Myopia, also known as near-sightedness, is a condition whereby the light rays going into the eye falls in front of the retina, which causes blur vision.
It is estimated that 65% of our children are myopia by Primary 6, which is around 12 years old, and projections show that 80% of Singaporean adults will be myopic in 2050.
The Health Promotion Board (HPB) Singapore does vision screening for children in primary and secondary schools, which is very useful in detecting when a child is not able to see clearly. In addition, there are also more comprehensive and holistic approaches such as incorporating more outdoor activities, as it has been shown that this may delay the onset or slow down the progression of myopia - this is good news!
Here are some general tips to help manage myopia:
1) Incorporate more outdoor activities into daily lifestyle
Try to spend at least 2 hours outdoors in the daytime, e.g. taking a walk in the park, spending time at the playground. Exposure to sunlight or brighter light may reduce the risk of onset of myopia or help slow myopia progression. Blue light may have a suppressive effect on myopia. The sky is blue.
2) Ensure good working distance
Holding reading materials such as books, tablets, and mobile phones at least 30cm away may be beneficial in lowering the risk and progression of myopia. A further working distance reduces the amount of accommodation required by the eye, i.e. the eye needs to 'focus' less. Good posture helps too.
3) Sufficient lighting for near work
Not having good lighting can mean holding the reading material closer than normal, which is not good (see Point 2 above). There seem to be conflicting suggestions about the type of lighting (such as fluorescent VS LED), so we suggest lighting that is comfortable, reasonably bright, and preferably diffuse or filtered to prevent excessive reflections and glare.
4) Reduce continuous time spent on near work
Continuous near work may increase the risk for myopia, therefore it would be good to take regular visual breaks. A good rule you may be familiar with is the 20-20-20 rule: every 20 minutes, look at something 20 feet away, for 20 seconds. A timer can be used as a reminder to help achieve this. Regular breaks may also help reduce eye strain - for adults with already-stable myopia.
5) Have good sleep
While it is still arguable, with different studies showing varying results, myopia risk could potentially be linked to sleep (or a lack thereof) or sleep quality. It may be prudent to get sufficient sleep - for children at least 9 hours and for teenagers at least 8 hours - since good rest is linked to better cognitive function anyway. If you're reading this article in the middle of the night....you know what to do.
6) Good diet, perhaps
Another arguable point, with studies giving varying answers, there could potentially be a link between diet and myopia. Since a good diet is essential to overall development, why not.
7) Regular eye checks
If you don't check, you never know. You can also keep a record of the prescription, so that you can monitor the progress of the myopia. Increase in myopia results in blurry distant vision, which can result in squinting (squeezing eyelids together) to see further objects like bus numbers, the television, or the whiteboard at school. Some children may rub their eyes more often, or try to tilt their head to an extreme gaze in order to look through the periphery of the lenses which may feel less blur. Moving closer in order to see clearly is also an indication that further vision is not clear.
For myopia that is increasing rapidly, the duration between checks should be shorter, e.g. 6 months or less. For more stable myopia, it can be 9 months or 1 year. Intervention may be considered for rapidly increasing myopia, as well as myopia that starts from a younger age, as these have greater potential to progress to higher amounts of myopia, which can increase the risk of eye diseases down the road.
Intervention Products
Myopia Control Lenses
There are three main categories of myopia control lenses:
1) Bi-Focals and Progressive Addition Lenses - these use a lower prescription at the bottom of the lenses
2) Peripheral defocus lenses - these use a lower prescription towards the periphery of the lenses
3) Lenslet method - e.g. Essilor Stellest (concentric rings of contiguous aspherical micro-lenses) and Hoya MiYOSMART (Defocus Incorporated Multiple Segments); these use micro-lenses of a lower prescription in the mid-periphery of the lenses
Note: there is no evidence that 'pin-hole' glasses or 'blue light blocking' glasses slow myopic progression - even if you don't believe me, you should believe SNEC.
Atropine Eyedrops
SNEC has been using it for many years, and is divided between low-dose and high-dose, each with its pros and cons.
Orthokeratology
Also known as OK lenses, these are rigid contact lenses that are put on before sleep to modify the shape of the cornea. Monitoring and follow up must be adhered to.
Contact Lenses
There are soft contact lenses that can be worn during waking hours, using concentric rings of a lower myopic prescription. Daily lenses are relatively less risky from an infection/cleanliness standpoint.
You can research and discuss with providers of each of the above products on a suitable myopia management plan. There are on-going research and published research on the intervention products listed above. You should discuss with your myopia management practitioner on what is efficacious, suitable for your lifestyle needs and wants, appropriate to your budget and intention, and on the pros and cons of whatever you want to proceed with.
Also, we like SNEC's page - it's a good summary.
The above for information only. As of writing this, we do not provide myopia control lenses, orthokeratology, or contact lenses. Atropine eyedrop treatment can be done at an eye doctor's clinic.
We provide lenses to correct myopia and astigmatism.
Comentarios