Myopia: Causes behind the sudden rise of short sightedness in India, treatment and preventive tips

In myopia, one has difficulty in seeing far into the distance due to the clouding of the lens, which leads to cataract due to vitamin A deficiency and a lack of pigments needed for photoreceptor cells to function properly. Studies show that the Covid-19 pandemic has increased the number of children who may be identified with myopia and those who have refractive error may further need correction, while also pointing out that overnight orthokeratology (Ortho-k) corrects myopia temporarily, allowing you to see clearly the next day without the need for glasses or contacts.

Causes:

In an interview with HT Lifestyle, Dr Shailja Tibrewal, Senior Consultant, Paediatric Ophthalmology, Strabismus, Neuro-Ophthalmology and Ocular Genetics at Dr Shroff's Charity Eye Hospital, shared, “It has been projected that half of the population all over the world will be myopic by 2050. With digitisation and increased screen time, we are also observing more children getting affected leading to the increased onset and progression of myopia. Outdoor activities are known to prevent the onset of myopia which has been largely decreased in the last two years. In some cases, when myopia gets increased to more than 6 dioptres, it leads to retinal complications like retinal detachment, maculopathy, blindness etc.”

According to Dr Ramesh Kekunnaya, Director at Hyderabad's LVPEI Network and Child Sight Institute, elaborated, “There are several reasons of sudden rise of short-sightedness or myopia in India. The check-up for the children is happening more frequently and parents are taking their children to the doctors on a regular basis, so we have more data available now. Second reason is the near work and screen time along with people spending more time indoors.”

He added, “A decade ago or two, people used to go out and play outdoors when there is good amount of sunlight available. Now, people are homebound, they are happy with their screens, tabs and TVs, they don't indulge in any kind of physical exercise or physical games. The third reason is that a lot of online classes have started especially post-pandemic. The last reason is a few decades ago, there was no electricity, people used to start their work at sunrise and end their work at sunset. Now people spend more time waking up at night. The lighting systems are different.”

Treatment and preventive tips:

Dr Shailja Tibrewal asserted, “The incidence of myopia is increasing day by day. There is a need for quality eye care and recommendations from the government to introduce the right age and time for children to get screened and undergo annual examinations.” She suggested, “Child vision screening should be made compulsory to cease the burden of eye problems. The outdoor time helps slow down the speed of change in refractive error and axial length for non-myopic children and as a result, it helps reduce the risk of developing myopia. There are certain treatment modalities which are available to halt the progression of myopia.”

Highlighting that there are natural things we should adopt, Dr Ramesh Kekunnaya recommended, “Parents should encourage their children to use less time on screens. They should encourage them to play more outside and engage themselves in more of physical games and physical activities, which are important. Even in schools, the lighting should be good. We can advocate to the school authorities that children have their outdoor games incorporated in their academics. If you don't give the screen to a child or a toddler, chances of them having myopia is less. So we must identify these issues at the pre-myopia stage. Pre -myopia is when a child has not gone into the myopia and we are preventing the myopia.”

He revealed that in one of the studies done by LV Prasad, it is projected that by 2050, 50% of our children will have some form of glasses, especially due to myopia or pharmacological reasons. He said, “We have some of the pharmacological treatments available in the form of low dose atropine of different doses. We can also use other anti myopia natural strategies to prevent it. We have some special lenses, the contact lenses or spectacles, which can help in preventing myopia. Different forms of light therapy can also help. All these things can help once the patient develops myopia and the further progression can be prevented.”

He insisted that all you need to do is monitor whether it is progressing (if you’ve already developed the disease). He said, “Once you know that it is progressing, we can implement different strategies like pharmacological or optical or through contact lenses. We also have Orthokeratology where Ortho K lenses can be used, or a multi modal approach can be used to prevent the progression of myopia but all in all, prevention is the best form of strategy to stop this epidemic of myopia in our country. Less of screen time, more of physical activities is the mantra behind preventing myopia.”