Myopia, particularly the prevalence of high myopes and myopia progression, is becoming a global crisis.
In the U.S., the percentage of myopes among us has just about doubled over the past few decades, with some predictions of 50% of the population suffering from myopia within the next few years. The World Health Organization has forecast that at the current rate of progression, 2.5 billion people globally will be myopic by 2020, and half of the globe will be myopic by 2050.
» U.S. MYOPIA RATES
» GLOBAL MYOPIA FACTS
52% of people in 2050 will be myopic (projected)
85% of young people (age 15-25) living in East Asian countries are myopic
Sources: Essilor of America, American Academy of Ophthalmology, WHO/Brien Holden Vision Institute
“Progressive myopia is related to problems like glaucoma, retinal detachments, cataracts, and more. So, we need to do something to slow this down,” says Craig Brawley, O.D., F.A.A.O., of Vision Care Consultants in St. Louis, MO.
In fact, one of those “somethings” has already begun.
Dr. Brawley is one of 14 eye health leaders named to Essilor’s Myopia Task Force, part of the company’s Myopia Initiative in Action campaign to create awareness about the rising prevalence of myopia. The Task Force will create a suite of myopia management solutions and design programs to educate physicians and optical professionals about the importance of changing the way we care for myopic patients.
The Digital Connection
Why is the rate of myopia increasing? Though it’s certainly not the only cause, staring at digital screens for hours each day seems to play a pretty important role.
According to Kathryn Richdale, O.D., of University of Houston’s University Eye Institute, no conclusive studies have linked the rise of myopia in children to their increased use of technology, but enough research and anecdotal evidence exists to support these theories. (The University Eye Institute is offering Texas’ first myopia management service to tackle nearsightedness in children.)
Screen Use on the Rise
of U.S. adults use digital devices for over 2 hours per day
use 2+ devices simultaneously
view a digital device screen in the first hour they’re awake
say they use digital devices just before going to sleep
of U.S. children report “playing on digital device” as their favorite activity
Source: The Vision Council
THE EB Q+A
MYOPIA IN PRACTICE
Craig Brawley, O.D., F.A.A.O., practices at Vision Care Consultants in St. Louis, MO. With 18 years of experience with patients of all ages, he was recently tapped to serve on Essilor’s new Myopia Task Force. EB got a chance to talk to Dr. Brawley about his experience with high myopes and how he’s tackling the digital screen issue with his patients.
EB: What are you seeing at your practice regarding myopia progression?
Dr. Brawley: I’ve been prescribing more contacts, glasses, and myopia control methods now than when I first started practicing. And I’m noticing what we call “myopia creep” going faster, and it doesn’t seem to be slowing down as much as it used to.
Usually we see myopia creep start to slow down at around 16, and we’re just not seeing that anymore. And, we’re seeing young adults getting late-onset myopia. So the patterns are really starting to change quite a bit.
EB: Other than genetics, what’s causing the modern prevalence?
Dr. Brawley: Studies are showing that not spending as much time outdoors as we used to is having an effect [on young eyes]. Everything we are associated with now is electronic and is in our near-vision zone almost exclusively. We’re just not getting outside for as long as we used to and using our distance vision, especially in early childhood when the eye is doing a lot of its growth.
We know the eye muscles want to relax as much as possible. If your eye is looking at something near-point all the time, it’s in a constant state of accommodation. The eye becomes encouraged to grow to match that near-point task that you’re now using all the time so that it doesn’t have to work as hard.
The more time you spend on digital devices is the less time you spend doing those distance-vision activities, and that may be contributing to the early development of myopia.
EB: How do you treat high myopes?
Dr. Brawley: Orthokeratology as a first choice. Second is a soft contact lens with a peripheral defocus to see if we can control that growth but also give patients nice clear vision. And, the third is using atropine drops to slow down that growth of the eye.
And, I’m hearing of some glasses that are being developed, but not in use yet, that can help slow down that progression.
EB: What’s your advice for myopes regarding digital screens?
Dr. Brawley: You’re not going to stop people from using them. Kids and young adults do basically everything on devices and laptops. Everything related to school is inceasingly digital. You can’t avoid it.
But you can try to limit their time best you can, and kick them outside. Make sure they are doing other activities that use their distance vision in addition to all of their near-vision work.
EB: What are your go-to lens products for digital eye strain?
Dr. Brawley: It’s not necessarily from a myopia control standpoint, but from the standpoint of alleviating symptoms of digital eye strain, [lenses with an added “bump” in the digital viewing zone] can absolutely be beneficial. But when I prescribe those glasses, I make sure that I also encourage the patient to take enough breaks from those devices and get themselves outside.