Myopia

Nearly half of all adults worldwide struggle with myopia, making it one of the most common vision problems today. While genetics play a key role in its development, lifestyle factors like extended screen time and limited outdoor activities also contribute to its increasing prevalence. Understanding this condition helps people make informed decisions about their vision health and available high myopia treatment options. 

What is Myopia? 

Myopia, commonly known as nearsightedness, is a vision condition where the eye cannot focus properly on distant objects while maintaining clear vision for nearby items. This condition occurs when the eye's physical structure prevents light from focusing accurately on the retina. 

The primary causes of myopia involve the eye's structure: 

• An elongated eyeball that is too long from front to back 
• An overly curved cornea (the clear front cover of the eye) 
• Problems with the lens shape inside the eye 

These structural issues cause light rays to focus in front of the retina rather than directly on it, causing blurred distance vision. For instance, someone with myopia might struggle to read road signs until they are very close but can easily read a book held near their face. 

Eye specialists classify myopia into two main categories: simple myopia and pathologic myopia. Simple myopia can be corrected with standard vision aids, while pathologic myopia may present challenges even with corrective measures. 

Symptoms of Myopia 

Common symptoms of this eye focus disorder include: 

• Blurred vision when looking at distant objects 
• Clear vision when viewing items up close 
• Frequent headaches and eyestrain 
• Regular squinting or partial closing of eyelids 
• Difficulty reading street signs or store displays 
• Problems seeing clearly while driving at night 

Children may display additional behavioural indicators that suggest myopia: 

• Sitting unusually close to television screens 
• Holding books or devices very close to their face 
• Poor performance in school activities requiring distance vision 
• Frequent eye rubbing 
• Reduced attention span during distance-viewing tasks 

A specific variation called night myopia affects some individuals who see clearly during daylight hours, but experience increased blurriness in dim lighting conditions. This particular symptom can make nighttime driving challenging and requires additional consideration during vision assessments. 

Causes and Risk Factors of Myopia 

The development of myopia can result from a complex interconnection between genetic predisposition and environmental influences. Research shows that children with myopic parents have a significantly higher possibility of developing the condition. Having one myopic parent doubles the risk while having two myopic parents increases the risk up to six times. 

Environmental factors play an equally crucial role in myopia development. Studies have identified several key risk factors: 

• Educational Activities: Extended periods of reading and studying 
• Screen Time: Prolonged use of digital devices, especially at close distances 
• Limited Outdoor Exposure: Less than 40 minutes of daily outdoor activity 
• Age: Development typically occurs between ages 6-14 
• Ethnicity: Higher prevalence in Asian populations 
• Urban Living: Increased risk in densely populated areas 

Complications of Myopia 

The most significant complications associated with myopia include: 

• Glaucoma: An ophthalmic condition causing damage to the optic nerve due to undue pressure within the eye, which can cause vision loss if untreated 
• Retinal Detachment: In this medical emergency, the retina detaches from its supporting tissue, which requires immediate treatment to prevent permanent vision loss 
• Cataracts: The clouding of the eye's natural lens, causing vision to appear foggy or blurred 
• Neovascularisations: Development of the unwanted blood vessels in the eyes 
• Myopic Maculopathy: A condition affecting the central retina, particularly in cases of high myopia, which can cause permanent central vision loss 

Diagnosis 

The primary diagnostic tests include: 

• Visual Acuity Testing: Patients read letters on a distance chart while covering one eye at a time 
• Retinoscopy: Using a specialised light instrument to measure how light reflects off the retinal 
• Phoropter Testing: A series of lenses are placed before the eyes to determine the exact prescription needed 
• Eye Health Examination: Assessment of various eye components, including cornea, pupil, and lens 

For children, the diagnostic approach varies slightly. Eye care specialists conduct age-appropriate vision screenings using picture charts or the "tumbling E game" for those between 3 and 5 years old. Most children receive their diagnosis between ages 3 and 12, making early and regular screening crucial. 

Treatment 

The following are some common myopia treatment options: 

• Prescription Eyeglasses: These provide immediate vision correction by changing how light enters the eye. They are particularly suitable for children and offer a safe, reversible solution. 
• Contact Lenses: Available in soft and rigid varieties, these float on the cornea to correct vision. Soft lenses are flexible and comfortable, while rigid lenses can provide sharper vision for some patients. 
• Orthokeratology: Doctors prescribe these specialised contact lenses to be worn overnight to temporarily reshape the cornea, providing clear vision throughout the day without daytime lens wear. 
• Refractive Myopia Surgery: For adults with stable prescriptions, procedures like LASIK or PRK can permanently reshape the cornea to correct vision. These surgical options typically provide long-term results but require careful patient selection. 

When See a Doctor 

Regular eye examinations serve as the cornerstone of maintaining healthy vision. For children and adolescents, specific age-based guidelines determine examination frequency: 

• Ages 3-5: At least one comprehensive eye examination 
• Ages -6: Tre-kindergarten screening 
• School-age Children: Annual examinations through high school 
• Children with Existing Myopia: Every six months 
• Adults: Ndults should schedule eye examinations based on age and risk factors. Those in their 20s should have at least one comprehensive exam, while individuals in their 30s should schedule two examinations during the decade. After age 40, regular comprehensive eye assessments become increasingly important. 

Emergencies requiring immediate medical attention include: 

• The sudden appearance of floating specks or lines in the vision 
• Flashes of light in one or both eyes 
• A curtain-like shadow across the field of vision 
• Sudden changes in peripheral vision 

Prevention 

The most significant preventive measure is increasing outdoor exposure. Studies demonstrate that spending at least two hours daily in natural light can reduce the risk of myopia development by up to 2% for every additional hour spent outside weekly. This protective effect occurs because natural sunlight stimulates dopamine release in the retina, which helps maintain proper eye shape. 

Key myopia prevention strategies include: 

• Following the 20-20-20 rule, take a 20-second break every 20 minutes to look at something 20 feet away 
• Maintaining proper reading distance (35-40 centimetres) from books and screens 
• Ensuring adequate lighting during near-work activities 
• Limiting continuous near-work sessions to 30 minutes 
• Creating a well-lit study environment, preferably with natural light 
• Taking regular breaks during extended screen time 

Conclusion 

Prevention plays a crucial role in managing myopia, especially for young children. Simple habits like spending time outdoors, taking regular breaks during near-work activities, and maintaining proper reading distances can significantly reduce myopia risk. These preventive measures, combined with regular eye examinations, help protect long-term eye health.

FAQS 

1. Is myopia a serious condition? 

Myopia affects nearly 30% of the population and requires attention, particularly in children. While mild to moderate myopia typically poses minimal risks when properly corrected, high myopia can lead to serious complications, including retinal detachment, glaucoma, and early-onset cataracts.

2. Is myopia bad for the eyes? 

When left untreated, myopia can impact overall eye health. Research shows that individuals with high myopia face up to 20 times greater risk of developing sight-threatening conditions. However, proper management through regular eye examinations and appropriate vision correction can help maintain healthy eyes.

3. What are the different types of myopia? 

Eye specialists recognise two main categories of myopia:

• Simple myopia: The common form that can be corrected with standard vision aids
• Pathologic myopia: The more severe form that may cause structural changes in the eye

4. How can reduce my risk of developing myopia? 

Several lifestyle modifications can help reduce myopia risk:

• Spend at least 2 hours daily outdoors in natural light
• Follow the 20-20-20 rule during screen time
• Maintain proper reading distance (35-40 cm)
• Take regular breaks during near-work activities

5. Which foods should I eat to keep my eyes as healthy as possible? 

A balanced diet enriched in specific nutrients supports optimal eye health. Key foods include:

• Fish: Rich in omega-3 fatty acids
• Dark leafy green vegetables: High in lutein and zeaxanthin
• Citrus fruits: Excellent source of vitamin C
• Eggs: Contain important nutrients for eye health
• Seeds: High in vitamin E and omega-3s

Dr. Neelu Agrawal

CARE Medical Team