Myopia: The other pandemic

While the world is preoccupied with COVID-19, we should not lose sight (pun intended, with apologies) of another pandemic: myopia. In simple terms, myopia, or nearsightedness, is when you can see things better when they are near but it gets blurry when you look at things further away. The International Myopia Institute projects that, by the year 2050, more than 4 billion people worldwide, or more than half the world’s population, will be myopic, and 938 million people are expected to suffer from high myopia. In addition to the economic, health, and social burdens that myopia brings, associated ocular complications may lead to visual impairment, including blindness.

Numerous studies confirm that children who start to become myopic on or before the age of 9 years old are most likely to suffer other serious eye complications such as cataract, glaucoma, retinal detachment, and myopic maculopathy. These risks are irreversible and may lead to loss of vision. Most people think 20/20 is the best vision one can have, that is, things 20 feet away are still seen well even if you’re 20 feet away from it. But this may not be true for myopes or nearsighted people. A myopic or nearsighted child may be enjoying 20/20 vision with his or her new pair of glasses every year, but as the child grows older, 20/20 vision may not be enough. The child might need help.

Heredity seems to play a minor role in the development of myopia. Professor Pauline Cho and colleagues at the Hong Kong Polytechnic University think rigorous educational systems in East Asian countries may also be the culprit. Young people are glued to their gadgets, and outdoor activities are not strongly encouraged in school and by family. As a result, kids and teens have become susceptible to myopia, and it has become a global public health concern.

Call center work resulting from the increase in BPO (business process outsourcing) business in the country may also be a reason for the increase in the prevalence of myopia in the workplace.

When myopia sets in, it is irreversible. We can only manage or slow down its progression. Myopia control or management is now the recommended route.

Prescription of single vision glasses and/or contact lenses is the most common management. While this option may initially provide 20/20 vision, it does not address the underlying causes and do not factor in the risks inherent in myopia. The myopic or nearsighted eye takes the shape of an elongated or long eyeball structure. The main cause of the condition is the elongation or lengthening of the eyeball. Single vision glasses and/or contact lenses seem to exacerbate the situation as they further cause the stretching of the eyeball, which in turn puts pressure on the nerve of the eye. This condition may eventually cause cataract, glaucoma, retinal detachment and, in extreme cases, strain on one of the most important parts of the eye, the macula, to the point where it may lead to permanent loss of vision.

Orthokeratology — from the word “ortho” which means to straighten, and “kera” or cornea — provides a safe myopia control alternative. This technology not only temporarily gives clear vision in the morning, but also provides a mechanism to control the lengthening of the eyeball.

Specially designed progressive lenses, soft multifocal contact lenses, and even traditional bifocal lenses are also options for myopia control that are available in the Philippines.

With the heightened use of devices during lockdown, parents should be mindful of their children’s screen time. It is best to consult a vision care specialist, including optometrists, for the best myopia management regimen for you and your children.

That sight is precious is plain to see. Take good care of it.

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Dr. Carmen Abesamis-Dichoso (carmen.dichoso@gmail.com) is an optometrist practicing in Makati City specializing in contact lenses and myopia management. She is a Fellow of the Philippine College of Optometrists, Fellow of the International Association of Contact Lens Educators, and Fellow of the American Academy of Optometry. She is a member of the executive committee of the Asia Pacific Council of Optometry and the Legislative Regulations and Standards Committee of the World Council of Optometry. She also serves as a regional clinic adviser of the Special Olympics International Asia Pacific Region.