In this video, I'm interviewing. Dr. Roman Gerber from Wink Family Eye Care on what it takes to stop myopia
What causes nearsightedness and how to prevent myopia from getting worse! So let's take a look
Hey guys welcome, this is dr. Joe Allen here from doctor eye health and I'm here today with dr
Roman Gerber from wink family eye care premier eye clinics located in Chanhassen and st
Louis Park, Minnesota
and we're gonna be talking about
nearsightedness and
myopia control and he at any point thought the video check out the show notes and links below for further information about everything that we
everything that we mention as well as some extra links so that you can get in contact with dr. Gerber at Wink family eye care
All right, so, dr. Gerber and Wink family eye care you guys focus a lot on
Myopia progression and what's called myopia control.
And hey, if you have not heard of the term myopia, that's the medical term for nearsightedness
But really what why do you think dr. Gruber its myopia progression is becoming such a problem
Why do we need to be concerned about it? So great question. Um
Oftentimes kids will start off and they'll be slightly myopic or nearsighted and they'll start by being around a minus one
And what that means for them is that they can function really well throughout the day
But the board is pretty fuzzy and they need the their classes and or contacts to see the board clearly later on
They will start getting more and more
Nearsighted where they will be about a minus three
Minus five or a minus eight and at those levels it becomes harder to function. They can't see their alarm clock
They can't move around a room
Clearly without having glasses or contacts so they become much more reliant and it becomes harder for them to see
Now disease wise as they get more nearsighted there
I will actually grow and get longer and so it increases their chance of developing a retinal detachment in one study it found that
patients who were minus eight
As compared to somebody who had no prescription were over twenty times more likely to develop a retinal detachment which can lead to blindness
for a condition like myopic maculopathy
It's almost 100 five times more likely that they could develop that condition as compared to somebody who doesn't have any
Nearsightedness so disease wise it's also an area that makes us a twink family. I care very concerned. So I totally agree
I think across the board
Eye care professionals we all want to prevent eye disease, prevent blindness, certainly those major conditions
Things like you mentioned, glaucoma things like cataracts retinal detachments and then that macula macd myopic maculopathy
Is a major concern and so yeah, I think if we can do anything to prevent nearsightedness from getting worse, you know
If someone just starts at a minus two if we can keep that to a minus two minus three
Rather than let that excel to minus eight that's gonna be a big win. So obviously here as eye care professionals
We want to stop myopia
And if you're somebody who's really concerned about the myopic
Epidemic or myopia epidemic then please go ahead and comment in the section below stop. Myopia. Go ahead and shout that out for us
Okay. All right. So well, if you don't mindDr. Gerber, let's go over a little bit more of what causes
Nearsightedness, could you shed some light on that?
Yeah, so there's this constant nature versus nurture debate and like most answers to that debate
This one the answer is both. There's usually a genetic component. We find that kids who have parents who are nearsighted
Are much more likely to develop nearsightedness themselves similarly?
we have seen a doubling and increase in myopia due to
Tablets due to phones and this has just been over the past 20 years
so that has not been a genetic change but has rather been a more nurture change when we
go abroad when I do charity clinics myself I go to places sometimes where
education ends in second or third grade and if that happens those kids do not develop nearsightedness in the same way that
Kids in the United States do so. It's definitely kind of both there. Also. I completely agree
I know we see a lot more kids nowadays on things like tablets and phones
Certainly, it's great that they're doing stuff for school
But that extra time up close has been proven to kind of push people to become more nearsighted earlier
On and develop those higher rates of myopia
So yeah, when it comes to clinic, I know we have a lot different tools available to us certainly have glasses
We have contact lenses. We can prescribe to help kids see better and then even as we get older, there's options like LASIK -
But what about helping prevent myopia from getting worse? What can we do to really help?
What are some of the tools and theories that we can apply as an eye doctor to really help our patients?
Well, what do you think?
So I think it is very important that we do
Do something for the longest time parents have asked us what they can do to slow down
Progression or stop myopia, and we haven't had great tools over 30 years ago
We used to use line bifocals and put kids in those and that appeared to help but only a minimal amount
So that has definitely fallen out of favor
the two things I find are the most beneficial are orthokeratology and soft multifocal contacts and
orthokeratology
Yeah, yeah in case you guys don't know orthokeratology
It sounds like a fancy term but really it's it's a special type of contact lens that helps fit on the eye
And won't let you go a little bit more about what what a little carrot ology is. Yeah, so it's a really cool contact
It's a large hard contact that is usually very comfortable that is only worn at night nowadays
So what happens is the cornea has the contact over it and then it gets flattened
by this
contact
that using orthokeratology and then the child wakes up takes the contact out and they can see clearly they
Don't wear glasses. They don't wear contacts and they can see the world very clearly. It does what LASIK does but only temporarily
and safely in children
So it's like kind of the opposite of wearing contact lenses during the day to see
It's actually a contact lens that you wear at nighttime you sleep with it. It's safe to sleep in but it actually
morphs and sculpt kind of molds the front surface of the eye so that during the day you can see clearly and
Again, kind of just repeated every night. Is that correct? Uh, yeah. That is absolutely excellent
And so that actually slows down to prevent and slows down the development of your nearsightedness. Yes
So a completely different mechanism is working on slowing down the progression of nearsightedness
using what appears to be hyperopic defocus
Appears to be the best theory that explains that but the eye doesn't elongate it actually has a dampening effect
on the elongation most studies show
Very large ranges, but I think probably 50 to 80 percent
Slowdown in progression using orthokeratology. That's a that's a great benefit. Right if you can slow down a child's progression by fifty to eighty percent
With those types of lenses. I mean that that's significant, right?
So especially for someone that could just wear the lenses at nighttime
That's a pretty simple solution, you know, just a quick thing on orthokeratology
who's who's the best candidate for that type of that type of instrument or that type of a
Really prescription who's gonna benefit the most from that. Um, so it's usually
Kids because it can slow down the progression but it can be used in adults just for vision correction as well. It can be
Low, myopic kids who have about a minus one or even higher my ops and the - three - four - five
Range and they can do really well and also does great for those of us with dry eye
Because you don't wear a contact throughout the day nothing gets drier as the day continues. That's an excellent point
I didn't even think about that for dry eyes
But now beyond just the Ortho-K
Okay, those type of contact lenses now soft multifocals' i've heard a lot about that as being another solution
Can you talk about those? Yeah, so soft multifocals were originally invented for those of us over 40
When it became hard for us to see our phones
And we wanted to wear contacts so we could see our phones and look for their way
so but they also found that soft multifocals have the same hyperopic defocus a
kind of
Progression and it stops the eye from getting longer
So that helps the eye out and you don't get the progression that you do kind of with regular contacts with regular glasses again
Similar about fifty to eighty percent. So the focusing mechanisms of these contact lenses
Still gave you a good vision for the person wearing them for the maybe your child a family member
but it actually helps it has this little defocused mechanism in theory that helps prevent that eye from
Elongating and making your nearsightedness worse
So that that's really fascinating is it so we really just have the contact lenses or there other options. There are other options as well
Atropine has been used for at least twenty thirty years or so
Atropine is a dilating drop and we all know how much
Patients loved dilating. Yeah
But at full strength
It dilates the eye for up to a week
Or more and then patients would use this and it did seem to slow down progression pretty well
The problem was you'd be dilated so you couldn't see up close and you'd be sensitive to light, right?
So there's actually a study that came out a few years ago called the adam2 study that seemed to show that
Lower concentrations of atropine were still protective for myopia, which was wonderful so you don't have the same
Dilation and loss of focusing power up close and it seems much better there. I primarily use it as an adjunct therapy
In combination with contact lenses, excellent. So I
Completely agree. I I know about all those different all those different
applications and tools
But I know that I don't think atropine isn't as common is it I think the contact lenses are a little bit more readily available
More practitioners are probably utilizing that what do you agree? From what I have seen?
Absolutely. What's great about the contacts? Is they fix the vision as well?
So the child can walk they can see clearly atropine would be used in combination with either contacts or glasses
And so it's an extra drop. Excellent
So what about you know children who don't want to wear contact lenses or use drops?
Is there even just kind of things lifestyle changes or different glasses or something else? That would be a good?
Modification for the as an option for for those people. Yeah great question
So what they could do is they could decrease screen time and particularly screen time up close
That's appears to be a the big factor that causes these big jumps and myopia
So if your kid is on a handheld device make them watch TV
Do small improvements? Yeah easier said than done. Yeah. I know a lot of times
It's like we don't want children to stop doing their studies
We ask them to keep performing well in school so they gotta finish their homework, right?
It's good for them to read but a lot of times I know for myself and I was growing up
I spent a lot of time playing video games, you know handheld like Gameboy stuff right up close and I think that's great
it's great for the kids to play and have fun, but perhaps just
Recommending or seeing if they could spend more time
Maybe playing games or hanging out with their friends outside and a little bit less time spent all day inside stuck on a screen
Yeah, I think you're absolutely right. So I health question of the day
Have you heard of any of these different methods for myopia control? Which one is your favorite?
And do you have any other questions about them go ahead and comment in the section below?
Let us know what your questions are. All right. So question round. We're doing some quick questions here as dr
Gerber to get to know him a little bit better so first
Tell us a favorite movie
Terminator 1 and 2. Oh my god. Ok, not 3 or 4 or 5 or not
No not 3, 4, or five. Yey Arnold. OK Cats or Dogs?
Dogs, I have a dog named Winnie named Winnie. What kind of dog? She's a Havanese?
9.5 lbs and shes wonderful. I have no idea. What a Havanese is. I'm gonna have to look that up. coffee or tea?
Tea tea, okay. Yes. Yeah, what kind of tea?
I like herbal tea Oh herb all stop to see I'm a green tea guy
I can't do coffee. .. favourite sport? tennis a well, but your favorite pastime? so
What I love doing more than anything is surfing I live in Minnesota. Yeah. No, I know
I live in Minnesota and I can barely surf but if I could do anything. Yeah, I would Surf that's awesome. Yeah, okay
All right favorite color. Um, dr. Sarah would kill me if I didn't say green so green. Yep. Yep, green
Yeah here in the clinic all green. Yeah favorite food
Spinach and kale because it's high in lutein and zeaxanthin and good for your eyes. Oh my god, totally eye doctor. Yes
Glasses contacts contacts. Okay awesome. What for?
Myopia control. Oh, yeah
Control. All right. All right guys. Thanks so much for watching
Make sure to go ahead and like subscribe and share this video with any friends and family want to say a quick
Thank you to dr. Gerber for having me here. Thank you so much for coming here
And thanks for letting me be part of this, of course, and so otherwise keep an eye on it. We'll talk to you soon