Understanding Myopia – Nearsightedness – in Children

Understanding Myopia – Nearsightedness – in Children

Mar 30, 2018

What To Do About My Child Becoming Nearsighted

If it is your child’s first time getting eyeglasses for myopia – the medical term for nearsightedness – rest assured, there could be better ways to help. We have come a long way in research and development and there is now evidence that several treatment options exist to control nearsightedness.

It is projected that by year 2050, 50% of the world (5 billion people) will be myopic if the current trends continue. Take action now and curb the myopia epidemic starting with one child at a time.

Nearsightedness is more than just blurry vision when looking at things far away, because it has a medical component: Myopia. Myopia and Nearsightedness are used interchangeably. A myopic person has an eyeball size that is longer than average. This means structures inside the eye are stretched thinner and weaker than average. In the long run, the myopic person has a greater risk of developing significant eye diseases such as retinal detachment, glaucoma, cataract and macular degeneration. Even low amounts of myopia (-0.75D to -2.75D), induces a 3 fold risk of retinal detachment compared to someone with no prescription.

Why Are Children Becoming So Nearsighted So Early On today?

This is a question that cannot be answered by pointing to one causative factor. Based on available research so far, myopia is related to a few of these risk factors:

  1. Parental Myopia – One parent being nearsighted means the child will have about 3x the risk of becoming nearsighted. Both parents being nearsighted means the child will have about 5x the risk of becoming nearsighted.
  2. Habits, Behaviour & Reduced Outdoor Time – How do we use our eyes? Is there a lot of near work strain including reading, computers, tablets and mobile phones without rest? There is evidence that spending time outdoors, between 40 minutes to 2 hours each day can be protective and help prevent the onset of myopia. Children need not be doing a sport activity when they are outdoors, simply an outside environment where surroundings and objects are at a faraway focusing distance is helpful. This means, do not stare at a digital screen when trying to reap the benefits of outdoor time! It is unknown how exactly an outdoor environment contributes to preventing nearsightedness, but scientific research is showing that it is a good thing. Just be sure your child had good UV protection while outdoors.
  3. Culture & Focus on Education – cultures and populations which stress high academic performance tend to have a higher prevalence of nearsightedness.
  4. Ethnic background – Perhaps related to culture, an Asian demographic is more likely to have myopia.
  5. Diet – higher intake of processed carbohydrates and saturated fats may be related to longer eyeball length.

While this is not an exhaustive list, it is intended to be a guideline.

Attempts to Curb Childhood Progressive Myopia

Currently, there is no known way to completely stop or permanently reverse childhood myopia. Yet fortunately, clinical trials have shown that there are at least three ways we can effectively curb childhood progressive myopia:

Method of Nearsightedness Correction Effect on Slowing Nearsightedess (%)
Orthokeratology (Ortho-K) 32-100%(8-15)
Daytime wear of Multifocal or specialized Contact Lenses up to 59% (16)
0.01% Atropine eye drops up to 77% (17-19)

Each type of therapy has its own advantages and limitations. Sometimes more than one treatment may be combined to reach optimal results. Many children all over the world are already receiving treatment to control nearsightedness. Speak to your eye doctor today to see what is best for your child and don’t just give them a stronger eyeglass prescription each year.

References:

  1. Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P., Wong TY, Naduvilath TJ, Resnikoff S, Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050, Ophthalmology, May 2016 Volume 123, Issue 5, Pages 1036-1042
  2. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Progress in retinal and eye research 2012;31:622-60.
  3. Jones-Jordan LA, Sinnott LT, Manny RE, et al. Early Childhood Refractive Error and Parental History of Myopia as Predictors of Myopia. Invest Ophthalmol Vis Sci 2010;51:115-21.
  4. Rose KA, Morgan IG, Ip J, et al. Outdoor Activity Reduces the Prevalence of Myopia in Children. Ophthalmol 2008;115:1279-85.
  5. Al-Bdour, M. D., Odat, T. A., & Tahat, A. A. (2001). Myopia and level of education. European journal of ophthalmology, 11(1), 1-5.
  6. Ip JM, Huynh SC, Robaei D, et al. Ethnic differences in refraction and ocular biometry in a population-based sample of 11-15-year-old Australian children. Eye 2008;22:649-56.
  7. Lim, L. S., Gazzard, G., Low, Y. L., Choo, R., Tan, D. T., Tong, L., … & Saw, S. M. (2010). Dietary factors, myopia, and axial dimensions in children. Ophthalmology, 117(5), 993-997.
  8. Cho P, Cheung SW, Edwards M. The Longitudinal Orthokeratology Research in Children (LORIC) in Hong Kong: A Pilot Study on Refractive Changes and Myopic Control. Current Eye Res 2005;30:71-80.
  9. Walline JJ, Jones LA, Sinnott LT. Corneal reshaping and myopia progression. Br J Ophthalmol 2009;93:1181-5.
  10. Swarbrick HA, Alharbi A, Watt K, Lum E. Overnight Orthokeratology Lens Wear Slows Axial Eye Growth in Myopic Children. Invest Ophthalmol Vis Sci 2010;51:1721.
  11. Kakita T, Hiraoka T, Oshika T. Influence of overnight orthokeratology on axial elongation in childhood myopia. Invest Ophthalmol Vis Sci 2011;52:2170-4.
  12. Cho P, Cheung S-W. Orthokeratology for slowing myopic progression: a randomised controlled trial. Cont Lens Anterior Eye 2011;34:S2-S3.
  13. Charm J, Cho P. High myopia-partial reduction ortho-k: a 2-year randomized study. Optom Vis Sci 2013;90:530-9.
  14. Hiraoka T, Kakita T, Okamoto F, Takahashi H, Oshika T. Long-term effect of overnight orthokeratology on axial length elongation in childhood myopia: a 5-year follow-up study. Invest Ophthalmol Vis Sci 2012;53:3913-9.
  15. Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, Gutierrez-Ortega R. Myopia control with orthokeratology contact lenses in Spain: refractive and biometric changes. Invest Ophthalmol Vis Sci 2012;53:5060-5.
  16. Chamberlain P, Logan N, Jones D, Gonzalez-Meijome J, Saw S-M, Young G. Clinical evaluation of a dual-focus myopia control 1 day soft contact lens: 3-year results. Presented at: British Contact Lens Association Clinical Conference, Liverpool, England.
  17. Chua WH, Balakrishnan V, Chan YH, et al. Atropine for the treatment of childhood myopia. Ophthalmology 2006;113:2285-91.
  18. Tong L, Huang XL, Koh ALT, Zhang X, Tan DTH, Chua W-H. Atropine for the Treatment of Childhood Myopia: Effect on Myopia Progression after Cessation of Atropine. Ophthalmology 2009;116:572-9.
  19. Chia A, Chua W-H, Cheung Y-B, et al. Atropine for the Treatment of Childhood Myopia: Safety and Efficacy of 0.5%, 0.1%, and 0.01% Doses (Atropine for the Treatment of Myopia 2). Ophthalmol 2012;119:347-54.
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