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You & Eye: S1EP4 08092020 – Does Delayed Myopia Treatment Causes Eye Diseases In The Future? | W OPTICS

Posted on September 8, 2020 under Events Share
*Disclaimer* This program offers health and nutritional information and is for educational and informational purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your eye health, you should always consult with a professional. Do not disregard, avoid, or delay obtaining medical or health-related advice from your health-care professional because of something you may have read on this site.

Does delay myopia treatment cause eye diseases in the future?

There will be consequences when we delay in treating myopia which may eventually lead to high myopia that we’re concerned about. So, what does high myopia mean? It means you have short-sightedness of more than 500 degrees based on the definition from World Health Organisation. Studies have also shown that for people with high myopia, the risk of having eye diseases is increased. (1)

Myopia is commonly also known as short-sightedness which means that if you look at an object at a distance, the object looks blurry to you. The clarity and sharpness of seeing the object clearly become blurred. (2)

Whenever we see anything, there are light rays that enter our eyes to form images on the retina, which is at the back of the eyeball. If we are myopic, light rays that enters our eye cannot reach the retina yet focuses in front of the retina resulting the image formed on the retina to be a blurred image. So, the reason why light rays cannot reach the retina, is because the eyeball is growing longer. If uncontrolled, it can grow at a fast pace, that is why power may increase every year when you go back to the optometrist for a review.

Myopia itself is not a disease, it is a visual condition whereby we see distant objects blurred. In order to have clear vision to look at objects and people around us, we will have to wear glasses to enable us to do so. As treatment is being delayed, the eyeball may grow and thus myopia progresses, which will lead to high degree or high spectacle power.

If a child has myopia, and there is a delay in treating or controlling it, the child grows up stabilising his/her power, but ending on a high note.

Not just about the high power or the need of wearing glasses, it also may mean that the child will not be able to develop his/her eyesight well. It may obstruct the child’s vision during classroom setting for example viewing of whiteboard, during PE lessons or even engaging in play time. Not being able to see clearly may be disruptive to their learning as well.

There were many clinical studies and population studies done specifically on highly myopic patients. Some studies [1,3] include myopia of 500 degrees, some use 600 and more, results show that high myopic patients are more likely to develop eye complications. Even though there seems to have related links between myopia and specific eye diseases, but we also cannot be certain that the eye diseases are solely due to myopia. The important thing is to know that the risks associated with myopia should not be underestimated. It requires efforts to prevent the onset as well as the progression of myopia. (3)

The 4 commonly seen eye conditions related to high myopia – Cataract, Glaucoma, Myopic Maculopathy and Retinal Detachment. All these eye problems have been found to have links with high myopia. (4,5)

Cataract. More commonly diagnosed in the later stages of adulthood, probably about 50+ to 60 years old. There are some evidences that persons with high myopia may develop cataracts earlier in their adult life. How they view things, in some cases, may be something like a diffused kind of blur.

Glaucoma, whereby it is due to damage to the optic nerve at the back of our eyes. Although not in all cases, but usually due to raised pressure within the eye. So, having myopia may increase the risk of glaucoma too. Someone with serious case of glaucoma sees things, like there’s tunnel-like field of vision.

Myopic maculopathy is commonly seen in people with very high myopia, or myopia of more than 600 degrees. It is due to the excessive elongation of the eyeball. What happens is that our eyeball grows or will become longer as we grow up. But if myopia is not controlled, the lengthening of the eyeball will continue. As the eyeball becomes bigger, the retinal layers get stretched. This leads to the degeneration of the retina, particularly to the central part of the retina called the macula. The macula has the highest concentration of cells that interpret colour images and is also in charge of processing detailed images. An idea of how someone with maculopathy would view objects – in some cases, vision loss or distortion of vision.

Lastly, retinal detachment. The retina is somewhat like a film in a camera. There are several layers of the retina, due to the eyeball being too long, it is more vulnerable to tearing and detachment from other layers. Retinal detachment can be as serious as being sight-threatening, having the risk to lose vision.

So, in short, some of these associated eye diseases may lead to substantial visual loss. Patients with high myopia are more susceptible to these abnormal findings. Therefore, it is important to have your eyes checked by an optometrist at least once a year if you are an adult, and every 6 months if you are a child with myopia.

 

1. WHO. The impact of myopia and high myopia. Report of the Joint World Health Organization–Brien Holden Vision Institute Global Scientific Meeting on Myopia, University of New South Wales, Sydney, Australia, 16–18 March 2015. http://www.who.int/blindness/causes/MyopiaReportforWeb.pdf Accessed 7 Sept 2020.
2. https://www.aao.org/eye-health/diseases/myopia-nearsightedness Accessed 7 Sept 2020.
3. Saw, S., Gazzard, G., Shih-Yen, E. and Chua, W., 2005. Myopia And Associated Pathological Complications. [online] PubMed. Available at: < https://pubmed.ncbi.nlm.nih.gov/16101943/ > Accessed 7 Sept 2020.
 4. Cho, B., Shin, J. and Yu, H., 2016. Complications Of Pathologic Myopia. [online] Pubmed. Available at: < https://pubmed.ncbi.nlm.nih.gov/26649982/ > Accessed 7 Sept 2020.
5. Flitcroft, D., 2012. The Complex Interactions Of Retinal, Optical And Environmental Factors In Myopia Aetiology. [online] Available at: < https://www.sciencedirect.com/science/article/abs/pii/S1350946212000444?via%3Dihub > Accessed 7 Sept 2020.

What are the signs that someone or a child has myopia?

Some common signs and symptoms that we can easily detect at home.

Does the child tend to move closer to the object like television or the alarm clock when he/she is looking at it? Squinting their eyes to look at something at a distance? Rubbing or blinking their eyes often, while struggling to see things afar? Loss of concentration while doing activities? Feeling tired due to blurred vision during the day or during play time. (6)

These are some of the more commonly seen symptoms that may raise the alarm bell for an eye examination.

With scientific studies pointing to us that if both parents have myopia, the chances that the child developing myopia has a much higher risk compared to parents who are not myopic. (7)

Other than genetics, reading habits and lifestyle does play a part too. Reading alone doesn’t make anyone myopic, it is the continuous reading without giving your eyes a break that lead to the development of myopia. Take simple steps to relax your eyes. Follow this rule of 20-20-20. This means after 20 min of reading or doing activities at near, look far for 20 seconds, for at least 20 feet or 6 meters. This will help your eye muscles to at least take a break. So, look far for a couple of minutes, and then continue with your reading. This principle also applies to playing games using handheld digital devices. This idea is not about whether is it a book or an electronic device, the main thing is about focusing at an up-close distance. And to add on, our sitting posture while reading or writing is important too. Slouching forward or looking at the textbook too near, would also cause unnecessary strain on the eyes. (8)

 

6. https://www.singhealth.com.sg/patient-care/patient-education/childhood-myopia Accessed 7 Sept 2020.
7. Kurtz, D., Hyman, L., Gwiazda, J., Manny, R., Dong, L., Wang, Y. and Scheiman, M., 2007. Role Of Parental Myopia In The Progression Of Myopia And Its Interaction With Treatment In COMET Children. [online] Available at: < https://iovs.arvojournals.org/article.aspx?articleid=2125052 > Accessed 7 Sept 2020.
8. https://www.singhealth.com.sg/patient-care/patient-education/childhood-myopia. Accessed 7 Sept 2020.

How can we prevent the development of myopia?

Knowing that there are related risks of eye diseases to myopia, preventing it from happening comes first. To prevent it, identify myopia first, then manage myopia. Managing myopia is not just about wearing a pair of special myopia control lens. It’s also about developing habits and lifestyle changes. With all these in mind, if you still have questions about myopia and how it works, always ask and seek advice from an optometrist if in doubt.

So, it is Identify, Manage, Develop and Ask (IMDA).

Identifying myopia simply means to find out if the child has myopia? If there’s any display of those symptoms that was shared? Does the parent themselves have myopia? It is because there are strong associations. In Singapore, to manage myopia, there are effective treatment options accessible to all but ultimately what you choose for the child would be something that both the parent and child should be comfortable with, in order for the child to enjoy the entire journey of managing myopia. Start managing myopia early. Don’t delay the treatment but delay the start of it and the progression instead. However, having just the treatment or wearing the glasses is not enough. We also need to develop good eye care habits and lifestyle. Which will require lots of determination especially from the parents and the grandparents! Proper reading posture, reading with enough lighting, taking visual breaks and the 20-20-20 golden rule are good eye care habits. (9)

Lifestyle adjustments such as spending more time outdoors helps to control myopia progression too. It is also important to ask your optometrist if you have any doubts or questions relating to myopia. With regular eye examination, it will help you understand your eye health status and early intervention helps. Wearing myopia management lenses, also help children to see clearly and control myopia progression, by slowing it down. Therefore, the aim is to have controlled eye power as he/she grows up.

Spending time outdoors, running around in the parks and looking at distant objects allow our eyes to relax. By having activities outdoors, it not only benefits our vision, it also helps the child to develop other motor and interaction skills. According to some research that was done in Australia, outdoor activities of about 2 hrs a day is suggested, as it helps in controlling myopia progression in children. (10)

 

9. www.singhealth.com.sg/patient-care/conditions-treatments/childhood-myopia/prevention Accessed 7 Sept 2020.
10. Jin, J., Hua, W., Jiang, X., Wu, X., Yang, J., Gao, G., Fang, Y., Pei, C., Wang, S., Zhang, J., Tao, L. and Tao, F., 2015. Effect Of Outdoor Activity On Myopia Onset And Progression In School-Aged Children In Northeast China: The Sujiatun Eye Care Study. [online] Available at: < https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-015-0052-9 > Accessed 7 Sept 2020.

What is the difference between a myopia management lenses compared to an ordinary optical lens?

When lenses claimed to be a myopia management lens, these lenses are uniquely designed for managing myopia, and they would be tested in clinical trials. Scientific research papers are usually published to explain some of the theories behind the whole making of the design, the ideology, the objective of running the research and most importantly, how much effectiveness is displayed by the usage of the particular lens over a period of time. Whereas an ordinary optical lens usually known as a single vision lens, is made to correct the power, but is not designed to manage myopia.

Another difference is the look of the lens. A single vision lens is single focused and looks clear and transparent everywhere of the lens. However, a myopia management lens is specially engineered and there are a few options out there, whereby each lens looks slightly different from each other.

Hoya MiyoSmart myopia management lens looks clear and transparent; akin to appear like a single vision lens. It is easy for the child to wear and adapt to the lens.

 

What is MiyoSmart myopia management lens and how it actually works as a treatment for myopia?

MiyoSmart, is an innovative spectacle lens for myopia control developed by Hoya together with its partner, The Hong Kong Polytechnic University. Based on a two-year clinical trial results, MiyoSmart is proven to curb myopia progression by an average of 60%. This lens is an easy and effective non-invasive method to manage myopia for your child. (11)

It is effective because this lens is supported by a Defocus Incorporated Multiple Segments also known as D.I.M.S. Technology, clinically proven to effectively slow down myopia progression by 60%. D.I.M.S. Technology is the driving force behind the lens. Innovated by a team of myopia researchers in Hong Kong, it creates a mechanism for the eye to respond by slowing down the lengthening of the eyeball.

The treatment zone on the lens adheres to D.I.M.S. Technology. It looks like a honeycomb design when one looked at the lens. From the research that was done in Hong Kong in 2017, not only were the power progression being studied into, the length of each child’s eyeball was also deeply assessed. Results shown that the slowdown of the growth of the eyeball averaged at 60%.

MiyoSmart is a safe product for children, because it is produced in an impact resistant material, and provides UV protection. As a pair of glasses, it is safe for children to wear it daily while performing their activities. The lens is also made easy for any child to wear and care for. As MiyoSmart is a pair of glasses, in terms of maintenance and the ease of wearing, it is almost hassle-free. This lens is suitable for ages 6 and up. So, if the child has myopia, it is most helpful to start managing it early.

To control myopia, not only do we wear MiyoSmart myopia management lens, it is also a combination of a holistic approach to inculcate good reading habits, good sitting and reading posture and not forgetting to engage in an active outdoor lifestyle.

11. Lam, C., Tang, W., Tse, D., Lee, R., Chun, R., Hasegawa, K., Qi, H., Hatanaka, T. and To, C., 2019. Defocus Incorporated Multiple Segments (DIMS) Spectacle Lenses Slow Myopia Progression: A 2-Year Randomised Clinical Trial. [online] Available at: < https://bjo.bmj.com/content/104/3/363.abstract > [Accessed 13 November 2019].

 

With the home-based learning system, children are exposed to more digital screen time. How can we tackle this problem?

We will still need to remember for our eyes to take that necessary break. Do remember this golden rule, the 20-20-20 rule. This rule guides us, after 20 min of near work, look far 20 ft for 20 seconds. This is the same concept for your child to rest in between reading. And this rule applies to adults as well. Especially with all the working from home, home-based learning, online shopping and connecting with friends over social media, it helps to allow our eyes to take breaks in between more often. (12)

12. http://safetytoolboxtopics.com/Office/the-20-20-20-rule-for-eye-strain.html#:~:text=It%20is%20pretty%20simple%20and,short%20break%20every%2020%20minutes. Accessed 7 Sept 2020.

 

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