This question came up on a parent support list. Many parents are looking for trying to understand why their child is going near-sighted, and what options are available. Thoughts and comments welcome!
“My 5 year-old daughter has been diagnosed with myopia that is progressing very quickly, as well as basic esophoria, accommodative insufficiency and accommodative spasm. She began reading right when she turned 3, and now I have been told that has most likely caused these issues – too much time spent looking close up. Can anyone tell me if they have tried vision therapy for these conditions (or most specifically the myopia)?”
It might help if you look at myopia as a SYMPTOM of the vision problem, rather than as the problem itself.
The visual system has made an adaptation based on how it is being used. Your daughter has placed so much interest in working at near-point that her eyes have become specialized for this function.
The question is not whether you can treat the myopia directly, but whether you can prevent or minimize progression by helping your daughter learn how to be flexible. This is flexibility in focusing and relaxing focus, flexibility in converging and diverging the eyes, and flexibility to work with both the focusing and eye-teaming systems in tandem.
Your goal should not be to reduce the myopia (although some degree of prescription reduction is common). You are looking to support your daughter to change the cycle which is causing myopia progression.
There is a strong correlation between parents having myopia and their children developing myopia. But this may not be purely genetic! It may be from habits, which are learned (often from our parents), AND from personality traits which impact how we function. These traits may also be inherited (like tenacity!). So, identifying a HEREDITARY COMPONENT does not mean that her genes have been encoded to make her myopic no matter what. There is always a FUNCTIONAL COMPONENT as well.
Behavioral/developmental optometrists prescribe glasses for near-point (perhaps bifocals) and may prescribe activities to improve flexibility of vision function in order to stabilize and support the visual system at the problem area. The problem is visual dysfunction at near-point. The symptom is myopia (near-sightedness). If the problem is addressed, the progression of myopia will come under control. In some cases, the patient may even learn to function with a lower prescription.
In studies which do show a very positive impact from the prescription of bifocals in reducing myopia progression, the greatest effect is found in those who have ACCOMMODATIVE EXCESS (spasm) and ESOPHORIA at near-point. This implies that your daughter is among those with a strong FUNCTIONAL COMPONENT… therefore, highly remediable!
I would recommend finding a behavioral/developmental optometrist who can assess whether it is a good idea to try therapy now, or to just monitor closely with some glasses prescription changing, and initiate therapy if she is showing progression.
Best of luck!
Samantha Slotnick, O.D., F.A.A.O., F.C.O.V.D.
If you have additional questions or comments about how to manage myopia progression please share your thoughts!