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Health sense: Managing and mitigating childhood myopia
Inside: A normal eye (top) focuses light on the retina
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Inside: A normal eye (top) focuses light on the retina. Myopia stems from a lengthening of the eyeball along its axis (bottom).(Courtesy of NIH) (top) focuses light on the retina. Myopia stems from a lengthening of the eyeball along its axis (bottom).(Courtesy of NIH)
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span class="inline inline-center">Inside: A normal eye (top) focuses light on the retina. Myopia stems from a lengthening of the eyeball along its axis (bottom).(Courtesy of NIH)
Parents ' especially those who are short-sighted and who have had to wear glasses since childhood ' are often concerned about the causes of myopia and whether their children are also fated to be as visually impaired.
Childhood myopia begins during a child's growing years and worsens throughout childhood.
Those suffering from this visual condition usually complain of having difficulty seeing distant objects such as oncoming bus numbers, classroom whiteboards or even television screens.
In a bid to 'see better', some might squint or hold objects up close to their eyes.
These are signs that should alert parents to the need for their child to see an optician. After all, it is commonly understood that myopia can easily be corrected with eyeglasses.
Myopia is a type of refractive error or focusing problem of the eye, where the light rays entering the eye are focused at a point in front of the retina rather than on it. This results in blurry vision when viewing distant objects and is why myopia is also known as short-sightedness.
The most common mechanism for myopia's progression is a gradual elongation of the eyeball. So in essence, childhood myopia occurs because the eye has grown too large.
Researchers typically attribute myopia to a combination of two risk factors ' genetics and environment.
For instance, if both parents are short-sighted, there will be a greater risk that their child will be short-sighted.
However, simply looking at a couple's family tree will not always provide definitive answers, as environmental factors, such as the extent of close visual work, level of education and lack of exposure to outdoor activities have been documented to affect the progression of childhood myopia.
To fight this, parents can encourage their children to go outdoors to play and ensure that there is adequate lighting when they are reading. Children should also hold reading material at least 30 centimeters from their eyes and sit back from the computer or television.
Parents should also ensure that children sit up to read whenever possible, take vision breaks of 5 to 10 minutes after long periods of close work and have a healthy diet and adequate sleep each night.
If your child already has good eye habits ' and if your child's myopia continues to progress rapidly ' interventional measures such as atropine eye drops can be considered.
Clinical trials by the Singapore National Eye Centre and the Singapore Eye Research Institute have shown that low-dose (0.01 percent) atropine is effective in slowing myopia's progression by 50 to 60 percent over a two-year period.
While normal concentrations of the drug might cause side effects such as pupil dilation, the inability to focus on near objects and a sensitivity to light; the low dosage in this treatment means the side effects are almost unnoticeable. Treatment is most suitable for those aged between 6 and 12 years.
Typically, children undergoing this treatment would apply low-dose atropine eye drops to the eyes once daily.
In the rare case that a child does not respond to the low dosage, a higher concentration might be considered. There may be 7 percent of children who may not respond as well to atropine.
For children with myopia, parents should be aware that their vision needs to be checked at least once a year to see if their glasses need to be changed.
If you suspect that your child has myopia, or any other eye conditions such as amblyopia ('lazy eyes') or strabismus ('misaligned eyes') that commonly manifest during childhood, do bring your child to an eye specialist to ensure early treatment.
The sooner a condition is identified and managed, the less likely it will result in visual problems.
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The author, a physician and opthamologist, is the deputy head and senior consultant at the pediatric ophthalmology and strabismus department of the Singapore National Eye Centre. For more information, visit snec.com.sg.
