he has for me, we are going to work as a team to get me healthy again. Similarly, isn’t that our job as eye doctors? To create a plan for our patients? If they’re in our chair for contact lenses, we explain their prescription, ocular health, and lens options with strong recommendations.

I also have a game plan similar to Chase's for my patients with dry eye and glaucoma. I explain their ocular health, what my plan is, and the expected outcome. I also let them know we have other options if the first plan doesn’t produce the desired results.

I’m excited to kickstart the evolution of my health journey with help from Chase. Can you say the same about your patients’ motivation to improve their ocular health and vision?