What Is Myopia?
Myopia is an eye condition that results in poor or blurred vision when viewing in the distance. It is also known as near-sightedness because people with myopia can still see things clearly that are close.
In myopic eyes, commonly, the length of the eyeball is longer than it should be, causing images of distant objects to be focused ‘in front of ‘ rather than ‘on’ the light sensitive layer of the eye known as the retina.
Approximately 30% of the world’s population suffers from myopia. Furthermore, based on current trends, it is estimated that by 2050, almost 50% (or a staggering 5 billion people) will have myopia.1
COVID-19 has significantly raised the stakes and increased the burden of myopia. Peer reviewed evidence from many parts of the world suggest that the quarantine measures of social distancing, stay at home, surge of near based activities and less time outdoors has resulted in a significant spike in prevalence, incidence (new cases of myopia) and progression of myopia.2-4
The impact of myopia is substantial.5
- Uncorrected myopia is a leading cause of avoidable vision impairment and, whether corrected or uncorrected, has an influence of the quality of life and social domains of a young person. For example, when uncorrected, myopia can affect children’s scholastic performance. In some situations when corrected, attitudes to wearing spectacles can affect their sychological-social well-being.
- Higher levels of myopia significantly increase the risk of developing sight-threatening complications – this risk exists even during the younger formative years but multiplies and is greater in older individuals. Complications include retinal detachment, glaucoma, myopia macular degeneration.
The most obvious sign of myopia is that objects in the distance appear blurry. Some children may report headaches and/or eye fatigue caused by the eyes straining to focus or having to move or sit closer to activities (for example, in classroom) to see clearly.
Myopia usually develops during childhood, so parents should start to check behaviours, such as sitting too close to the television or screens or books, holding screens close to the face or squinting when looking at objects. Observant teachers may also notice children who have difficulty reading the blackboard.
Myopia often progresses through childhood and at times into teenage years and early adulthood. Progression is recognised by distance vision getting blurry despite correction.
Of the many factors found associated with myopia, such as ethnicity, parental myopia and urban living, two factors are significant and found to be causally related.6
- Near work and education. The greater the time spent on near work, the greater the risk of myopia- both onset and progression. In children of the same age, those who were in a higher class/grade at school (greater academic load) have a more myopic refractive error.
- Less time outdoors. Those that spend less time outdoors are at significant risk of myopia.
Traditional corrective lenses (spectacles and contact lenses) help restore clear vision at distance, but do not control the progression of myopia. The intent of myopia management is to slow or stop lengthening of the eyeball through specially designed spectacle and contact lenses that reduce or modulate defocus (blur) at the periphery of the eye or with drug therapy.
Additionally, improved time outdoors was shown to be effective in reducing the onset of myopia.
Although higher levels of myopia are associated with increased risk of complications especially later in life, no level of myopia is safe. People with high myopia (-5.00D or worse) have an increased risk of retinal detachment, cataracts, myopic degeneration and glaucoma, which can all cause vision loss. People with high myopia should ask their eye care professional about the warning signs for these conditions, and ensure they have comprehensive eye health examinations regularly.
Evidence indicates that it is possible to reduce the risk of onset of myopia. The condition may be delayed or prevented by spending less time on devices and more time outside, possibly due to increased exposure to sunlight or the need to look into the far distance regularly. While myopia cannot be completely prevented, when it onsets, it can be managed through the use of specially designed glasses or contacts – and through drug therapies (eye drops). These management approaches aim to slow the progress of myopia thus reducing the risk of the eye reaching higher levels of myopia.
References & Resources
For Practitioners
There exist several resources (both online and in print) as well as education programs that practitioners can access to improve their knowledge on myopia management. For a summary highlighting the key areas and current evidence refer to International Myopia Institute (myopiainstitute.org).
For current approaches in myopia management visit Review of Myopia Management (reviewofmm.com), or the practitioner friendly tools and calculators at BHVI’s Global Myopia Centre.
- Raise your brand awareness in your local area, community as a myopia professional and/or a myopia management practice.
- Ensure your practice is child-friendly; train staff to work with children and their caregivers.
- Demonstrate the risks of not intervening early and hard. Discuss the benefits of interventions that prevent and/or slow progression of myopia.
- Consolidate and provide information for the parents in a manner that is user friendly
- Become a partner in the journey of your myopic patient. Engage with them and support them as required.
For Parents
There are simple strategies you can put in place to help prevent your child from developing myopia. From introducing device breaks and encouraging outside play time, you can improve the environmental factors that we know play a crucial role in the prevention or development of myopia.
If you wish to know more about myopia, you can access the resources at Global Myopia Awareness Coalition (allaboutvision.com/gmac), International Myopia Institute (myopiainstitute.org) and BHVI’s Global Myopia Centre. However, please be reminded that your practitioner is best suited to discuss the individual needs of your child as they will take into account the circumstances surrounding your child’s eye health.
- Eye health is as important as physical health. Make your child’s eye health a priority.
- Support and work together with your child in adopting positive eye health habits.
- Stay informed. Book an eye examination for your child with an eye care professional before they commence schooling and at regular intervals thereafter.
- Activate outdoor time – encourage skipping, hopping, and moving outdoors as a daily routine. Be a role model for your child.
- Encourage taking a break from near tasks/digital media – moving eyes to look at distant objects, outside the window, a little walk outside is important to reduce risk. Praise, encourage and support your child.
- If your child is already myopic, there are ways to slow the progression and reduce the burden. Keep in touch with your eye care professional.
- Holden, B.A., et al., Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology, 2016. 123(5): p. 1036-42.
- Wang, J., et al., Progression of Myopia in School-Aged Children After COVID-19 Home Confinement. JAMA Ophthalmol, 2021. 139(3): p. 293-300.
- Hu, Y., et al., Rates of Myopia Development in Young Chinese Schoolchildren During the Outbreak of COVID-19. JAMA Ophthalmol, 2021. 139(10): p. 1115-1121.
- Wong, C.W., et al., Digital Screen Time During the COVID-19 Pandemic: Risk for a Further Myopia Boom? Am J Ophthalmol, 2021. 223: p. 333-337.
- Sankaridurg, P., et al., IMI Impact of Myopia. Investigative Ophthalmology & Visual Science, 2021. 62(5): p. 2-2.
- Morgan, I.G., et al., IMI Risk Factors for Myopia. Investigative Ophthalmology & Visual Science, 2021. 62(5): p. 3-3.
