“Keep Your Eye On Myopia” is the theme of this year's global Myopia Awareness Week, May 22-26, 2023. Myopia education and management is an important and growing problem for people, especially children. Every 3 out of 10 kids are now seen with spectacles due to short-sightedness. Pavan Verkicharla, PhD Head & Consultant Optometrist - The Myopia Centre who works extensively in this space helps us understand the essentials of this eye condition.
What is myopia?
Myopia is a medical term for short or near sightedness. An individual with myopia will not be able to see objects that are far away. Close to the eye is clear but as the object moves away, it gets blurry.
What do the terms refractive and non-refractive errors mean?
The eye normally can form a clear image because the cornea and lens bend or refract incoming light rays and focus them on the retina. When the light rays fail to focus on the retina, a clear image is not formed. This is called a refractive error. These errors occur when the shape of the eye or cornea has changed. Reasons can be due to myopia where the eyeball is too long or hyperopia where the eyeball is too short. Myopia causes nearsightedness and hyperopia causes farsightedness.
Eye diseases such as glaucoma, cataracts, retinoblastoma etc. which are not caused by refraction errors are called Non-refractive errors.
Is incidence of myopia increasing in India? Why do you think that is?
We are definitely seeing an increase more so after the Covid era. Two decades ago, 5-10 out of 100 children would have myopia. Now that number has increased to 25 to 30 out of 100. This is likely to go up in the coming years.
Common triggering factors?
Things related to near work or holding the reading material too close to the face puts stress on the eyes and triggers myopia. Other triggers include indoor centric lifestyle with less time outdoors, excessive reading, bad posture and genetics. If both parents have myopia, their child has a higher risk.
How does going outdoors reduce risk of myopia?
Light levels outside are 10 to 100 times higher than what we see inside. There is a very different light level with lower brightness inside. The spectral composition of light also varies; the amount of blue and green seen outside is vastly different. Being outdoors also provides sunlight, vitamin D along with release of good hormones that are beneficial to the eyes. Physical activity in open spaces is also known to reduce risk of myopia. Indoors, our length of vision is limited as we have our desk, furniture, work material at a distance of not more than 1 meter. In an open space, nothing is close to the eye, this relaxes the eye and increases the length of vision.
Is pollution a trigger?
There is no relationship noted between polluted cities having higher rates of myopia vs less polluted cities. Environment however does play an important role with regards to how much time is spend outside. Pollution does hinder outdoor activities and play.
How can one prevent or delay myopia?
Myopia can be prevented if you follow these steps:
- The best strategy is to have an outdoor centric lifestyle.
- Spend 1 to 2 hours doing outdoor activities during the day. Night-time activities do not count.
- Keep reading material as far away from the eye as possible. Children have shorter arms so their working distance is less compared to adults.
- When reading take frequent breaks.
- Maintain good posture.
What are the early signs or symptoms that should be spotted in children?
This condition typically occurs in school children. Myopia can occur in young adults too after the age of 15, however majority of the times, it occurs in childhood. Signs to watch out for in children:
At class: Squeezing of eyes as they are unable to see the class board.
Copying notes from their peers sitting next to them.
At home: Sitting very close to the TV or any screen.
Bending too much while reading or keeping the reading material too close to the eyes.
Are there any screening guidelines for children?
The government recommends an annual check-up. Many schools mandate a yearly check-up regardless of whether the child has myopia or not. Several eye diseases can only be detected in an eye exam done by an Ophthalmologist, so do not ignore regular testing protocols. Myopia should be checked regularly since it can progress over time.
Is myopia reversible?
Post the age of 18, many options besides spectacles are available to correct myopia. These include contact lenses, corrective surgery, LASIK etc. However, the damage to the eye is already done. The eyeball is like a balloon; with each increase in power it keeps stretching.
How is myopia corrected?
Broadly there are 3 categories available for correction:
- Lifestyle or behavioural modifications such as spending more time outdoors, taking frequent breaks while doing near work, good posture etc.
- Optical strategies to control progression. Special myopia control lens options are now available in spectacles called Peripheral defocus lenses, Bifocal or Multifocal lenses. Newer lenses are coming that can also alter the contrast. The technology available in spectacles is also available in contact lenses. In contact lenses, we have now lenses in the soft format. Semi-soft contacts are used where you can wear the contacts at night, sleep in them and remove them in the morning. The myopia is corrected by morning and you can have a lens-free day. This is called Orthokeratology or corneal reshaping contact lenses. Red and blue light therapy is also in the pipeline for myopia correction.
- Pharmacological solutions include eyedrops. The most commonly used eyedrops are low dose atropine.
Care tips for people with Myopia:
Get your eyes checked once a year
If your eye power is constantly changing and increasing year on year, speak to your Ophthalmologist about myopia control lenses.
If you are wearing contact lenses, be aware of eye infections that it can lead to if you don’t maintain proper care. Infections can be caused if there is lack of proper hand hygiene, sleepin with contact lenses or wearing them for more than 8-10 hours.
Advice to all children and their parents?
Prevention is better than cure! The more myopia you have, the more is your risk for visual impairments, complications etc in the future. Take care of your eyes and follow good lifestyle habits to prevent damage to your eyes.
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Common myths on Myopia Myth: Myopia is caused by by too much reading or working long hours on a computer. Fact: Increase in near-sighted activities, combined with genetic and environmental factors increases risk of myopia. Myth: Carrots can improve myopia. Fact: Carrots are associated with good vision due to their vitamin A content, however there is no evidence to suggest that carrots can improve or treat myopia. Myth: Eating specific foods can prevent or cure myopia. Fact: Currently there is no conclusive evidence to support the idea that specific foods such as carrots, coriander etc can prevent or cure myopia. Myth: Myopia only affects children and teenagers. Fact: Myopia can develop at any age, although it typically starts during childhood or adolescence. However, it is possible for myopia to progress or develop in adulthood. Myth: Myopia can be cured. Fact: While various treatments are available to manage myopia, there is currently no known cure. Treatments may include corrective lenses, orthokeratology (corneal reshaping contact lenses), or refractive surgeries like LASIK. These methods aim to improve vision but do not eliminate myopia permanently. Myth: Power never stops increasing . Fact : After 15-18 years of age, myopia should stabilize Myth: Can eye exercises reverse myopia Fact : Eye exercises may improve the vision but will not reverse myopia. |
