Myopia, Myopia Management & Myopia Control

Myopia, commonly known as short-sightedness, is a refractive error of the eye where objects in the distance appear blurry while close objects can be seen clearly. This occurs when the eyeball is too long or the cornea has too much curvature, causing light rays to focus in front of the retina instead of directly on it.

Myopia can develop in childhood and typically worsens during the growing years. It is a common condition worldwide, and its prevalence has been increasing rapidly in recent years, especially in urban areas with higher levels of education and more time spent on near work activities such as reading and screen time.

Myopia is classified as a disease, as it is associated with an increased risk of other eye conditions.It is, however, essential to understand that myopia is a naturally occurring condition, and many individuals with myopia lead perfectly healthy lives with proper correction and management. Treatments for myopia, including glasses, contact lenses, and myopia control techniques, aim to manage the condition and reduce its progression rather than “curing” it as one would with a disease. A rapidly increasing myopic spectacle prescription is a sign that myopia control should be explored.

The global prevalence of myopia was estimated to be around 23% of the world’s population in 2022. However, in some regions, particularly in East and Southeast Asia, the prevalence is much higher, with rates exceeding 80% among young adults in some urban areas. 

Furthermore, there are predictions that myopia rates will continue to rise in the coming years, with some projections suggesting that by 2050, 50% of the world’s population will be myopic if current trends persist.

CAUSES OF MYOPIA

Myopia, or short-sightedness, is primarily caused by a combination of genetic and environmental factors. The exact cause of myopia is not fully understood, but several key factors contribute to its development:

• Genetics:  Myopia tends to run in families, suggesting a strong genetic component. If one or both parents are nearsighted, their children are more likely to develop myopia. However, the specific genes involved in myopia are complex and not fully identified.
• Visual Environment: Environmental factors, particularly those related to prolonged near work and limited outdoor activities, play a significant role in myopia development. Spending extended periods of time engaged in activities such as reading, using digital devices, or doing close-up work can increase the risk of myopia, especially during childhood and adolescence.
• Eye Anatomy: Structural abnormalities in the shape and length of the eye can contribute to myopia. In myopic individuals, the eyeball tends to be longer than normal, or the cornea may be excessively curved. These anatomical variations cause light rays to focus in front of the retina rather than directly on it, resulting in blurred distance vision.
• Aging: Myopia often develops during childhood and tends to progress until the late teenage years or early adulthood. However, in some cases, myopia can continue to progress throughout adulthood, particularly in individuals with high myopia.
• Other Factors: Certain factors such as low birth weight, premature birth, and maternal smoking during pregnancy have been associated with an increased risk of myopia. Additionally, some systemic conditions like diabetes can affect the eyes and contribute to myopia development.

Overall, myopia is a multifactorial condition influenced by both genetic predisposition and environmental factors. The interplay of these factors varies among individuals, leading to differences in the onset and progression of myopia.

 

 

 

 

MYOPIA MANAGEMENT 

Short-sightedness, is typically corrected using one or more of the following methods:

• Prescription Glasses: Glasses/spectacles are the most common and simplest way to correct myopia, improving distance vision.
• Contact Lenses: Soft or rigid gas permeable contact lenses can also be used to correct myopia. Contact lenses provide clear vision without the need for glasses and may offer a wider field of view. They are available in various types, including daily disposables, frequent replacement, and specialty lenses for conditions like astigmatism.

MYOPIA CONTROL

Myopia control refers to various techniques aimed at slowing down the progression of myopia, particularly in children. These techniques may include:

• Behavioral modifications: Encouraging good reading habits, such as holding books at an appropriate distance and taking frequent breaks during near work activities, may also contribute to myopia control.
• Environmental interventions: Encouraging children to spend more time outdoors and limiting screen time and near work activities may help reduce the risk of myopia development and progression.
• Myopia Control Lenses: Multifocal contact lenses or glasses with special designs can be used to control myopia progression in children. These lenses have different powers in different zones, which may help reduce eye strain and slow down the elongation of the eyeball.
• Multifocal contact lenses or glasses:  These lenses have different powers in different zones, allowing clear vision at various distances. Some studies indicate that multifocal lenses may help slow down myopia progression by reducing the stimulus for eye growth.

 

 

 

 

 

 

 

• Peripheral defocus modifying contact lenses:  These lenses are designed to alter the peripheral optical environment of the eye, potentially influencing eye growth and slowing myopia progression.
• Orthokeratology (Ortho-K):  Ortho-K involves wearing specially designed rigid contact lenses overnight to temporarily reshape the cornea. This reshaping provides clear vision during the day without the need for glasses or contact lenses. Ortho-K may also help slow down the progression of myopia in some cases.
• Atropine Eye Drops: Low-dose atropine eye drops have been used in some cases to slow down the progression of myopia, particularly in children. Atropine works by temporarily paralyzing the eye’s focusing muscle, which may help inhibit excessive eye growth.

Myopia control methods should be discussed with an optometrist to determine the most suitable approach for individual circumstances. While these methods can be effective in slowing down myopia progression, they may not completely eliminate the need for glasses or contact lenses.

The choice of treatment depends on various factors, including the severity of myopia, lifestyle preferences, age, and overall eye health. It’s essential for individuals with myopia to have regular eye examinations with an optometrist to monitor their vision and determine the most appropriate treatment options.

 

NOTE:

Refractive surgery, such as LASIK and PRK, is not considered a form of myopia control. Instead, refractive surgery is a procedure aimed at permanently correcting refractive errors like myopia by reshaping the cornea to improve vision.

Myopia control refers to techniques or treatments that aim to slow down the progression of myopia, particularly in children and young adults. These methods typically focus on reducing the rate at which the eye elongates and the degree of myopia that develops over time.

While refractive surgery can effectively correct existing myopia, it does not address the underlying factors that contribute to myopia progression. In fact, refractive surgery is typically recommended for individuals with stable myopia whose eyes have finished growing, usually in adulthood.Therefore, while refractive surgery can provide excellent vision correction for individuals with myopia, it is not considered a primary method for controlling the progression of myopia. Individuals interested in myopia control should consult with an optometrist to explore appropriate treatment options tailored to their specific needs and circumstances.

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