Myopia – What is it? Why it matters!
Video on Myopia
Printable A4 Leaflet
Questions on Myopia and Genetics – Early eye detection
Once Myopia starts what then?
Are screens bad?
Myopia
(Short-sightedness)
What is it and why does it matter?
For an ever increasing number of people when we look at things in the distance they are blurry. This is often known as being short-sighted, the correct technical term is Myopia. This happens because the eyeball has grown too long and images come into focus at too short a distance inside the eye. In order to help a person who is Myopic (short-sighted) to see better, a lens is needed to push the image into the correct position. If we bring something closer to us this also pushes the image back and makes it clear as well.
Myopia is becoming increasing common and is happening to children at a younger age more than ever. Experts have estimated that the number of Myopic people will grow to almost 50% of the worlds population by the year 2050. There has been a lot of research to explore why eyeballs are getting longer (axial elongation).
The short video below explains this and is useful to start to understand more about Myopia.
Tips to manage MYOPIA and protect vision printable A4 leaflet
Click the button below to download and print “Tips on managing Myopia and protecting vision”.
This is a valuable tool for parents, schools, communities, practices and, surgeries.
Can we correct Myopia?
Great question! The blurry vision caused by Myopia is also known as refractive error, we can correct the refractive error to give clear vision. The most common methods for correction are wearing glasses or contact lenses. The strength of the correction is the smallest power lens that gives clear vision.
Using glasses or contact lenses or even refractive surgery like LASER does not do anything to treat the underlying reason we are short-sighted. We can correct the symptom of blurred vision but this does not treat Myopia.
Does wearing glasses make eyes worse? NO!
This is one of the most common myths about eyesight. This is an area that has seen an awful lot of research over the years because like many myths and conspiracy theories, it sounds like it should be true… but like the ‘flat-earth’ theories the data proves otherwise.
You may even have heard this from an optometrist or an eye-doctor in the past but we now know that this is not true and this has been confirmed by many independent researchers. In fact, there is greater evidence that under-correcting the vision (or not wearing your glasses or contacts) is associated with worse outcomes than having your vision corrected properly.
Can we delay or slow down when children develop Myopia?
As mentioned above we can correct the blurred vision caused by Myopia and we know that children are developing Myopia earlier and earlier. We also know that the earlier someone develops Myopia, the more time the eye is at risk of getting longer (axial elongation) and the greater the chance of developing High-Myopia and therefore increasing the risk of eye problems in later life. So we need to identify those at risk and talk about ways to delay the onset.
We now know that there are a number of complex reasons behind this trend and that there is a complex interplay between genetics and environmental factors at work. It is very easy to try and blame the rise in the use of technology and devices, but it is not that simple.
Genetics- early identification
One of the things that we know about Myopia is that short-sighted parents are far more likely to have short-sighted children. Statistically when a parent is short-sighted the chance of having a child with Myopia is around 80% or 4 out of 5 children will need vision correction.
This means that when a parent is Myopic, then children are far more likely to be Myopic than the average child. This means that these children (and their parents) need to know how to reduce the risk or slow the development of Myopia.
Furthermore, these children should be monitored regularly to see if they are developing Myopia, early identification is really important and its important to realise the school eye examination only takes place in Junior Infants (if at all) and does not happen again.
Spend time outdoors
One of the surprising risk factors that has been identified is the amount of time that children spend outdoors. Children today spend longer in school, they do more homework, are more likely to travel in a vehicle rather than walk or cycle and often have hobbies that are indoor based than in the past.
Best practice guidelines suggest that children should spend at least 2 hours a day outdoors. The evidence from research shows that there is a strong link between lack of outdoor time and spending longer inside.
It is also important to use natural light as much as possible for all tasks.
Reduce close work
This is probably not a surprise, but excessive close work is associated with being more Myopic and faster progression of Myopia. It is important to reduce the amount of time we spend doing close work and to take more frequent breaks when doing close work. It is important to realise that there is little evidence that using a screen is more of a risk that reading a book. Close work is close work whether it is a device or a book!
Children should be encouraged to take a break from close work every 20 minutes (the 20/20/20 rule- every 20 minutes take at least 20 seconds to look at least 20 feet away).
If you (or your child) holds a fist to the chin, reading material should be no closer than the elbow. This is sometimes known as the ‘Harmon Distance’. This distance is easy to show and easier to measure than calling for a distance in centimetres or inches. It also grows with the child so it applies equally to a young child, or to a teenager or even an adult. It is very tempting to feel like holding something closer to us is easier to see, but it is really important to encourage good habits and holding things at the right distance is critical.
This advice is the same for devices like phones / tablets as well as books or papers- regardless of what we are reading or looking at keeping it at a longer working distance is really important.
Always take regular breaks (max 20 mins) and reading a distance no closer than the distance between the elbow and the fist against the chin.
Once Myopia has started what can we do?
Once a child has been identified as having Myopia, what comes next?
The first obvious thing is that the vision needs to be corrected. It is not fair to put a child at a disadvantage if their vision is blurry compared to everyone else. The standard correction of Myopia is by using glasses or contact lenses. Surgical options like LASER are not suitable for children because their eyes are growing and changing.
Vision correction
To wear or not to wear – that is the question!
This is a question that has been hotly debated over the years and as mentioned above; wearing glasses does not make your eyes worse. The next question is; when exactly should glasses be worn. The latest advice established on evidence-based principles is that children should wear glasses full-time and not use them when you feel like it or feel you need to! This needs to be emphasised.
Children who are myopic (short-sighted) should wear their glasses or contact lenses for full time wear and should not take them off to read or for any other reason during the day.
Beyond clear vision
We have mentioned the reason Myopia develops and gets worse is due to eyeball getting longer (axial elongation). So the obvious question is how do we stop this? Apart from the advice offered above we now know now that there are some options beyond the traditional glasses or contact lenses that have been shown to reduce the rate of how quickly children get worse. There is increasing evidence and data to show that a variety of techniques can be helpful and that some of the methods and advice from the past may not have been as beneficial as first thought.
There are a number of different strategies that can be used with the most popular being contact lenses or spectacles with a specialised design to reduce progression of Myopia. Your local optometrist can help you to understand if one of these options may be helpful for you or your child.
It is important to note that these modern options are usually not covered by the HSE standard allowances, and these can be relatively expensive compared to conventional ordinary glasses or contact lenses.
There are also several research studies evaluating current (and future) options for Myopia Management taking place in the Centre of Eye Research Ireland (CERI) which is part of TU Dublin.
Are screens bad? Digital hygiene
A significant proportion of people who use screens regularly will complain of tired eyes, headaches and eyestrain. However, the majority of the problems are related to how we use screens rather than anything inherently dangerous about the screen.
As mentioned elsewhere, regular breaks from screen use (the 20:20:20 rule) is important as is making sure thecorrect working distance is observed along with using the proper vision correction. When people use a screen in a sensible and safe way problems are minimised. Good habits (digital hygiene) should be encouraged from a young age.
