Treehouse Eyes partners with KABOOM!

Updated December 28, 2020

Treehouse Eyes is excited to announce a new partnership with KABOOM! – a national nonprofit that works to achieve playspace equity for kids. As an organization whose mission centers around getting kids active and outdoors, KABOOM!’s mission is a great fit for Treehouse Eyes.

Teaming up with local communities, KABOOM! builds incredible playspaces that help give every kid the opportunity to thrive. Those who don’t have access to play miss out on a rich childhood and are denied critical opportunities to build physical, social, and emotional health.

As part of our partnership with KABOOM!, a $50 dollar donation from Treehouse Eyes will be made in the name of each parent who writes a review regarding their myopia management experience in our Tysons Corner, VA, and Bethesda, MD locations through December 31, 2020.

If your child is a Treehouse Eyes patient and you would like to leave a review and have a $50 donation made in your name, contact our Tyson’s Corner, VA or Bethesda, MD corporate centers by clicking here.

To find a Treehouse Eyes provider near you, click here.

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5 Ways to Get Your Kids Outdoors This Winter and Save Their Vision

Updated December 4, 2020

Just because the weather is cooling down, it doesn’t mean that your kids should be kept indoors all winter long. In fact, there are many reasons to have them spend time outdoors, not least of which is to protect your child’s vision. Studies show that children who spend time playing outdoors in the sunshine experience less myopia progression than those who stay indoors. Moreover, encouraging more outdoor playtime is important for promoting overall health and wellbeing in your kids.

Below we’ll explore some fun outdoor activity ideas to try with your kids and discuss why spending time outdoors may slow a child’s myopia progression or even postpone its onset.

5 Outdoor Activities to Do With Your Kids This Winter

1. Snow Play

If you live in a snowy region, bundle up your kids in warm layers and have them:

  • Build a snowman
  • Enjoy a snowball fight
  • Paint the snow with some food coloring or watercolors
  • Make a snow maze
  • Build an igloo
  • Build snow castles (the same way you would sand castles)
  • Make snow angels
  • Collect snowflakes during a snow flurry and study their beautiful shapes

2. Blow Ice Bubbles

Kids love playing with and popping bubbles. If temperatures are low enough, they might freeze in mid air! They’ll get a kick out of watching them freeze and possibly catching or popping them.

To make your own bubble solution, mix 1 part water with 4 parts dish soap and a few drops of light corn syrup. It’s best to try this activity when winds are calm, as harsh breezes can cause the bubbles to pop before they freeze.

Once the bubbles have landed on a surface and are completely frozen, they are beautiful to photograph — which can be part 2 of this activity.

3. Go Sledding

Sledding is a classic winter activity that your child will love. To go sledding, all you need is snow, a sled, and a hill! Easy enough.

But before you hit the slopes (or hills), be sure to follow these safety guidelines:

  • Choose a sled that can be steered and can brake
  • Wear a helmet
  • Dress warmly, but be careful as the scarf can get caught under the sled
  • Children 5 years old and under should sled with an adult

4. Go on a Winter Scavenger Hunt

A winter scavenger hunt is a wonderful way to explore nature with all of your senses. Before you head out, make a list of things to see, smell, listen for, and feel. Ask your child to check each item off the list.

For example, your list can include listening for the sounds of birds chirping, footsteps crunching in the leaves, or water babbling in a nearby stream. On the list of things to look for, you can include different types of trees, animals, animal tracks, cloud shapes, birds’ nests, and more. Take your camera along and let your child take pictures of what they find.

You can also leave an empty space on the list for your child to fill as they explore new things on their own.

5. Decorate a Tree with Edible Ornaments For Animals

This activity is an unconventional twist on building a bird-feeder and perfect for those who live near a forest. The idea is to make edible ornaments and hang them on a tree (or potted plant in your garden) for wildlife to feed on during the winter.

Your ornaments can be made using various seeds, peanut butter, dried fruit, and popcorn. It’s best to use biodegradable materials to hang your ornaments, and don’t use fishing lines, as birds can get caught in it.

What’s the Connection Between Time Outdoors and Myopia?

There is increasing evidence that children who spend extra time daily playing outdoors have a reduced risk of developing myopia; and if they already have myopia, time spent outdoors could slow down the worsening of this condition, also known as myopia progression.

These findings are significant, as having myopia significantly increases a child’s risk of developing sight-threatening eye diseases later in life. Moderate to high levels of myopia make a child more susceptible to developing cataracts, retinal detachment, macular degeneration, and glaucoma later in life.

At Treehouse Eyes, our mission is to battle childhood myopia by providing myopia management to nearsighted children. Our myopia management treatments can effectively slow down your child’s myopia progression and reduce their future risk of eye disease.

If your child has myopia, or if you need your first consultation, contact us today to schedule a myopia eye exam.

Wishing you and all of our patients a healthy and enjoyable winter season!

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The Myopia Epidemic – What it is, Why it Matters, and What Moms (and Dads, and Kids and Doctors) Can Do About it

Updated September 14, 2020

Dr. Thomas Aller, OD, FBCLA
Dr. Thomas Aller, OD, FBCLA

The Myopia Epidemic

Myopia is an eye disease with the symptom of blurred distance vision. If myopia were limited to a small portion of the population, if it were stable over time, if it could be corrected with eyeglasses, and if it rarely caused serious eye problems, it could be treated today the same way it was treated for hundreds of years.

What is becoming more and more clear is that myopia is starting earlier in life, it tends to worsen through young adulthood, it is reaching higher levels in those who develop it, it is affecting greater and greater percentages of the population all around the world, and there are increasing risks of serious negative eye health consequences for every increase in one’s level of myopia(1, 2).

What makes continually worsening myopia a serious eye health concern is not that the prescription number is getting higher or the glasses are getting thicker, or the vision without glasses is becoming worse. These are all annoyances, easily fixed by updating the eyeglass or contact lens prescription. It is what is happening to the eye while the prescription number is increasing which makes it critical that a new approach is used to not only correct the vision in people with myopia but also to slow the worsening.

When the eye increases in myopia, it almost always is because the eye is growing. As it grows, beyond what it was designed to do, the structures and tissues inside the eye stretch and thin. It is these stretching forces that are the likely cause of eye diseases that are linked to myopia.

Many people may be aware that retinal tears and detachments are more likely to occur with high myopia. Less well known, but equally serious, is that myopia is associated with higher risks of myopic maculopathy as well as cataracts and glaucoma. What is really important is that while the risks increase with higher levels of myopia, there are actually measurable increases in risk with any level of myopia(2, 3). This is why it is important to reduce myopic progression, no matter how much or how little myopia there is, as any increase in myopia increases the risk of future visual impairment, and any reduction in progression lessens those risks(4).

While it used to be thought, and many doctors still may think, that myopia was genetically pre-determined, that it would stop worsening at age 16, that there were no health risks associated with low and moderate levels of myopia, and that there was nothing that could be done, or should be done to slow the progression, doctors skilled in the treatment of myopia progression know that myopia can and must be treated in order to reduce excessive elongation of the eye(5).

Much has been learned over the last 30 years about myopia. What started the revolution in treating myopia progression were animal studies which showed that the growth of a young eye could be altered simply by changing the power of lenses that various animals would wear. If those early chickens and monkeys were like some children and refused to wear their little chicken glasses, we might not have made these important discoveries. Luckily for us humans, what has developed is an understanding that there are four effective treatments, proven to significantly slow myopia progression.

The first treatment is easy, free, fun, healthy, and can be done with virtually any child. It has been observed in multiple studies that the longer a child spends outdoors before the development of myopia, the longer the beginning of myopia can be delayed(6). This is important because if a child develops myopia at a very young age, the natural rate of myopia progression will be quite rapid and the level of myopia predicted for young adulthood will be quite high. Now, don’t forget your sunscreen and sunglasses and as they say in Singapore, “keep myopia at bay – go outside and play.”

The next treatment to consider is a treatment that can be used at any age and can slow myopia by an average of 60%. Atropine eye drops have been studied for 50 years as a treatment for myopia and what has made it a useful treatment lately are the findings from many studies that low doses can be quite effective(7, 8). At commonly used lower doses, there are minimal side effects of dilated pupils, leading to sun sensitivity and sometimes to blurred vision up close. These side effects may be managed by using sunglasses outside and by prescribing glasses to help near vision, or the dosage can be adjusted to lessen any annoying side effects(9). In the US, atropine is not approved for the control of myopia and your doctor has to send the prescription to a compounding pharmacy.

Two types of contact lens treatments are known to significantly slow myopia progression, multifocal or bifocal contact lenses (MFCLs), and orthokeratology (OK). While young children and sometimes even adults can be apprehensive the first time they put on a contact lens, most children do remarkably well with contact lenses. There are known risks to wearing contact lenses with eye infections being the primary concern, though, with proper professional care, the risks are minimal and manageable. Young children, in fact, have been shown to have the lowest risks with contact lenses, likely because they are young enough to still listen to their parents10. In multiple clinical studies, all around the world, these two types of contact lens-based treatments have been shown to slow myopia by 40 to 80%(11). The MiSight lens is a daily disposable bifocal contact lens which just achieved FDA approval for the treatment of progressive myopia in children(12).

So, the next step is to schedule an eye examination with an optometrist or ophthalmologist who cares about myopia and works with them to find a treatment that suits you and your child. Remember that most treatments and lenses are not FDA approved, but the FDA doesn’t regulate the practice of medicine and your doctor may use any lens or treatment approved for other conditions and choose to use it to control myopia, based on the available scientific evidence. Remember also that myopia tends to increase rapidly when first discovered, or even the year before and all treatments merely slow down the worsening, so it is best to start early to flatten the myopia curve(5).

Ready to speak to a doctor regarding myopia? Find a doctor and make an appointment here.

References:

  1. Holden B, Sankaridurg P, Smith E, Aller T, Jong M, He M. Myopia, an underrated global challenge to vision: where the current data takes us on myopia control. Eye (Lond). Feb 2014;28(2):142-6. doi:10.1038/eye.2013.256

  2. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. Nov 2012;31(6):622-60. doi:10.1016/j.preteyeres.2012.06.004

  3. Haarman AEG, Enthoven CA, Tideman JWL, Tedja MS, Verhoeven VJM, Klaver CCW. The Complications of Myopia: A Review and Meta-Analysis. Invest Ophthalmol Vis Sci. 04 2020;61(4):49. doi:10.1167/iovs.61.4.49
  4. Bullimore MA, Brennan NA. Myopia Control: Why Each Diopter Matters. Optom Vis Sci. 06 2019;96(6):463-465. doi:10.1097/OPX.0000000000001367

  5. Aller TA. Clinical management of progressive myopia. Eye (Lond). Feb 2014;28(2):147-53. doi:10.1038/eye.2013.259

  6. Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. Aug 2008;115(8):1279-85. doi:10.1016/j.ophtha.2007.12.019

  7. Cooper J, Schulman E, Jamal N. Current status on the development and treatment of myopia. Optometry. May 2012;83(5):179-99.

  8. Yam JC, Jiang Y, Tang SM, et al. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology. 01 2019;126(1):113-124. doi:10.1016/j.ophtha.2018.05.029

  9. Cooper J, Eisenberg N, Schulman E, Wang FM. Maximum atropine dose without clinical signs or symptoms. Optom Vis Sci. Dec 2013;90(12):1467-72. doi:10.1097/OPX.0000000000000037

  10. Bullimore MA. The Safety of Soft Contact Lenses in Children. Optom Vis Sci. Jun 2017;94(6):638-646. doi:10.1097/OPX.0000000000001078

  11. Huang J, Wen D, Wang Q, et al. Efficacy Comparison of 16 Interventions for Myopia Control in Children: A Network Meta-analysis. Ophthalmology. Apr 2016;123(4):697-708. doi:10.1016/j.ophtha.2015.11.010

  12. Chamberlain P, Peixoto-de-Matos SC, Logan NS, Ngo C, Jones D, Young G. A 3-year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optom Vis Sci. 08 2019;96(8):556-567. doi:10.1097/OPX.0000000000001410

 

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It’s time to treat Myopia

Updated September 9, 2020

Please read our summary of the recent mention of Treehouse Eyes in The Wall Street Journal.

 


In ten years, roughly 3.3 billion people will be myopic according to the World Health Organization. By 2050, it’s expected that roughly 50% of the world’s population will be myopic. These are staggering numbers for a disease that people know very little about and one that significantly increases the risks of serious, sight-threatening diseases such as retinal diseases and glaucoma.

A recent Wall Street Journal article featuring Treehouse Eyes dove deeper into the growing myopia epidemic to figure out why myopia matters, the risks and development of the disease, and new ways to now manage and treat myopia.

“Every amount of myopia matters in terms of increasing risk” – Dr. Donald Mutti

Genetics have been shown to play a key role in the development of myopia, however researchers also believe environmental factors such as a lack of outdoor time and more near work, like reading and time on screens, are fueling the ever-increasing cases of myopia. Myopia typically starts in childhood and progresses (the eye keeps getting bigger), or gets worse, until early adulthood. During this time the symptom of myopia, blurry distance vision, gets worse, meaning the child needs stronger glasses to continue to see clearly. Intervening in this process to stop the eye from getting bigger is the goal of myopia treatment.

Myopia Management: ‘A godsend’

As the article further explores the management of myopia we learn of the most common types of treatments available. One option is customized overnight contact lenses, also known as orthokeratology, which are lenses placed on a child’s eye at night before bedtime and taken out in the morning. They work by gently reshaping the front surface of the eye, called the cornea, overnight. The second treatment is a customized soft contact lens worn during the daytime. These lenses are put on the eye in the morning, worn all day, and then taken off at night and either disposed of or disinfected/cleaned. And the third treatment option used, sometimes in combination with the other treatments, is the prescription eye drop known as atropine. The goal is to slow down the eyes from becoming too long so that myopia can be managed. 

When interviewed by the Wall Street Journal, Raghu Parthasarathi, a parent of a Treehouse eyes patient and resident of Germantown, Md., said that a combination of treatments worked for his 11-year old daughter whose myopia was rapidly progressing. Starting with customized overnight lenses and combining with prescription eye drops 6 months later, his daughter’s vision finally stabilized. “To us, it’s a godsend,” he said.

Book an appointment with a local Treehouse Eyes provider by clicking here.

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Can Myopia be Cured?

Updated September 8, 2020

As an eye doctor specializing in treating myopia in children, I am excited that so many parents are becoming better informed about this issue. Recent articles in the Wall Street Journal, New York Times, and other consumer media outlets are driving more awareness and interest from parents looking to help their children.

Myopia is a disease where the eye grows too long, resulting in blurry distance vision and increased risks of serious, sight-threatening eye diseases, such as glaucoma (1), cataract (2), or retinal eye diseases (3). An estimated 1 in 3 children in the U.S. have myopia and the prevalence has grown dramatically over the last 30 years (4). Research has shown a lack of outdoor time for kids and more near work, like reading and time on screens, drive the massive increase we are seeing in myopia (5-7).

Is there a cure?

With more parents now aware of myopia, a question often asked is “Can Myopia be Cured?” The simple answer is no, but there are now promising methods we can use to treat myopia like we do other diseases such as diabetes to minimize the impact on children. Cambridge Dictionary defines cure as “to make someone healthy again, or to cause an illness to go away.” In that context, we currently cannot cure myopia as there is not a proven method to shorten the length of the eyeball. Once an eye starts growing too long, which usually starts in childhood, eye elongation cannot be reversed. While adults can have refractive surgery, such as LASIK, to help them have clear vision, their eyes still remain too long. Currently, we can reduce the symptom of myopia, blurry distance vision, by prescribing glasses or contact lenses to help a person see clearly at a distance. However, it does not treat the underlying issue of myopia but rather manages the symptom.

While myopia cannot be cured, it can be treated to slow or even stop it from getting worse. Because myopia typically presents and develops in childhood, these treatments are targeted to children, typically between 6 and 15 years old. Some patients in my care are as young as 4 and as old as 17. The goal of myopia treatment, or management, is to slow down or mitigate the accelerated growth of the eye. Effective treatment means more than simply correcting blurry vision for children; it also means preventing a child’s vision from deteriorating and, therefore, reduces their lifetime risk from serious eye diseases caused by myopia. Over the last decade, several treatments have been proven effective at treating myopia in children.

Myopia Management

There are currently 3 treatments for childhood myopia that we use at Treehouse Eyes. These have been proven through numerous, well-controlled studies around the world which are available to review online. An excellent summary of the current state of myopia treatment was published in April 2020 and is a good resource for parents looking for more clinical data. Two of these treatments work in a similar fashion by using a specially designed contact lens to change the way light falls on the retina. Another treatment uses a prescription eye drop at a specific concentration. All of these products are approved by the FDA, but not all are specifically indicated for treating the progression of myopia. Genetics as well as environmental factors play a role in assessing each child’s risk. In my practice, where we have treated over 500 children with myopia, I make recommendations on the best treatment for each child based on a thorough exam and discussion of the risk factors for that child.

The first treatment is a customized overnight contact lens that we call KIDS (Keratometric Induced Dioptric Steepening). These lenses are placed on a child’s eye at night before bedtime and taken out in the morning. They work by gently reshaping the front surface of the eye, called the cornea, overnight. We design these lenses specifically for each child’s eye shape so that it sends a signal to the eye to slow down growth. A great additional benefit of this treatment is that children can see 20/20 all day without glasses or contact lenses, so no worrying about breaking glasses or losing contacts away from home.

The second treatment is a customized soft contact lens worn during the daytime. These lenses are put on the eye in the morning, worn all day and then taken off at night and either disposed of or disinfected/cleaned. These work similarly to our KIDS lens in that they change the way light falls on the retina, but have to be worn for the treatment to be effective. This treatment works really well with active children who don’t want to wear glasses or older kids who are compliant with lens care and disinfection routines.

A third treatment we use, sometimes in combination with the other treatments, is the prescription eye drop known as atropine. The goal is to slow down the eyes from becoming too long so that myopia can be managed. Typically, one drop is placed in the child’s eye at night before bedtime. I often prescribe this treatment for younger children who are yet to be ready for a contact lens option, those rapidly progressing, or in combination with a contact lens treatment where needed.

All of these treatments can be effective, but require customization for each child’s situation so there is no “one size fits all”. Like all medical treatments, there are potential risks of each treatment that we need to consider vs. the benefits. This is an important discussion I have with parents when deciding which treatment option is best for their child. All of these treatments are better than no treatment at all, which we know will result in the child’s myopia getting worse irreversibly. I strongly recommend all parents to intervene and treat myopia early, as the sooner we start myopia treatment for your child the better the results both now and for their lifetime.

 

Ready to speak to a doctor regarding myopia? Find a doctor and make an appointment here.

 

Dr. Kevin Chan, OD, MS, FAAO

Dr. Kevin Chan, OD, MS, FAAO
Senior Clinical Director
Treehouse Eyes

References:

  1. Ophthalmology, 118(10), 1989-1994.systematic …
  2. Ophthalmology, 112(8), 1395-1401
  3. Japanese journal of ophthalmology, 32(3), 310-315.
  4. Arch Ophthalmol. 2009 Dec;127(12):1632-9.
  5. Ophthalmology . 2008 Aug;115(8):1279-85.
  6. Ophthalmology . 2013 May;120(5):1080-5
  7. PLoS One. 2015 Oct 20;10(10):e0140419
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Is Myopia a Disease?

Updated September 1, 2020

The World Health Organization (WHO) projects that 50% of the world’s population will have myopia by 2050, a staggering figure. Myopia significantly increases the risks of serious, sight-threatening diseases such as retinal diseases and glaucoma. We know the prevalence of myopia increased 66% in just 30 years in the U.S. alone between the early 1970s and early 2000s. So, with myopia on the rise and the serious eye health consequences of higher myopia, why is there still no clarity on the question, “Is Myopia a Disease?”

The answer, like many in medicine, relates to how we define myopia and measure it.

What Is Myopia?

The definition of myopia is an eye that is too long from front to back.  This causes the symptom of nearsightedness or blurry distance vision.   Historically, eye doctors like myself have been trained to equate myopia as synonymous with nearsightedness and treat them as a “refractive error”, along with other conditions of the eye such as hyperopia (farsightedness) and astigmatism (an eye that isn’t perfectly round). These conditions cause blurry or distorted vision, at near, distance, or at all ranges of vision. Fortunately, most are easily compensated for with glasses or contact lenses, so as an eye doctor I have a lot of tools to help people see clearly. When I went to optometry school the focus was on providing my patients with clear vision. We didn’t put any focus (no pun intended) on the size of a myopic eye.

However, myopia is different from other refractive errors like hyperopia or astigmatism. Myopia typically starts in childhood and progresses (the eye keeps getting bigger), or gets worse, until early adulthood. During this time the symptom of myopia, blurry distance vision, gets worse, meaning the patient needs stronger glasses to continue to see clearly. If blurry distance vision is the symptom of myopia, what exactly is myopia? Stated again, myopia is an eye that is growing too long. How do we know this? We measure it using special non-invasive technology to calculate the length of the eye from the front (cornea) to the back (retina). This distance is known as the axial length and is measured down to fractions of a millimeter with advanced equipment. So, myopia is an abnormal elongation of the eye.

Myopia and the Risks

Myopia matters because it is proven that higher myopia significantly increases the risks of serious, sight-threatening complications. A person with a higher myopic prescription of -6.00D has a 40 times greater risk of myopic maculopathy and 3 times greater risk of glaucoma than a person with no myopia. The elongation of the eye is what’s at issue; the greater the myopia, the longer the axial length of the eye and thus greater risk. It is critical that myopia is treated (like most things in medicine, earlier treatment works better) to reduce its progression both to ensure clarity of vision and reduce the risk of serious eye health consequences. A recent Wall Street Journal article about myopia and it’s treatment, which featured an interview with a Treehouse Eyes patient, stated “every amount of myopia matters in terms of increasing risk.”

Is Myopia a disease?

Encyclopedia Britannica defines a disease as “any harmful deviation from the normal structural or functional state of an organism, generally associated with certain signs and symptoms and differing in nature from physical injury.” Myopia increases the risk of serious eye health issues, so it’s clearly harmful. Myopia also has symptoms, blurry distance vision, that are not caused by an injury. Myopia has both genetic and environmental factors that contribute to both its onset and progression. Simply put, Myopia is clearly a disease. One that requires treatment to reduce the negative impact it can have on a person’s eye health and vision.

Myopia is a disease that has potentially serious consequences which will impact over 4 billion (about half the planet!) people by 2050. Fortunately, we can treat myopia and not just compensate for the symptoms to help reduce the burden of this disease. Interventions, including specially designed contact lenses and prescription eye drops, are proven to reduce the progression of myopia. Because myopia usually starts in childhood, these interventions are used with children while their eyes are still growing. As medical professionals, we have an obligation to offer these treatments to children and discuss the implications of myopia with their parents, so that we can treat this disease and help the over 15 million children in the U.S. alone who already suffer from myopia.

Use our Make An Appointment feature to find a Treehouse Eyes provider in your area today.

Dr. Gary Gerber, O.D.
Chief Myopia Eradication Officer
Treehouse Eyes

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