MYOPIA CONTROL: PROTECTING EYE HEALTH

Myopia, short-sightedness, is a common eye disorder that causes blurred distance vision. It typically starts in children around the age of 10 years, deteriorating until the late teens or early twenties when it stabilises. There is growing concern worldwide around the alarming increase of myopia and its rapid progression, affecting quality of life, increasing eye health risks and posing a threat to the future visual health of children.

In children, the eyes are meant to grow steadily until the teenage years, then stabilise. With myopia, the eye is longer than normal from front to back, or the cornea is too steeply curved. Myopia progression is the ongoing deterioration of vision caused by the eyes growing too quickly and too long for the normal rate of eye growth.

Research suggests that children who spend long periods of time indoors doing near-focused activities, such as computer work, video games, and reading, have higher rates of myopia than those who spend more time outdoors. Even after a childhood of normal vision, young adults can suffer myopia progression, albeit at a slower rate than children and teenagers.

Myopia progression brings with it increasingly blurred vision, the need for frequent changes in glasses or contact lens prescription and an increased risk of eye diseases and vision problems over a person’s lifetime.

Earlier onset of myopia can lead to a higher degree of myopia, a faster rate of progression and an earlier onset of eye diseases typically associated with adults, such as cataracts, glaucoma, macular degeneration and retinal detachment. Even at levels of myopia traditionally considered fairly low, there are increased risks of eye diseases compared to someone who is not myopic.

While family history may be a factor in the development of myopia, research has shown that the child’s visual environment can increase the risk of onset and progression significantly.

This includes the amount of time spent indoors versus outdoors, the amount of screen time on digital devices without breaks and holding books or handheld devices too close to the face.

Prolonged periods of time indoors reduces the benefit of outdoor light and opportunities for the eyes to change focus from near to distance.

Myopia control treatments can’t stop myopia progression but there is evidence for slowing it down.

One option is the use of low-dose atropine eye drops used each night for 2 to 3 years for children aged between 5 and 18 years to slow the lengthening of the eye.

Although not completely understood, some results are reported to show that in a high percentage of children the rate of myopia progression slows by about half.

A side effect of these eye drops can be red itchy eyes.

Orthokeratology contact lenses are worn overnight, flattening the front surface of the eye to correct daytime vision. The effect is temporary, as without the lenses the cornea slowly returns to its original shape and vision is blurred once again. Over time these lenses may provide some permanent reduction in myopia progression.

Orthokeratology lenses are more difficult to fit than regular lenses, need more follow-up visits to the optometrist and, as with all contact lenses, there is the risk of infection.

Vision therapy is a programme of exercises using aids such as filters and computer games to help the eyes and brain work together more effectively. It can train the eyes to adjust focus better between close and distant objects, which can help slow the advance of myopia and help ease the eyestrain and headaches that often go along with myopia to help make visual tasks easier.

While myopia cannot be reversed, it has traditionally been corrected with glasses or contact lenses, which ‘fix’ the focus of the eyes to create clear vision while they are worn, but do not ‘fix’ the myopia or excessive eye length or protect the eyes against myopia progression.

There are many treatment options available to slow myopia progression in children and teenagers, and even in young adults.

Over recent years a significant amount of research has been focussed on a new revolutionary lens-design technology called Defocus Incorporated Multiple Segments (D.I.M.S). The lens corrects the visual defect on its entire surface and has a ring shaped treatment area to slow down myopia progression. The alternation of the focus area and defocus area provides clear vision and manages myopia simultaneously

Myopia control treatments offer the short-term benefits of better vision now and long-term benefits of protecting eye health in the future. Hand in hand with managing eye health, myopia management takes into account lifestyle and environmental factors which can trigger myopia progression.

Once myopia has been diagnosed, your optometrist will monitor its progress with regular eye examinations to track changes in the prescription and in the axial length of the eyes.

To ensure the best outcomes for myopia progression, certain lifestyle changes may need to be made. Encourage your child to spend time outdoors in natural light and be sure that he is working in good lighting indoors. It may be difficult, but limit screen time.

Help your child to take regular breaks from screens and close work and teach him the 20-20-20 rule – every 20 minutes look at something 20 feet away for 20 seconds.

Myopia is not just about a pair of glasses!

It’s about quality of life and protection of eye health. With myopia control, children and teenagers will have less frequent changes in their prescription. With vision being more stable and deteriorating less between eye examinations, children and teenagers will have better vision for school, sport and other daily activities. The long-term benefits of myopia control are reducing the risks of eye health problems and vision impairment later in life.