Many of my patients come to me and say, “I need 1 more click.”  Implying they can tell their eyes aren’t working and a “click” makes it better.

What my patients don’t know is that I am highly myopic (my eye is too long to focus.)  This means when I remove my glasses all I see is colors melted together making indistinguishable shapes.  I’m from the generation of “one more click” and my doctor gave it to me almost quarterly. 

A terrifying mountain experience, alone, with my barking dog at night in my myopic blur quickly had me headed to my favorite LASIK surgeon years ago.  What followed made me re-think “one more click” as a doctor.  Unable to safely complete my surgery, I lived 6 months with migraines due to unequal vision.  Two surgeons later, I was able to work again.  

This experience is why co-managing with trusted and experienced LASIK Surgeons and specialists is highly important to me.  It is also why I do a detailed evaluation and discuss all treatments including referrals with you in detail. 

My patients understand, I take my “clicks” seriously. There is science behind a “click.”  A “click” is not the only treatment, and frequently not the best treatment.  Treatment may vary from medication, lifestyle changes, prism, or a referral to another specialist.  Multiple changes in power is NOT “normal” and should be monitored.

Myopia progression is one such time.  In young children giving false power can leave them legally blind with risk of retinal detachment and retinal tears.  The eye has multiple layers and multiple causes for visual changes that do not need a change in lens power.

Slowing down Myopia

1.  I encourage two hours of outdoor play.  We are learning more about light stimulating our eye and brain and outdoor play may decrease myopia progression.  Wolffsohn JS, Calossi A, Cho P, et al Global Trends in Myopia Management Attitudes and Strategies in Clinical Practice. Cont Lens Anterior Eye. 2016;39’106-16

2.     Decrease digital device use and shut down 2 hours before bedtime. Our behaviors may play a bigger role than our genetics.  Holden, Brien A., et al Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. AAOJournal. 2016;123’1036-1042

3.  I have been using multifocal contacts with my patients for many years now with great success.  Recently the FDA approved MiSight for the treatment of myopia.4.     Drops are an additional option, and according to Jaclyn Garlich, OD and founder of 20/20 Glance, Micropine, a drop by Eyenovia is seeking FDA approval for the first microdosed treatment.