Lifestyle Modification and Near Vision Hygiene to Control Myopia Progression

Yogapriya Vijayaragavan, B. Optom.

Paediatric Optometrist, Aravind Eye Care System, Chennai, India

Myopia or near-sightedness is a ubiquitous eye focusing disorder. ⁽¹⁾ It has been sky-rocketing for several decades, and it is reckoned that nearly half of the population in the world may develop myopic disorder. ⁽¹⁾

Why Control Myopia?

Rapid progression of myopia may result in frequent changes of spectacles, axial length elongation, myopic maculopathy, posterior sub-capsular cataract, retinal detachment, and increased intraocular pressure. Controlling or slowing down myopic progression helps to circumvent these visual complications. ⁽²⁾

Myopia Controlling Strategies to the Rescue

To control or slow down myopia progression, several strategies have been introduced, ranging from spectacle interventions like myopia-controlling lenses to pharmacological interventions such as atropine eye drops. ⁽³⁾ These strategies have shown promising results, particularly in children experiencing rapid progression. However, treatment alone might not be sufficient; lifestyle modifications and proper near vision hygiene must accompany therapy to achieve optimal results. ⁽³⁾

Figure 1: Strategies of Myopia Control

Lifestyle Modification and Near Vision Hygiene

1. Screen time (Television, Mobile, Computer, Tablet) is the major stumbling block for many myopic kids to get entailed with other healthy activities. It is probably better to avoid or decrease screen time to less than 30 minutes a day.
2. Proper distance between the eye and the screen must be maintained while the child is under screen time. A distance of 30-40 cm must be present while using gadgets, and the minimum distance of 3 metres must be maintained while watching television. ^(4,7) Generally, one arm distance is appreciated when myopic children are drawing on computers. ⁽⁶⁾
3. It is better to implement the 20-20-20 rule, which is, every 20 minutes focus on something 20 metres away for 20 seconds when the child is engaged with any near activity for more than 45 minutes to 1 hour relentlessly. ⁽⁵⁾
4. Several studies suggest that myopic kids who spend more time outdoors make the most of slowing down myopia progression. It is crucial that the child spends a minimum of 2 hours per day outdoors. ⁽⁵⁾
5. Sleep pattern is another salient factor of onset and myopia progression in most of the kids. ⁽⁸⁾ It is a requisite that a child should have more than 7 hours of sleep. ⁽⁹⁾
6. Maintaining proper reading and writing distance with better lighting conditions is important. ⁽⁵⁾ It is implied that a child can put forward the elbow rule, that is, having forearm distance between the eye and the book. ⁽⁵⁾

Conclusion

Many parents and children believe that medical or optical interventions alone are enough to slow myopia progression. In reality, these treatments are only effective when paired with lifestyle modifications and near vision hygiene. ⁽¹⁾ Both elements must work together, like two sides of the same coin, to successfully control myopia and protect visual health. ⁽¹⁰⁾

References

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