When a child is diagnosed with nearsightedness (nearsightedness), the first and foremost concern of parents is whether it is curable or reversible. Parents also worry about whether the child will have to wear glasses for life. To understand the answer to this question, we need to know the various causes of myopia.
What is myopia?
Nearsightedness or nearsightedness is a common eye problem where a child must wear negative power glasses. There are three main types of myopia.
1. Axial myopia: This refers to the condition where the size of the eyeball increases and becomes more than normal for the child’s age. This is the most common type of myopia.
2. Corneal myopia: In this type of myopia, the most anterior part of the eye (the cornea) becomes more inclined due to pathological conditions such as keratoconus or keratoglobus. Very often this type of myopia is associated with high astigmatism (cylindrical power) due also to the change in the shape of the cornea.
3. Lenticular myopia: Here, the lens of the eye has an abnormal shape or location. In all three types of nearsightedness, the end result is that light rays are focused on a plane in front of the retina, causing blurred vision. Mild degrees of myopia affect only distance vision. However, with severe degrees of myopia, vision is affected for all viewing distances.
Also read: Nearsightedness may increase the risk of developing cataract complications
Treatment for myopia
The million dollar question? Is myopia curable or reversible? Well, it also depends on the type of myopia you have.
The type of corneal myopia due to keratoconus has a specific treatment available in which the corneal collagen is strengthened to prevent the progression of corneal steepening. In advanced stages, it may be necessary to perform a corneal graft. Nearsightedness in these cases may be reduced after treatment, but the patient continues to require glasses or contact lenses for clear vision.
Lenticular myopia can be treated with lens surgery in which the abnormal lens is replaced with a normal-shaped lens. Nearsightedness will be reduced after surgery, but the patient will require glasses to focus near reading.
Axial myopia is increasing at an alarming rate throughout the world. The reasons that have been postulated for this rise in myopia in recent times are changes in lifestyle. These include excessive close work and a lack of outdoor exposure, especially during the Covid-19 restrictions. Since the reason for this type of myopia is the elongation of the eyeball, one can understand that the size of the eyeball cannot be reduced by any medication or surgery. Therefore, once myopia occurs, it cannot be reversed.
In fact, axial myopia tends to progress with age. The frightening part of eyeball elongation is that in severe myopia (eyeball size > 26 mm) the risk of retinal complications of myopia, such as retinal detachment and retinal degenerations, is multiplied. So, the focus of treatment for myopia is to prevent the
progressive elongation of the eyeball.
The rate of progression varies among different populations and is seen to be higher in Asian countries compared to the Western world. The various risk factors for the progression of myopia are:
* Presence of parental myopia (when the parents are also myopic)
* A higher degree of myopia at the beginning
* Younger starting age
* Excessive close work
How to reduce the risk of myopia?
Children with myopia should be encouraged to avoid long hours of close work, such as reading story books, using digital devices, or drawing and painting.
Recommendations are a total of 4-5 hours of close work, including school related work. Increased outdoor activities would engage them in alternative sources of entertainment and expose them to protective natural sunlight. They should practice good reading habits, such as reading upright and with adequate lighting. Also, night reading should be avoided.
Although the lifestyle modifications mentioned above are important, they may not be enough to slow the progression of myopia in many children. Follow these tips to improve a child’s vision.
Tips to stop myopia
Certain pharmacological and optical methods can slow down the progression of myopia. These include certain eye drops, as well as specialized glasses and contact lenses for nearsightedness control.
Your child’s ophthalmologist will be able to guide you on what is most appropriate. A combination of the methods may be necessary in children with very high rates of progression.
Glasses can be removed with refractive surgery such as LASIK (laser in situ keratomileusis), ICL (implantable contact lenses), or CLE (clear lens extraction). These surgeries can be performed only after the growth of the eyeball stops and the power of the eye is stable. This usually occurs after 18-20 years of age. Before that, it is important to control the elongation of the eyeball through the various modalities mentioned above to reduce the risk of sight-threatening complications of myopia.