13.DEC.2018 4 MIN READ | 4 MIN READ

About 11% of 6-year-olds in Singapore are reportedly myopic. Dr Jimmy Lim, ophthalmologist at Gleneagles Hospital, tells us more about the condition and what parents can do to prevent it.

For majority of Singaporeans, spectacles are not just a fashion accessory, but also a necessity to correct poor vision due to myopia. The condition, also known as short-sightedness, affects many of us from a young age, hence parents play a significant role in promoting healthy habits that could prevent myopia or myopia progression.

If you haven’t already realised, myopia is a huge Singaporean problem, which is more alarming when we compare the statistics with our Australian neighbours. By the time Singaporeans reach the ages of 15 – 19, a whopping 74% of us are myopic, whereas in Australia, the number is around 30%.

1. What causes myopia?

Genetics: The tendency to develop myopia is a hereditary trait, so a child born to parents with myopia is naturally more susceptible to it. In some cases, short-sightedness can even progressively develop from a young age, and stabilises in one’s 20s.

Too much near-sighted work: When we perform tasks that require up-close vision, such as reading or using our smartphones, there is a lot of focus on the centre of the eye, while the peripheral vision is defocused. Prolonged periods of time performing these tasks can cause myopia. Thus it’s recommended that we take breaks after 30 – 40 minutes of near work to look at distant objects. This helps with eye fatigue and dry eyes.

Limited outdoor time: Based on studies and observations, greater exposure to natural light is significant in helping children avoid developing myopia, or slow down myopia progression. On average, Australian kids spend about 7 hours more outdoors per week than Singaporean kids. As Dr Lim recommends, encouraging outdoor activities such as bike rides or playing sports, can help your children get more ambient light exposure.

2. What can I do if my child already has myopia?

Myopia in children - Prevent it from worsening
Certain old wives’ tales suggest that myopic children can be 'trained' to develop perfect vision again by discouraging them from wearing their spectacles. However, science has shown that not wearing spectacles does not work to control or prevent progression of myopia. In some cases, it might actually worsen myopia due to the increased accommodation your eyes have to go through without spectacles.

If your child is short-sighted, they need a pair of prescription glasses to correct their vision. After which, parents should encourage healthy eye habits such as reduced screen time and engaging in more outdoor activities to prevent their myopia from worsening.

3. Is there a way to treat myopia?

Atropine: While this medication does not prevent the development of myopia, many studies have shown its effectiveness in controlling the condition. Currently, atropine is only used in eyes drops at concentrations as low as 0.01%, so it doesn’t cause side effects such as photophobia, a condition where our eyes develop sensitivity to sunlight or strong lighting. The eye drops are typically used daily over 2 years, and if the condition has stabilised then, medication will be stopped for a year with regular follow-ups with an eye doctor to monitor for rebound.

Good eye habits: There are currently no studies in support of a particular sequence of exercises one can do to control myopia progression. Instead, Dr Lim mentions that having good eye habits such as outdoor play in ambient lighting and taking breaks by looking at distant objects will be effective in preventing progression of myopia.

4. But why the hassle if I can fix everything with LASIK in the future?

Myopia in children - Lasik
LASIK has become a popular procedure for those who wish to correct their vision, but contrary to popular belief, it is not a miracle cure for all eye problems. Instead, LASIK only reshapes the cornea to allow light to focus on the retina. It does not help to resolve the rest of the problems that high myopia can lead to.

“The fundamentals of myopia is that there’s an elongation of the eyeball, but the elongation of the eyeball itself predisposes you to other problems, like early cataract development, retina tears and breaks, glaucoma, or even the nerve being thinned out, which is a condition also known as macular atrophy,” said Dr Lim.

Treating the progression of myopia is still very important, with or without one’s intentions to undergo LASIK treatment. Hence parents still need to take extra care to keep their children’s myopia under control, and nothing beats the benefits of inculcating healthy lifestyle habits. Besides pharmaceuticals and devices, it’s still important for people to understand that outdoor play, ambient light, and less screen time for children is still very key to combatting the development and progression of myopia.”

 

Article reviewed by Dr Jimmy Lim, ophthalmologist at Gleneagles Hospital

Reference

Patterns of Daily Outdoor Light Exposure in Australian and Singaporean Children. Retrieved on 16 November 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976264/

13.DEC.2018
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Lim Wei Kheong Jimmy
Opthalmologist
Gleneagles Hospital

Dr Jimmy Lim is an ophthalmologist and eye surgeon practicing at Gleneagles Hospital, Singapore. He specialises in cataract surgery, refractive surgery (LASIK), cornea disease treatment and general ophthalmology.