You have probably heard the line “ more than 50% of the world's population will be myopic
by 2050” a million times before- but what does that mean for you or your child who is myopic?
Myopia or short-sightedness refers to a refractive error in which light rays entering the eye
focus in front of the retina due to the eye being too long. This then presents an out of focus image at distance resulting in symptoms such as headaches, eyestrain, etc. Myopia can be classified into 3 categories according to the amount present:
- Mild - up to -3.00 Dioptres
- Moderate - between -3.00 to -6.00 Dioptres
- High - over -6.00 Dioptres
Regular visits to the Optometrist allow for early detection of any vision related problems - resulting in earlier and better management. As the old saying goes “prevention is better than
cure” - this is also true for the management of myopia as it can be progressive and detrimental if not managed correctly.
*There is a common belief that every visit to the optometrist equals new spectacles in every year- which is false. An eye examination not only checks for visual problems but the overall health of your eye as a lot of changes take place in between your yearly check ups.*
There are various risk factors which can lead to myopia:
- Family history
- Increased near vision
- Age onset
- Current refraction
- Environmental factors
- Binocular vision disorders
Genetics are very important as research shows that if one parent is myopic, the child is three times more likely to be myopic. If both parents are myopic it increases to six times and risks further progression to high myopia. If left uncontrolled myopia can lead to more serious eye conditions at a later stage. Such as
- Retinal detachment
- Myopic maculopathy
- Glaucoma
- Cataracts
For the past decade, there has been a tremendous amount of research into myopia management as this is a worldwide pandemic. Which is why before I recommend any form of myopia control strategy I ask myself a few questions about the patient's suitability for that type of management.
- What other risk factors does the child have?
- Is the amount of myopia normal for the child's age ?
- Will the refractive error emmetropize (get better over time)?
- If left uncompensated for, will the refractive error result in further visual problems thus affecting the child's daily activities?
- Will doing myopia control slow the progression of myopia ?
These questions allow me to decide on the best method possible but also allow me to also individualise that type of strategy for my patient.
Types of myopia management:
- Myopia Control Lenses: These are specialised spectacle lenses designed to shift light rays in the eye in a way to slow the progression of myopia. This shifting of light takes into account the length of the eye and the amount of myopia present, amongst other factors.
- Contact lenses : There are specialised hard lenses (Orthokeratology) worn at night which work by altering the shape of the cornea to slow myopia progression. Soft contact lenses are the alternative and used during the day providing clear vision whilst slowing myopia progression.
- Atropine dosing : The use of pharmaceutical atropine in different concentrations is mostly done if other forms of myopia control were not efficient. This involves instilling one drop of Atropine in the eye once a day - at night time. Thereafter monitoring regularly for efficiency and possible side effects.
Whilst the above methods have been proven to be 50% effective in slowing down myopia progression, lifestyle changes also need to be made to support the whole process. These include:
- Regular breaks in between screen time
- Exposure to sunlight by playing outside
- Encourage the use of print media to allow regular blinking
- Use of safe reading distance
A well informed patient is a happy patient- therefore it is very important to educate the
parent on the options available for them when it comes to myopia management for
their child.
LINKS TO FURTHER MYOPIA MANAGEMENT ARTICLES