•Dr Priscilia Imade
The month of July is myopia awareness month. So our discussions will be centered around myopia.
INTRODUCTION
Myopia, commonly known as nearsightedness, is a refractive error where distant objects appear blurry while close objects are seen clearly. It occurs when the eye grows too long from front to back, or when the cornea is too curved, causing light rays to focus in front of the retina instead of directly on it.
CAUSES
Several factors contribute to the development of myopia:
• Genetics: A family history of myopia increases the likelihood of developing it.
• Environmental Factors: Prolonged close-up tasks such as reading, using digital screens and lack of outdoor activity during childhood.
• Visual Stress: Excessive near work and inadequate lighting conditions.
• Urbanisation: Higher rates of myopia are seen in urban areas, partly due to reduced outdoor time.
STATISTICS
• Globally, over 2.6 billion people are myopic.
• It is estimated that by 2050, half of the world’s population may be affected by myopia (World Health Organisation).
• In Nigeria, emerging studies show an increasing prevalence among school children, particularly in urban cities like Lagos, Abuja and Port Harcourt.
• Myopia often starts in childhood and progresses during teenage years.
SYMPTOMS
People with myopia may experience:
• Blurred vision when looking at distant objects
• Squinting or straining to see clearly
• Headaches due to eye strain
• Difficulty seeing the board in class or road signs while driving
• Frequent rubbing of eyes in children
RISK FACTORS
• Family history of myopia
• Early age of onset (before age 10)
• Prolonged screen time and close-up work
• Lack of sunlight exposure (less than 1–2 hours daily)
• Urban lifestyle with limited outdoor activities
COMPLICATIONS OF MYOPIA
While mild myopia is usually manageable with glasses or contact lenses, high or progressive myopia can increase the risk of serious eye diseases later in life, including:
• Retinal Detachment: As the eye elongates, the retina becomes stretched and thin, increasing the risk of detachment, a medical emergency that can cause permanent vision loss.
• Myopic Macular Degeneration: Damage to the central part of the retina (macula) can result in irreversible vision loss.
• Glaucoma: Myopic eyes are more susceptible to increased intraocular pressure, which can damage the optic nerve.
• Cataracts: Myopia is associated with an earlier onset of cataracts.
• Vitreous Degeneration: Floaters and light flashes become more common in highly myopic eyes.
TREATMENT
There is no cure for myopia but several treatment options help correct vision and slow its progression:
1. Optical Correction
• Eyeglasses: The most common and simplest method for correcting myopia.
• Contact Lenses: Suitable for active individuals; available in soft, rigid gas permeable and hybrid forms.
2. Pharmacological Treatment
• Low-Dose Atropine Eye Drops: Used in children to slow the progression of myopia. These drops relax the focusing mechanism of the eye.
3. Orthokeratology (Ortho-K)
• Specially designed rigid contact lenses worn overnight to temporarily reshape the cornea and reduce daytime myopia.
4. Refractive Surgery
• Procedures like LASIK and PRK can permanently reshape the cornea for adults who meet specific criteria. Not suitable for children.
MANAGEMENT
Managing myopia involves not just correcting vision but actively monitoring and slowing its progression especially in children and teens.
• Regular Eye Examination: Early detection through routine eye checks (at least once a year) is needed.
• Monitoring Eye Growth: Measurement of axial length and refraction over time helps track progression.
• Myopia Control Programmes: Combining optical, behavioral and pharmacological methods tailored to the individual.
PREVENTION
While genetics cannot be changed, environmental and behavioral interventions can help delay or reduce myopia onset and progression:
1. Increase Outdoor Time
• At least 2 hours of outdoor activity daily for children reduces the risk of developing myopia.
2. Limit Screen Time and Near Work
• Practice the 20-20-20 rule: Every 20 minutes, look 20 feet away for at least 20 seconds.
3. Proper Lighting and Posture
• Ensure adequate lighting when reading or working. Maintain a safe viewing distance from screens and books.
4. Early Eye Checkups
• Begin comprehensive eye examination by age 3, or earlier if there’s a family history.
CONCLUSION
Myopia is no longer just a refractive inconvenience, it is a looming public health concern. With early detection, proper management and preventive action, we can safeguard the vision of the next generation. At Modern Eye Clinic, we are committed to raising awareness and providing evidence-based interventions to reduce the burden of myopia in Nigeria.
*Dr Priscilia Imade is CEO, Modern Eye Clinic, Lagos.
E-mail: moderneyecliniclagos@gmail.com
Another edition of the column returns on Monday in The Frontier.
