Interventions to Prevent and Control Myopia in Children; Association with Parental Myopia

Rohit Sachdeva, B. Optom

Intern Optometrist, CL Gupta Eye Institute, Moradabad, India

Short-sightedness or near-sightedness, often known as myopia, is a highly common disorder that normally develops in early childhood. The chance of developing additional ocular issues is increased in severe forms of myopia (pathologic myopia). Although there are regional variations in occurrence, this condition affects all populations and is becoming epidemic in East Asia. Environmental and genetic risk factors can contribute to myopia development. ⁽¹⁾

Although families are known to share lifestyle habits in addition to genes, myopia is generally thought to have a genetic cause when there is a favourable parental history. As an alternative, there is the idea that parents with myopia, who are typically better educated, foster situations where myopia may develop in their offspring. For instance, these parents might expect more academic work from their kids, which might lead to them spending less time outside. Additionally, parents that read a lot could also inspire their kids to read more often. ⁽²⁾

Why is Myopia concerning?

The main factor contributing to vision impairment and blindness worldwide is uncorrected refractive error. Uncorrected myopia as little as -1.50 D can cause a moderate visual impairment, whereas an uncorrected refractive error of -4.00 D is enough to cause blindness. Even though optical correction is generally useful, axial length variations caused by biometrics cannot be reversed. The risk of vision-threatening problems such retinal detachment, myopic maculopathy, glaucoma, and cataract increases when axial length in myopic eyes increases along with thinning of the retinal pigmentary epithelium, choroid, and sclera. ⁽³⁾

Most of the practitioners (86.42%) suggested increased outdoor activity as a successful strategy for treating paediatric myopia. The next two most effective modalities, according to nearly 50% of respondents, were low-dose (0.01%) topical atropine (49.01%) and good visual hygiene (49.01%). The management plan for children’s myopia was chosen after considering a variety of issues. These elements came from the patient and the doctor. Nearly 80% of optometrists rated the pace of a child’s myopia advancement over the previous year, together with the patient’s present refractive defects, as being the most crucial factors to consider. We discovered that people who were interested in managing their myopia were more likely to mention the rate at which it was progressing. Similarly, more than 80% of participants said. ⁽⁴⁾

Conclusion

From both a practitioner’s viewpoint and a parent’s perspective, increasing outdoor activity is an effective strategy for managing myopia. Additionally, various other methods can be employed in myopia management. These include the use of low-dose (0.01%) atropine eye drops, single-vision eyewear, and orthokeratology. Soft contact lenses, such as multifocal lenses and distance-centre soft contacts, are also beneficial. Furthermore, progressive addition spectacle lenses, peripheral defocus glasses, bifocals, high-dose (>0.5%) atropine eye drops, and 1% cyclopentolate eye drops are viable options. Employing multifocal and prism lenses, ensuring an adequate working distance, and maintaining proper lighting are also important considerations.

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