Reshaping Vision
Myopia or nearsightedness in kids has risen sharply
By Eric Herr, for the Courier-Post • March 22, 2010 (Reprinted with Permission)
One of the first things Jianan Huang, a junior at Eastern High School in Voorhees, does when he awakes is remove his contact lenses with a tiny suction cup-like device.
Joshua Fram, a sophomore at The Lawrenceville School, goes through a similar morning routine before getting set for his daily activities.
While it may seem odd for these teens to remove -- rather than insert -- their contact lenses before breakfast, they represent a growing number of constantly on-the-go young adults who have opted for orthokeratology, a non-surgical method that corrects nearsighted vision by actually reshaping the cornea.
According to recent National Institute of Health statistics, cases of myopia, or nearsightedness, have risen sharply, from roughly 25 percent in the early 1970s, to more than 66 percent this decade.
While not absolutely conclusive, so called "near work," associated with the proliferation of computers, video games, text messaging and a host of other technology that requires constant close focusing, is at least partially to blame.
Both Huang and Fram clearly are part of these myopia statistics, but that aside they have another thing in common: They both are patients at Trenton-based EyeCare Professionals, P.C.
"Orthokeratology, also known as corneal reshaping, is often preferred by our younger patients, like Jianan and Joshua, who are still experiencing growth spurts, because it is non-surgical and is reversible," explains Dr. Nicholas Despotidis, one of three partners at EyeCare. "LASIK technology, on the other hand, is a surgical procedure and while perhaps more readily recognized by name, is irreversible," he continues.
Simply put, orthokeratology is a Federal Drug Administration-approved process in which a computer takes precise measurements and maps the contour of the eye to create a custom-designed corrective lens.
The user inserts the lenses into the eyes before going to bed.
Overnight, these oxygen permeable lenses -- lenses that can breath -- gradually re-shape the front surface of the eye (the cornea) to temporarily eliminate or significantly reduce nearsightedness and minor astigmatism typically for a 24- to 48-hour period without the need to wear glasses or other corrective eyewear.
That's a real plus for Huang, now 17, whose parents first found out about the technology in 2002 after noticing their son's vision getting progressively worse.
"I play a lot of different sports, so not having to wear contacts and being able to see clearly is huge," notes Huang, who confesses that wearing regular contact lenses can be a hassle because they shift and often get dirt and dust lodged between the eye and the lens.
Fram also loves sports and is active in baseball, football, rowing and other activities.
His mother, Carine, remembers when her son's vision problems became evident as early as the fourth or fifth grade.
"We realized that as active as he is, Josh would not be a good candidate for glasses, so the more flexible, non-surgical corneal reshaping technology, although temporary, was clearly the best choice," she notes. She adds that when Joshua reaches maturity, he still can pursue a more permanent surgical option if he chooses.
But orthokeratology, which only corrects myopia, is just one aspect in a broader, more holistic approach to solving vision-related problems at EyeCare.
The fact is, vision therapy has been a journey of discovery of sorts for optometrist partners Drs. Despotidis, Barry Tannen and Ivan Lee.
The trio has collaborated to author a book, "My Children Are Nearsighted, Too," which addresses personal experiences and explores the influence of genetics, diet, culture and the environment on visual acuity.
"Unlike in years past, when outside activities predominated and children were exposed to a wide variance of focal points, today's generation is mostly engaged in tasks that require close focus," says Despotidis, alluding to the recent NIH findings.
But being tested for so-called perfect vision and subsequent correction through corneal reshaping or other techniques just may be the tip of the proverbial iceberg, according to Tannen, whose specialty is developmental optometry.
"20/20 eyesight tells us how well we can see to drive or to see a blackboard, but learning-related vision problems can severely impede a child's ability to read and do well in the classroom," says Tannen. He says a standard vision exam is fine, but often doesn't detect things such as eye tracking, consistent focus and other problems that can point to potentially more complex problems.
Take Jenna Cohen, of Monmouth, for example. She was diagnosed by Tannen with convergence insufficiency, or the inability for both eyes to work together.
"She had an amazing ability to compensate for her difficulties, such as eye tracking, skipping, adding or omitting words and, therefore, this wasn't deemed problematic by the schools," observes, Jenna's mother, Lauren, a professional occupational therapist.
After completing vision therapy and some three months of outpatient therapy, Jenna apparently is on track, with marked improvement in her reading fluency, overall behavior and ability to focus.
"She is literally a different child," says Lauren, adding her daughter's organizational skills also have increased.
"Instead of simply asking questions, such as which image is clearer on a chart, more functional questions related to playing sports, video games, reading activity and extracurricular activities, not to mention diet, can be far more revealing and give us much greater insights," says Lee.
Like Jenna Cohen, 8-year-old Andy Neumann also eventually was diagnosed with the same convergence insufficiency disorder.
"As early as age 2, we noticed he would cock his head to the side when he was watching TV or at other times," explains Andy's mother, Sandy. "We had been told he had 20/20 vision, but later discovered he had this problem related to a muscle weakness in his right eye."
After four months of treatment, along with ongoing home-based maintenance tutorials, second-grader Andy, an avid book worm, is reading at the upper end of his grade level.
The bottom line in all of this, say Despotidis, Lee and Tannen, is that beyond the recommended yearly eye examinations, what's equally important is that parents, teachers and everyone else be aware of excessive blinking, headaches after reading, losing place or skipping words as warning signs that can signal more latent developmental vision problems.
