Myopia management

THE INCREASING PREVALENCE AND SEVERITY OF MYOPIA IN CHILDREN:  

More than 40 percent of Americans have myopia and that number is increasing at an alarming rate, especially among school-age children (1). One in four parents have a child with myopia and about three-quarters of children with myopia were diagnosed between the ages of 3 and 12 (2). Two-thirds of Eye Care Practitioners (ECPs) say the presence of myopia among children in their practice has increased over the past 5-10 years, and 81% of ECPs recognize it as one of the biggest problems impacting children’s eyesight today (3).

CAUSES OF MYOPIA: 

Myopia typically occurs during childhood when the eyeball develops a longer shape, meaning the distance between the front of the eye and the retina at the back of the eye is longer than an eye without myopia. Blurry vision due to myopia is the result of light rays focusing at a point in front of the retina rather than directly on its surface (6). However, the upward incidence of myopia can be attributed to different factors, and is occasionally the result of a combination of these factors: 

• Genetics – Family history plays a role in a child’s risk of myopia. If neither parent has myopia, the chance the child will develop myopia is relatively low. But if one parent has myopia, it increases the child’s chance of developing myopia by 3x – doubling to 6x if both parents have myopia (7).
• Environment – Environment – Exposure to sunlight, vitamin D levels, dopamine levels and the amount of time a child spends outdoors may have an impact on the likelihood of myopia development. Research shows spending more time outdoors lowers the risk of developing childhood myopia (8).

MYOPIA LEVELS: 

Myopia usually starts in childhood at mild levels and often progresses (4). It may increase in severity to moderate and high levels without any interventions. Each level of myopia is defined by a specific diopter (D) range. A diopter is the unit used to measure the correction, or focusing power, of the lens the eye requires to see clearly.

• Mild Myopia: -0.50 to -2.75 D
• Moderate Myopia: -3.00 to -4.75 D
• High Myopia: -5.00 or higher 

LONG-TERM OCULAR HEALTH IMPACTS: 

As the eye continues to grow and the amount of myopia increases, ocular tissues change in response to the eye growth, resulting in eye health risks that are not as evident in a non-myopic eye. The more nearsighted a child is, the greater these risks become (5) and these risks increase exponentially as myopia progresses (5). Leaving myopia untreated may contribute to more severe eye health complications later in life (5), including:

• Cataracts – a clouding of the lens of the eye that can cause changes in vision. Though cataracts can affect everyone as they age, they often develop sooner in those who have myopia.
• Glaucoma – a condition, usually linked to high pressure inside the eye, that causes damage to the eye’s optic nerve, potentially causing irreversible vision loss and blindness. Studies show myopic people have a 2-3x greater risk of developing glaucoma (5).
• Retinal detachment – occurs when the retina, a thin layer of tissue that surrounds the entire inside the eye, pulls away from supportive layers of blood vessels that provide its necessary oxygen and nourishment (5).
• Myopic Maculopathy – caused by the deterioration of the central portion of the retina, and is a leading cause of severe, irreversible vision loss.