There is an epidemic growing in the eyes of American children. Literally.
Myopia rates have sharply increased in the past few years and doctors are becoming more concerned about the rise in cases. This concern has been high in Asian countries for years, but in 2019 the American Academy of Ophthalmology assembled a task force on myopia to help address the health issue in the U.S. According to a 2016 study published in the American Academy of Ophthalmology Journal, if myopia rates continue to rise at current levels, more than half the world’s population will be myopic by 2050.
Known more widely as nearsightedness, myopia doesn’t sound concerning on its own, especially with the modern advances in eyeglasses and contacts available to help sharpen eyesight. But myopia can lead to serious issues such as glaucoma, retinal detachment, and even permanent blindness down the road, and the risks rise the younger a child’s myopia starts.
According to the American Optometric Association, myopia is caused by misshapen eyeballs or cornea.
“Normally, you want light to enter the eye and focus on the back of the eye, the light-sensing part of the eye, called the retina. And then that goes back into the brain to give you a nice clear picture,” says Dr. Michelle Trager Cabrera, pediatric ophthalmologist and clinical chief of ophthalmology at Seattle Children’s Hospital. “In myopia, the eye is often too long, so the light that enters the eye focuses in front of the retina and therefore is blurry.”
Genetics play a role
Myopia is generally a genetic condition. If a child has one parent with the condition, that doubles their odds of needing glasses for myopia. Two parents with myopia quintuples the chances. But myopia rates are growing regardless of hereditary factors and ophthalmologists’ concerns are growing as well.
“Myopia is something that develops during childhood and the reason it develops then is that when children are born, their eyes are relatively short. As they are growing, their eyeballs are growing too,” says Cabrera. “And what we are seeing more and more is that the eyeballs are growing too fast. We think that is a combination of genetics and environmental factors. One of the environmental factors that we think is a great preventive measure is outdoor time.”
Outdoor time not only reduces anxiety, helps build the body’s vitamin D stores and boosts the mood, but it also helps reduce nearsightedness in children. In terms of preventing myopia, Cabrera says, the most important time to get kids outdoors is during the preschool and elementary school years.
Unfortunately, kids spend less time outdoors than they used to and more time on screens and other “close” activities, such as reading and studying. This contributes to increased myopia rates, and other health problems as well. Outdoor light and the outdoor environment help to slow down the development of myopia due to how the eye is exposed to light and how eyes function in large spaces.
The bottom line says Cabrera is this: “If you spend more time outdoors, you’ll get less myopia. It’s a great preventive measure because spending time outdoors is also healthy for getting exercise and preventing obesity. It tends to be a very safe intervention that we know works.”
One family’s experience
Ballard residents Brina Nelson and her husband Jeff both developed myopia as children, so she was not surprised when one of her twin boys started to develop the condition when he was quite young.
“I was excited to hear about the advances that have been made so we could possibly slow the progression,” says Nelson. “There was a small part of me that was worried about how he would adjust to wearing glasses (being the first kid in his class with them) and thinking back to how I felt embarrassed wearing my glasses when I got them in first grade. After some uncomfortable feelings initially, he adjusted surprisingly well.”
Nelson advises parents to start treatment as early as a doctor recommends it. Her other twin son was recently diagnosed with myopia as well. She says the results of treatments have been impressive for both her boys compared with her own experience as a child.
Options for treatment
Treatment is not overly complex and is proven to help slow the growth of myopia in the eye. The most common treatment is an eye drop called atropine, often prescribed at a low dose. There are few side effects to the eye drops. Some kids do have a bit of light sensitivity and giving eye drops every day can be a challenge.
“Atropine is an eye drop that has to be given every day and not all kids love getting eye drops so that’s a big downside,” says Cabrera. “It has been shown to be effective and can even prevent myopia onset. I usually recommend it for kids who are young and have myopia at a young age. What I’m concerned about is that as time goes on, if they are very young, their eyes are just going to keep growing longer and the myopia will just get worse, leading to serious consequences such as retinal detachment and glaucoma. So it is a good idea to start some kind of prevention in that case and atropine is a really great option.”
Talk to kids
Nelson urges parents to have early, open conversations with kids about why they are receiving treatment and how taking care of their condition will have long-term benefits.
“If caught early, their eyesight might not be too bad and the kids might not think they need to wear the glasses but it can make a big difference in their vision down the road,” she says. “Talk about your experiences getting glasses or contacts as a kid, and how you felt, to normalize anything they might be feeling.”
Jeff Nelson suggests getting comfortable glasses that are also durable. He adds that transition lenses are ideal so they can wear them outside. He also has learned to turn down the lights when putting in the eye drops. Other options for myopia treatment include multifocal soft contact lenses, glasses, and OrthoK or orthokeratology lenses which patients wear at night to reshape the eye.
Eyedrops can make a difference
Glyn Komkai of Fairbanks, Alaska has been treating her son for myopia for years.
Born premature, his first eye check-up was at 30 weeks with a pediatric ophthalmologist in the NICU who mentioned research on atropine drops. Myopia was a concern due to both his prematurity and his family history. Komkai and her father are nearsighted and her husband also wears glasses.
Now that Komkai’s son is 18, his eye doctors have suggested continuing the eye drops through college due to late nights, reading in dim lights, and the heavy use of screens.
“This (the eye drops) seems worth the benefits, for the minimal inconveniences. I do feel better that it’s slowing down the progression, so it’s not getting worse faster,” says Komkai. “I was always worried that his eyesight might be an issue, even if only from heredity, not knowing prematurity would also play into his story.”
Check out this video
Vox recently published a video that explains myopia, treatment, and risk factors in just under 7 minutes. It’s a great primer for parents whose kids have been diagnosed with this increasingly common eye condition. Click on the image to watch the video.