What is Myopia?

Myopia is also known as short sightedness or near sightedness. Myopia occurs when the eyeball is too long or when the cornea is too curved. This causes the eye to focus the image in front of the retina and not on the retina. People with this condition can see objects clearly at near, but distant objects appear blurred. The World Health Organization (WHO) has predicted that by 2050, 50% of the world’s population will be myopic.

Myopia in Children

Generally, myopia occurs in children. These children do not usually complain of blurring of vision. However, there are certain signs that parents can look for in their children such as squeezing their eyes to see clearly, go up close to see an object, rub their eyes and some may also tilt their head to see. Myopia in children is usually genetic in nature. If their parents have myopia, then there is a high chance for their child to develop myopia. Early onset myopia which usually starts before the age of 6 are hereditary. There are certain activities that have been shown to increase myopia in children. These are excessive near work such as reading and increase of screen time with a computer, laptop or handphone and lesser outdoor activities.

Research on Myopia

Strong evidence has shown that exposure to ultraviolet light (sunlight) outdoors at a young age influences the growth of the eyeball. When the eyeball gets exposed to ultraviolet light, there is a release of a neurotransmitter called dopamine which prevents elongation of the eyeball. A study in 2008 done among school children has shown that outdoor activity is a major protective factor against myopia in childhood. Another study done in Taiwan among school children showed that by increasing 18 minutes a day of outdoor activity during recess time showed a reduction of 20% of myopia within a year. This shows that natural sunlight has a positive effect on reducing risk of myopia progression. Excessive near work and increased screen time with gadgets such as laptop, computer and smartphones have also been associated with increase in progression of myopia. The ciliary muscle in the eye tends to work harder when doing excessive near work in unnatural lighting thus causing reduction of dopamine levels in the brain leading to myopia. The American Academy of Pediatrics recommends that children below age of 2 should not be exposed to any of the tablet devices.

In summary, myopia in children is naturally progressive in nature. Children’s eyes tend to grow during childhood and myopia progresses till about the age of 20. Treatment for myopia is a proper prescription of glasses. Myopia in children who are still progressing in their early childhood and not responding to the conservative method will require myopia control treatment. The best age to get your child’s eye to be tested is between ages of 4-6. Your child’s eyes are best checked by a Pediatric Ophthalmologist.

Myopia Control Treatment

Children with myopia, also known as short sightedness or near sightedness tend to show regular progression or worsening of their vision over time. The increase in myopia prevalence has led to new development of new standards of care. There are several effective treatment to slow down its progression.

Atropine Eye Drops

Atropine eye drops are given to slow down myopia progression in children. A 0.01% concentration of atropine is usually advised to be used at night. This eye drop works by relaxing the ciliary muscle in the eye which gives an effect to the brain to increase the release of dopamine. Dopamine prevents elongation of the eye and thus reducing the progression of myopia. Low-dose atropine for myopia is used for children between 5 and 18 years old. The drops are put in the eye each night at bedtime. Side effects may include redness or itchiness around the eye.

Ortho-K Lenses

Orthokeratatology are special contact lenses that a child wears overnight to correct blurry vision during the day. It is used to flatten or steepen the curvature while sleeping, reshaping the cornea to get clearer vision during the day. Ortho-K lenses only improves your vision for a short time. Once a child stops wearing the lenses, the cornea goes back to its normal shape and myopia recurs. However, it does provide reduction in myopia progression.

Myopia Control Glasses

Bifocal or multifocal glasses are also prescribed to young children to prevent myopia progression. The top portion of the glasses allows for clear distant vision while the bottom portion contains reading power by reducing or eliminating the accommodative effort associated with myopia. Special spectacle lens design has also been developed which work similarly as Ortho-K lenses by causing peripheral blur and reducing the overgrowth of the eyeball. These spectacle design has shown to be more effective than bifocal or multifocal lens design in controlling childhood myopia progression.

Know Your Ocular Sport Injuries

Everyone enjoys sports! Sports can help to achieve fitness goals and maintain healthy weight. Furthermore, it also helps to promote good mental health. Football, badminton, golf, tennis, squash and martial arts are some popular sports among Malaysians. However, these sports are potential for eye injury which can lead to permanent damage to the eyes.

Sports are further classified to low, high and very high risk categories based on the potential eye injuries. Low risk indicates no use of a ball, bat or racquet, and no body contact. Examples include track/field, swimming, gymnastics, and cycling. High risk sports involve the use of a ball, bat or racquet, and/or body contact. Examples of high risk sports include baseball, hockey, football, basketball, racquet sports, tennis, fencing, and golf. Very high risk sports, such as boxing, wrestling, and contact martial arts, are those in which eye protectors typically are not worn.

The most common mechanisms of eye trauma involve blunt, penetrating, and radiation injuries. Most sports related eye injuries are blunt trauma. The extent of ocular damage depends on the hardness, size and velocity of the object. Usually a blunt object smaller than the eye’s orbital opening induces more damage than a large object. It is due to rapid and great force transmitting to the internal ocular structures while larger objects exert force on the eye socket, resulting fractures of thin bones.

Penetrating injuries are relatively uncommon but such injuries may range from mild abrasions to serious lacerations. Broken glasses, fishing hooks and contact with other player’s equipment can cause penetrating injury. Contra to blunt and penetrating injuries, radiation injuries occur as a result of extensive exposure to ultraviolet light in snow skiing, water skiing, and other water sport.

Eye injuries can cause vision loss or blindness if not treated immediately. It is important to see an Ophthalmologist to examine the eye as soon as an injury occurs. Even if the injury seems minor, do not try to treat the injury by yourself.

Eye protection has reduced the number and severity of eye injuries and it is strongly recommended that protective eyewear be worn by all participants in sports in which there is risk of eye injury. Protective eyewear made of polycarbonate, a highly impact resistant plastic is stronger than regular eye glasses. Polycarbonate lenses are available in prescription and non-prescription lenses and can be fit into wrap-style frames which cover more eye area and protect eyes from flying objects. If you need prescription sport glasses, you must purchase these from an optical store with a valid eyeglass prescription.