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April 26, 2018
What do we do, as parents, when we realize that our child can’t see? What are we supposed to think? Did we do something wrong that led them to need glasses? Did we let them have too much screen time? Did we not make them go outside and play enough? Did we give them bad genes?
These are questions from parents that I get every day. The diagnosis of nearsightedness (or myopia) is rising in epidemic proportions. It is now estimated that 27% of the world’s population has myopia—this is over 2 billion people. By the year 2050, it is thought that half of the world will be nearsighted.
The implications of uncorrected myopia have numerous and vast consequences. The World Health Organization (WHO), in their landmark study on the impact of myopia, concluded that there is a global loss of productivity equaling $202 billion dollars. Furthermore, in children, the results indicate a lower level of school function, psychological and social development, and overall quality of life.
What’s even more alarming is that the same study found that myopia can lead to eye diseases that can cause blindness. In Asia, roughly 2% of those with extremely high myopia have degenerations of the retina. There is often no cure for these conditions.
The WHO along with other groups makes numerous recommendations for children to help slow down and possibly prevent myopia. We know that too much near work and time indoors can contribute to myopia. When we look at objects up close, there is evidence that the eye is stimulated in such a way as to cause the eye to grow longer, thus making it more nearsighted. We also know that genetic factors of parents with high degrees of myopia can contribute to the development of myopia in their children. Studies of twins with myopia also indicate a possible genetic link.
The things we can control fall into a few different categories and treatments.
Research shows that spending two hours or more outdoors reduced the incidence of myopia by almost 50%. It is believed that the demand on the eyes from being indoors is related to how close objects are when we are inside. When we are outside, our eyes naturally will focus more in the distance, and, therefore there will be less demand on the focusing system.
Looking at an object 20 feet away, every 20 minutes for 20 seconds—also demonstrated less stress on the eye, and, therefore less myopia. We should discuss the need to vary the activities that our children do. It is important for the kids to know that they should not only be learning, reading and studying, but that they should also be playing outside, going for a bike ride and just staying off of the screens and away from the books for short periods of time throughout the day.
Through a licensed and specialized optometrist or ophthalmologist is another option to limit myopia progression. More commonly known as ortho-K, treating the eyes with multifocal soft contact lenses or overnight rigid gas permeable lenses have shown to decrease the rate of progression of myopia from 25% up to 75% vs. wearing glasses. Most of the contacts that are used in myopia control work on the principle of reducing peripheral retinal defocus, which reduces the risk of eye elongation. A longer eye—from the front to the back of the eye—is the definition of myopia. Research shows that children as young as eight years old, can learn to handle, insert and remove the contact lenses from their eyes with proper training.
An eye drop that dilates the eyes, has shown to be another method of reducing and controlling myopia. Typically, this treatment is done on children aged 5-15 with rapidly increasing myopia who might, otherwise, have problems with the use of contact lenses. There is still a lot to learn about this treatment, but many doctors are finding great success with this treatment in reducing myopia even up to 50%.
This epidemic of myopia is only getting worse with our information society growing. We are increasingly using smart phones and computers and our lives are often spent indoors. We can control some of these behaviors and perhaps influence our children to adopt them, as well. We can monitor our vision, using the EyeQue Insight and track changes so we can report to our doctors. If we can make an impact it can have vast reaching benefits for the world as a whole.