A Less Myopic View of Myopia -- Increasing Incidence of Myopia in our Children
A Less Myopic View of Myopia
Myopia (or near-sightedness) is a condition that is very common and its incidence is on the rise, world-wide. In fact, it is a silent epidemic that few people are talking about. The health risks are underappreciated.
Fifty years ago about 25% of young adults in the United States were myopic. Now in the span of one generation the rate has doubled to about 50%. In East Asia the percentages are staggering. Over 90% of teenagers are myopic in South Korea, for example.
Myopia commonly begins in the second or third grade with blurry vision for distance tasks such as board work. It often progresses until the high-school years at which point it plateaus. By this time many people need their glasses for all activities, near and far. Although vision can be improved with glasses, contact lenses or refractive surgery, there are risks associated with myopia that glasses, contact lenses or refractive surgery do not remove. Most myopes have an eye that is elongated compared to a non-myopic eye: the more myopic you are the more elongated the eye is.
Genetics have a significant role in myopia, but the rapid rise in the incidence cannot be explained by genetics alone. Book work, and more recently, hand-held electronic devices may be the culprit in the rapid increase. However it may not actually be the near-work activity but rather the reduction in time spent outdoors. Focusing at longer distances and exposure to bright light may have a protective effect against myopia.
Significant myopia, defined as greater than 5 or 6 diopters, can be associated with numerous ocular complications such as retinal detachment, glaucoma, cataracts and retinal bleeding. Clearly, treatments to prevent or slow down the progression of myopia are needed.
Recently the use of daily Atropine drops has been shown in numerous clinical studies to slow the progression of myopia in children. The drops are instilled daily and potential side-effect are felt to be minimal. A strong consideration for the use of these drops should be discussed in children with a strong family history of high myopia, and/or children who are showing myopia that is progressing more rapidly than typically seen.
Myopia is commonly thought of as harmless and simply treated with glasses. The reality is that myopia is becoming an epidemic with significant health implications. Understanding the condition and treatment options can help combat its untoward effects.
Post by Darron A. Bacal, MD, FAAP. Dr. Bacal is a specialist in Pediatric Ophthalmology and Adult Strabismus. He is the Chair of Professional Education for the American Association for Pediatric Ophthalmology & Strabismus and an Assistant Clinical Professor @ Yale New Haven. For more information about treatment, or any of the services we offer, contact us at any of our 4 offices in Milford, Orange, Branford, or Shelton. We’re looking forward to hearing from you soon.