Myopia, a new disease?
Myopia, also known as nearsightedness, has always been with us. In every part of the world, nearsightedness has been, in rare cases, a help but mostly a hindrance to daily life. Although not considered a disease, nearsightedness is the condition that causes a person to have blurred vision in the distance and clearer vision at near. It is considered a serious and major health concern. Worldwide 34% of the world is myopic. In the US population, the number is 42%. By 2050 the nearsightedness is projected to be at least 50% according to the World Health Organization (WHO)(1). Nearsightedness can be thought of as an elongation of the eyeball. The length from the front to the back of the eye increases. As the length increases the level of nearsightedness increases causing increased blur and difficulty in daily life. But to add to this as the eye length increases the risk of sight-threatening conditions increases. As the eye becomes longer there is an increased risk of other eye diseases such as glaucoma, macular degeneration, cataract, retinal tears, and retinal detachment. (2) In fact, a person with nearsightedness has:
• 100 times higher risk of macular degeneration
• 3 times higher risk of retinal detachment
• 3 times higher risk of cataract
• 1.6 times higher risk of glaucoma
Children are being diagnosed at a much younger age now than in the past, and a younger age of onset has been linked to increased progression and severity of nearsightedness. (3) As it is with most diseases, nearsightedness is a condition that has associated genetic and environmental factors that contribute to it becoming an issue with a person. Environmental factors seem to be the greater drive of the increased prevalence of nearsightedness. The increase of nearsightedness in the population has corresponded to environmental factors such as dim lighting when performing near tasks such as reading, decreased time sleeping, reading at less than 10 inches (approx. 25cm.) and less time spent outdoors. (4) In a study published in 2015 found that adding 40 minutes of outdoor activity at school daily among 6-year-old children reduced the nearsightedness incidence rate over the following three years. So this leads us to now see the correlation between nearsightedness and time on the smartphone. Studies of data usage in smartphones in children with nearsightedness vs. children without nearsightedness show that nearsighted children have twice the data usage than their counterparts. Studies also show that less than three hours per week of physical activity and more than six hours per day of smartphone screen time can almost double the risk of a teen developing nearsightedness or if present, making it worse. (5)
What can be done to decrease the onset of nearsightedness or slow its progression? What has been documented to work are the following:
• Appropriate amount of time outdoors
• Reduced screen time on smartphones
• Proper lighting
• Reading at the appropriate distance use the (Harmon distance which is the distance between your middle knuckle at eye level and your elbow at the reading level).
Other solutions that have been proven to work and should be discussed with your eye doctor are executive bifocals, orthokeratology, multifocal contact lenses, and low dosage (0.01%) atropine eyedrops.
So, with the increased time indoors this past year, children are increasingly exposed to the risk factors that may contribute to nearsightedness. We can take the steps to decrease these risk factors.
- Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036-42.
- Verhoeven, VJ, Wong KT, Buitendijk GH, et al. visual consequences of refractive errors in the general population. Ophthalmology. 2015;122(1):101-9.
- Flitcroft DI. The complex interactions of retinal, optical, and environmental factors in myopia etiology. Prog Retin Eye Res. 2012;31:622-60.
- Grzybowski A, Kanclerz P, Tsubota K, et al. A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmol. 2020;20(1):27.
- Hansen M, Laigaard P, Olsen E, et al. Low physical activity and higher use of screen devices are associated with myopia at the age of 16-17 years in the CCC2000 Eye Study. Acta Ophthalmol. September 9, 2019.
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