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Myopia (near-sightedness) – an under recognized eye condition in Children
  • Around 5% of Indian school children have some degree of refractive error.
  • In India, around 50% of blindness in children occurs because of reasons which are preventable or treatable.
  • There are more than 2,00,000 blind children in India, which means that 1 out of every 1000 children is blind.

Childhood myopia is a progressive form of near -sightedness that starts during the child’s growing years and increases later. It is a refractive error in which the object at a distance appear blurred. This happens because the image falls in front of the retina instead of the retina.

Over the years, various research studies across the globe shows significant increase in myopia. This confirms the findings of many ophthalmologists and optometrists. The prevalence of myopia is very high in many parts of the world : in the USA it is 40%, while in Eastern and South East Asian countries like Singapore and Taiwan, it is as high as 80%. I believe that it would be around 40% in many parts of India. It is considered to be the second most common problem in children after obesity. In fact, some researchers believe that there is no other medical condition that has such a high prevalence worldwide.

IS MYOPIA A SERIOUS PROBLEM? IS IT SOMETHING THAT WE SHOULD WORRY ABOUT?

Yes, we have seen a rise in the number of young children coming to our centre. In a large case study known as the Andhra Pradesh Eye Study, many children were found to be partially sighted and having defective vision. They were either not identified to have refractive error or were not wearing the glasses. In China, only 20% children who need glasses actually have them or wear them. Usually, children don’t realise the complication with their eyes. They adjust to it by being closer to the object or by rubbing their eyes or by avoiding work that requires visual concentration. The impact of myopia during the childhood is very severe and irreversible.Such children are at higher risk of developing cataract, glaucoma,reduced vision in dim lighting conditions and retinal breaks leading to retinal detachment. Typically, it occurs frequently in a person with – 6.0 or more refractive error. According to Dr.Flitcroft from Ireland “Myopia has as significant impact on eye health as hypertension does on cardiovascular health”. For example, a high myope has 10 times the risk of developing retinal detachment than a person without myopia.

Although the optical correction with glasses or contact lenses, works to a great extent, but it does not treat the progression of myopia and other sight threatening complications.

WHAT ARE THE FACTORS INFLUENCING THE OCCURRENCE AND PROGRESSION OF MYOPIA?

Frankly, no set factors have been established yet. But eye usage and genetics are most common factors related to the occurrence of myopia. Studies have shown that if one or both the parents are myopic, higher are the chances of child developing myopia. The children who spend more time outdoors are less likely to be myopic. Research studies have shown that kids with normal vision spent 3.7 hours more per week outdoors than those with myopia. In some parts of the world the progression of myopia was 3 times more in cloudy winter than in brighter summer. In Sydney, Australia – the prevalence of myopia is low, because children in primary school spend 3 to 4 hours playing outdoors. Children need about 10,000 lux illumination to slow the myopic effect while a well-lit class room has only 800lux. The bright sunlight is not the only factor that helps but the outdoor activities by children gives their eyes a good exercise.

According to Dr Tan in Singapore, children who spent only half an hour outdoors have 60% higher risk of myopia.With increasing popularity of electronic media used indoors ,children who spent a lot of time with near work like reading, writing or playing computer games, were at a higher risk of developing myopia. In Europe “Those going in for university education were twice likely to be myopic as those who received only a primary/secondary school education.”

In India, awareness among teachers and parents have increased, but the rate of progression of myopia is very high.

My advice to all the parents:

  • Get the child examined by an eye specialist,at an age as early as one year.
  • Encourage the child to spend more time in outdoor activities and games, minimum 2 to 3 hrs.
  • Ask them to take ‘short-breaks’ while reading or screen viewing and make them perform other near or far activities, in-between
  • Look for family history: If any of the parents is myopic the chances of the child developing myopia is higher and if both the parents are myopic, 50% chances are that their child will become myopic
  • Half yearly periodic eye check-up is essential
  • Convince the child to try spectacles or contact lenses if the myopia is increasing
  • Short height, less weight, over nutrition, excessive vitamins, juices etc are not linked to or influence the progress of myopia.

Dr. Abhay R. Vasavada is the first Indian and the second Asian to be awarded one of the highest honours conferred for outstanding contribution in the field of Ophthalmology, the Binkhorst Medal Lecture by the American Society of Cataract & Refractive Surgeons (ASCRS) in 2011.

REH – BE AN ANGEL PROGRAM

We aim to create awareness about paediatric, Free Eye screening for children and provide free treatments to underprivileged children with the help of donations. We have multiple options under this initiative where donors can sponsor an eye examination, a surgery or low vision aids for children.