Myopia is a very common vision problem that allows you to see clearly up close but causes poor vision in the distance. It usually manifests itself in children, usually after 5 years of age, and progresses during childhood and adolescence, generally up to 18 years of age, and may even, in the highest myopia, continue to increase until after 25 years of age.
What are the symptoms?
The first symptoms are related to poor distance vision. It is common for parents to notice that children squint to focus on distant objects.
To detect this problem as soon as possible, it is important to carry out a first ophthalmological check-up on all children from 3-4 years of age, the age at which they begin to collaborate with the visual acuity measurement. At this age, before they have myopia, you can already detect that they are going to develop myopia and prescribe an early treatment that will be more effective.
How is myopia controlled in children?
The fundamental thing is to perform the first ophthalmological examination on all children between the ages of 3 and 4 to detect the appearance of myopia early. This is more important if there is a family history of nearsightedness or eye problems.
In addition to detecting refractive errors or ophthalmological problems in the child, data and medical and ophthalmological history will also be collected in the consultation that will allow you to establish the risk of evolution of the child’s diopters.
Based on the examination carried out, you can establish what the current situation is, what the evolutionary risk of the child’s myopia is, and recommend the treatment that each child requires. Once treatment is started, controls will be carried out every 6 months unless a change is observed that makes it advisable to review the established treatment.
Lately, much attention has been paid to the myopic children and it has been seen that the feelings they have about their own appearance, as well as their participation in group activities, especially sports, are below normal. That is, the myopic child participates less in some activities and tends more to take refuge in other individual activities that require near vision, such as electronic games.
In this sense, both the self-perception of their physical appearance and the percentage of their sports and social activities decrease in such a way that children under 12 years of age, with myopia and glasses, present a worse quality of life in scientifically designed tests, although this real psychological problem does not affect all children equally.
Thus, differences have been seen depending on age and those moments in which wearing glasses is more or less accepted.
Despite all this, these problems could be avoided if the predisposition to be myopic is detected early and the evolution of their myopia is stopped.
Why does myopia develop?
Myopia is a complex polygenic disease, as is type II diabetes, Alzheimer’s, and many others. An eye is myopic when its length is greater than normal which means that objects, instead of focusing on the retina (the inner layer of the eye responsible for sending visual information to the brain), arrive out of focus, and are projected in front of the retina, resulting in a blurred image.
In all of them, there is a genetic basis and an influence on the environment in which children live and the activities they develop. If they spend the day at home playing with a tablet, they will develop more myopia than if they are playing football. Once myopia begins in a child, biochemical alterations arise in their retina that causes it to continue evolving until approximately 25 years of age.
Types of myopia depending on its development
It is a rare form of myopia whose causes are a genetic anomaly, prematurity, or pregnancy problems. It is usually high myopia but with little progression, it is essential to detect and correct them early to prevent amblyopia.
Pathological myopia or Magna or high myopia:
It is the most severe form of myopia. High myopia or pathological myopia is considered when the patient presents 6 or more diopters of myopia. This myopia has a greater hereditary component and is usually very progressive throughout life. It is also frequently associated with anomalies in the fundus of the eye and a greatly increased risk of ocular pathology, which is why these patients require frequent visiting to eye care hospitals for check-ups.
Simple or axial myopia:
It is the most frequent form of myopia. You speak of simple or axial myopia when the person has less than 6 diopters. It usually manifests itself in childhood, from the age of 5, and progresses during the child’s growth until adolescence, around the age of 20. They do not have as much ocular pathology as high myopia, but they have an increased risk of different ocular pathologies compared to non-myopic people.
Most myopic people begin to be so in childhood, although there are cases of mild myopia where diopters do not appear until after adolescence. On the other hand, there is very aggressive myopia, which is present from birth and is usually part of syndromes in which, in addition to myopia, other problems are manifested.
Problems derived from myopia
Myopia is the second leading cause of blindness in the world. Globally, including more and less developed countries, it is responsible for some cases of blindness and some cases of moderate vision loss or visual impairment.
Myopia, when it exceeds 6D, is known to generate serious complications that can lead to blindness in some cases.
One in three people with high myopia, equal to or greater than 6 diopters, develops irreversible visual impairment or blindness, as a result of myopic maculopathy, retinal detachment, or glaucoma, and in this order of importance.
In a final conclusion, you can follow all precautions and affirm that today myopia can be stopped and the visual complications of high myopia can be avoided and children’s quality of life be improved.
Animesh Rai is a postgraduate in health and hospital management from the Indian Institute of Health Management Research, currently working as a Deputy Administrator at the Association for the Prevention of Blindness, a non-profit society, operating 200-bedded JL Rohatgi Memorial Eye Hospital. Hospital also has a training institute that offers optometry diploma courses in Kanpur.