Myopia I: What it is and How It's Treated

(Definitions can be found on many websites on the Internet, but here are a couple of sites that are useful, and where I gleaned some of the information below from. Please refer to the section "Sources" below.)

Myopia occurs when the eyeball elongates or the cornea/ lens is too curved.¹ This causes light rays that enter the eye to focus in front of the retina instead of on it, resulting in a blurred image formed.

Unfortunately, this common condition is inflicting more and more perople. It affects nearly 30% of the U.S. population, and up to 45% of the population in Singapore. There are different stages it may set in, in infancy, childhood or adulthood. However, the most common onset is during childhood. True myopia is irreversible and as the body grows, the condition often worsens. It typically stabilizes in adulthood.

If myopia is not diagnosed and treated early, it may be associated with more serious vision problems, such as retinal tears, macular degeneration, glaucoma and cataracts. If left untreated, it may lead to blindness.

What is the usual treatment for myopia?
The most common treatment is the use of prescription eyeglasses or contact lenses. These restore clear distance vision by refocusing light rays onto the retina. Sometimes single focus or bifocal lenses are recommended to help reduce visual stress from close activities, and prevent or slow the progression of nearsightedness. Bifocals can definitely be a help for many, especially those that have a tendency for their eyes to cross (esophoria).

Vision Therapy has gained popularity as well. It involves the participation in various programs that help to slow the progression or reduce the severity of myopia. Both adults and kids can benefit from this. Problems with eye-focusing, eye coordination and visual function that contribute to myopia can be alleviated by therapy.

For adults, another popular option currently would be laser-based corrective surgery and other surgical procedures (e.g. LASIK). LASIK has allowed sports athletes with myopia a lot more convenience and freedom in movement. Also, accelerated orthokeratology can reduce myopia and hence reliance on eyeglasses or contact lenses.

How to prevent incidence or progression of myopia?
Good visual hygiene, reading with good posture, using good lighting and taking frequent short breaks during near-work (reading/ computer) would greatly help. This is especially important for children because of the fact that myopia frequently develops during childhood.

Diet and supplements may also help. A balanced diet is very important. However, besides that, some anti-oxidants can protect the eye tissue in the macula from damage by free radicals, thus helping to prevent or reduce the severity of myopia. Vitamins C, E, selenium, carotenoids like lutein and zeaxanthin are some of them. They are commonly found in fruits and vegetables like red grapes, peppers, corn, green leafy vegetables and pumpkins. Eggs, certain nuts/ seeds⁷ and some herbs like milk thistle and bilberry also contain such carotenoids.⁶

Besides lutein and beta-carotene, some Chinese herbs and tonics are said to be extremely useful, e.g. Gingko biloba.⁷
Some studies have shown that children who received mineral supplements as infants were 5 times less likely to develop myopia than those who were not.⁸

Vision therapy as described above. Vision therapy is different from eye exercises in that it involves professionals who examine the individual and then map out a specific program or procedure tailored to the patient and performed under the supervision of the doctor or professional. It also involves the use of medically regulated devices like optical prisms.

Eye exercises and massage. For example, Singapore schools and schools in China incorporate eye exercises into students' daily routine. In some primary schools, this may take place during mass assembly, where all the students follow a set of exercises set to classical music, and take at least 5 minutes to massage their eyes and the muscles around the eyes.

Atropine drops. Experts say the solution is currently the most promising treatment for children with myopia. A study by the Singapore Eye Research Institute (SERI) on 400 myopic children showed that the solution slowed down the deterioration of their eyesight. Children on Atropine had their glasses increased by just 25 degrees in two years compared to about 100 degrees for those who did not receive the treatment. However, atropine eye drops have potential side effects associated with dilation of the pupil, including photo phobia, difficulty in reading and possible long-term effects, such as increased risks for cataracts or retinal disease.

Sources
1. http://www.agape1.com/myopia.htm
2. http://en.wikipedia.org/wiki/Myopia
3. http://www.allaboutvision.com/conditions/myopia.htm
4. http://www.medicinenet.com/myopia/article.htm
5. http://www.snec.com.sg/eye/myopia.asp
6. http://www.raysahelian.com/myopia.html
7. http://www.iquestsight.com/myopia.html
8. Pohlandt, F. Eur J Pediatr. 1994 Apr; 153(4):234-6.