Myopia (Nearsightedness)

A person with myopia, or nearsightedness, can see close objects clearly but distant objects appear blurred.

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What Causes Myopia?

Myopia is a condition caused by the focal point of a visual image falling in front of the retina instead of directly on it. The eyeball may be too long from front to back. Singapore has one of the highest rates of myopia in the world.





The actual cause of myopia is not clearly known. However, genetic as well as environmental factors play a part in the development of the condition. Studies have found that a child is more likely to develop myopia if he/she:
Has one or both parents who suffer from myopia
Is constantly involved in near-work activities such as reading, writing, watching TV, or playing computer games 

Myopia usually develops in children of schoolgoing age, and continues to worsen until they reach their early 20s, after which the condition usually stabilises.

Myopia Symptoms 

The following symptoms may be present in myopic people:
Blurred vision
Headaches from straining eyes
Squinting

Testing for Myopia

Vision is tested through the identification of a series of letters or numbers of diminishing size on a chart placed three or six metres away. If the vision score is found to be lower than average, a refraction assessment (using lenses of different strengths) will be performed to look for any vision problems.
 
Cycloplegic eye drops are often used in children to obtain accurate test results. These eye drops serve to reduce the eye muscle spasm, which is a natural occurrence in children, helping them to focus more on near objects rather than farther objects. These eye drops also dilate the pupils and allow the doctors to perform a full eye examination. It is important to note that the child’s vision may be blurred for up to a day after dilatation, though the effects are only temporary.

Myopia Treatment 

There is no cure for myopia, but the condition can be corrected with the following types of treatment:
Glasses or contact lenses are the most common ways of correcting the condition as they help to refocus light rays onto the retina.
Special eye drops known as atropine have been studied in a clinical trial in Singapore and have been shown to be effective in some children in preventing their myopia from worsening. This form of treatment is available at National University Hospital. The pros and cons of using this form of treatment will be discussed with you after your child’s eyes have been examined. 
There are also surgical procedures (e.g. LASIK) to improve or correct myopia. However, such surgical procedures  serve only to correct refractive errors and are only for adults. They do not treat the elongated myopic eyeball or reduce the risk of complications that result from severe myopia. It is therefore not advisable for children to undergo these surgical procedures as their eyeballs are still developing and their myopia has not stabilised.

Prevention of myopia and delaying its progression early in life are important steps to take in the management of this condition.

Complications of Myopia 

The higher the degree of myopia, the greater the risks of developing complications, which lead to reduced vision and blindness. The following are some complications that can occur:

Retinal Detachment 

A medical emergency, this is where your child’s retina (inner layer of the eye) becomes separated from the eyeball. Other than myopia, it can be caused by genetic factors, or a severe blow to the eye. Seek medical help because it could result in blindness. 

Glaucoma 

Here, there is increased fluid pressure within the eyeball. Your child’s optic nerve, which transmits visual impulses from the eye to the brain, could become damaged. Glaucoma develops gradually and may not be detected until a later stage. Taking your child for regular eye checks can help detect glaucoma at an earlier stage. If left untreated, it could cause blindness. 

Macular Degeneration 

This is where the central part of the retina, which gives the clearest vision, degenerates. If your child experiences dark patches in his/her vision or other visual distortion, these could be signs of macular degeneration, which could lead to blindness. While usually age-related, macular degeneration is not confined to older sufferers. 

Amblyopia or “Lazy Eye”

Sometimes, as children grow, their eyes may not develop normal vision. This leads to a big difference in the degree of myopia between the two eyes. To prevent blurred vision, the brain reads the image from the “stronger” eye and not from the “weaker” eye. As a result, the visual abilities of the “weaker” eye do not develop well, and your child experiences reduced vision in one eye. There are many causes of amblyopia, and severe myopia may be one of them. 

Cataract 

When your child has a cataract, the clouding of the lens in the eye leads to blurred vision. This can make reading difficult for your child.

Preventing or Reducing Myopia

It is important not to spend an excessive amount of time on near-work activities. Children should be encouraged to take a break after 30 to 40 minutes of near work such as reading or writing. They can do this by looking at distant objects out of a window. Spending time on outdoor activities may reduce the risk of developing myopia, so children should be encouraged to go outdoors for activities and it is good for family outings to be outside.

Good nutrition and adequate sleep are also important for the eyes. Ensure that your child has a balanced diet and enough rest to keep his/her eyes healthy.

If your child already has myopia, you can still help him/her to slow down the progression of the condition with good eye care practices. Take your child for eye checks at least once a year. Teach your child to take care of his/her glasses, too. Cultivating healthy eye care habits early may halt the progression of myopia.




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