Myopia Awareness Week: Is myopia curable or reversible?

When a child is diagnosed with nearsightedness (myopia), parents’ first concern is whether it is curable or reversible. Parents also worry about whether the child should wear glasses all his life? To understand the answer to this question, we need to know the different causes of myopia.

What is myopia ?

Nearsightedness or nearsightedness is a common eye problem in which a child needs to wear less motor glasses. There are three main types of myopia.

1. Axial myopia: It refers to the condition in which the size of the eyeball increases and becomes larger than what is normal for the age of the child. It 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 stiffer due to pathological conditions such as keratoconus or keratoglobus. Very often this type of myopia is associated with high astigmatism (cylindrical power) also due to a 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 myopia, the end result is that light rays focus on a plane in front of the retina, resulting in blurred vision. Mild degrees of myopia only affect distance vision. However, with severe degrees of myopia, vision is affected at all viewing distances.

Read also : Myopia may increase the risk of developing cataract complications

Treatment of 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, a corneal transplant may be necessary. In such cases, myopia may diminish after treatment, but the patient continues to need glasses or contact lenses for clear vision.

Lenticular myopia can be treated with lens surgery in which the abnormal lens is replaced with a normally shaped lens. Nearsightedness will decrease after surgery, but the patient will need glasses to concentrate for near reading.

Axial myopia is increasing at an alarming rate across the world. The reasons postulated for this boom in myopia lately are lifestyle changes. These include excessive close work and a lack of outdoor exposure, particularly during Covid-19 restrictions. Since the reason for this type of myopia is the elongation of the eyeball, it can be understood that the size of the eyeball cannot be reduced by any medication or surgery. Thus, once myopia occurs, it cannot be reversed.

Indeed, axial myopia tends to evolve with age. The scary part of eyeball elongation is that in severe myopia (eyeball size >26mm), the risk of retinal complications of myopia like retinal detachment and retinal degenerations increases dramatically. Thus, the objective of the treatment of myopia is to prevent the
progressive elongation of the eyeball.

Progression of myopia

The rate of progression varies between different populations and is considered to be greater in Asian countries than in the Western world. The different 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 onset
* Younger age at onset
* Excessive near work

How to reduce the risk of myopia?

Nearsighted children should be encouraged to avoid long hours of close work, such as reading storybooks, 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 natural sunlight that protects them. They should practice good reading habits, such as reading in an upright position and with proper lighting. In addition, night reading should be avoided.

Although the lifestyle changes mentioned above are important, they may not be enough to delay the progression of myopia in many children. Follow these tips for improving a child’s vision.

Tips to slow down myopia

Certain pharmacological and optical methods can slow the progression of myopia. These include certain eye drops as well as specialized myopia control glasses and contact lenses.

Your child’s eye doctor will be able to tell you what is best for you. A combination of methods may be needed in children with very high rates of progression.

Glasses can be removed with refractive surgery such as LASIK (laser keratomileusis in situ), ICL (implantable contact lenses), or CLE (clear lens extraction). These surgeries can only be performed after the growth of the eyeball has stopped and the eye power has stabilized. It usually happens after 18-20 years. Prior to this, 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.