DR. ZSOLT TAPASZTO
Myopia, Causes, and Solutions.
Topics covered include: Different side effects of myopia, the causes of myopia we’re experiencing now, reducing the time we look at screens, why it’s important to start treatment with myopic children as soon as possible, signs to look for if your child is myopic, how ortho-keratology works, and the benefits of combination therapy.
What is myopia?
Near-sightedness — the visual images come to the focus in front of the retina of the eye resulting especially in defective vision of distanced objects.
Myopia is recognized everywhere in the world as a medical condition — DWHO is aware of how myopia is dramatically increasing, by 2050 about half of the world’s population will be myopic.
Myopia isn’t considered a disease in the early stages, but when it reaches a higher stage it becomes a disease in the ways that it presupposes a variety of other medical conditions (cataracts, retina issues, etc.)
The side effects of myopia are glaucoma, macular degeneration, retinal detachment, MMD, etc. The symptoms are not being able to see far distances.
Who’s at Risk?
The cost of myopia is rather high in societies. For people who cannot do a proper job because they cannot see, there are dangers in different depositions.
The people who have myopia are in more rural areas than in urban, city areas — and they have pathologic myopia problems. We see that the patients who have myopia are increasing in different kind of areas.
Genetics, racial background are important here. Some studies show that Caucasians have less myopic patients than the Asian population and less than the African American population.
Uncorrected myopia in 2015 was estimated to cost 250 billion US dollars — professionals need to do something to work against this.
What are the Causes?
The technology, environment, people not engaging as much, interacting more with their screens — in a closed environment, not using the distance vision enough.
We can predict who will become myopic through a Myopia calculator that shows us what ethnicity, age, etc. play in myopia management.
Normally, myopia has been treated by wearing glasses, contact lenses, etc. — getting as comfortable as one can be.
Tips for Parents
If your child is reading too much, or playing on a screen, encourage them to look up from the screen and see with distance, make sure they can see clear and sharp, then they can go back to what they were looking at. It relaxes the muscles in the eye, relaxes the accommodation, so that stress is not aiding the myopia.
Slowing the progression
Retinal detachment is 4 times more likely for someone who is myopic — over 2 times a greater chance for glaucoma and cataracts — important to pick it up as soon as possible.
At what age can we begin to slow the progression? Change the diopters, after -5 there’s serious impact on the eyeball, the retina — what we’re unable to control after -5 — start to do a myopia treatment as early as possible
The different techniques we can use to decrease the progression of myopia (can go from -0.5 to -25 / -30 and most people normally fall somewhere between 1 and 8) — what can we do to decrease the progression?
Prescribing glasses — have 2 form optics, have a wider optical center range — lucky enough to have different kind of instruments to determine the plus power within the periphery — if not seeing any plus power, recommend multifocal lens which could be quite challenging.
Unfortunately Europe doesn’t have an institution like the FDA. So encouraging people to use glasses is a first step.
How does Ortho-Keratology work?
Hard lens, high oxygen transferability, has a shape which basically pushes the central portion of the cornea and redistributes the fluids from the central unto the periphery — reshaping of the cornea so that patients can see well.
Ortho-keratology lenses for the people over 40 or 50 who have trouble reading, etc. — do they work well? — for most cases they rather use soft multifocal lenses
People who are far sighted who don’t have enough power in their eyes
The multifocal lens as disturbing the distance vision — whether the kids will be able to accommodate to this disturbed visual environment
Getting the myopia progression reduction — what are the wave sources coming into the eye, diverting light — different kinds of designs that manufacturers are trying — the study and development on this kind of design needs to be redone.
The technology used to see who’s a good candidate
We measure the length of the eye for each patient through treatment on a yearly basis.
Eye drops to slow down myopia — there are different kinds used prior, then the eye practitioners recommended a singular one — see better and better results with higher doses of atropine — big disadvantage is that it dilates the pupils.
Using combination therapy? Using ortho-keratology first, if myopia increases, then use additional treatments (atropine) but also other kind of shortening drops at night so that it doesn’t bother the patient with the pupil dilation
Don’t let children use the mobile devices too early (games, shows, etc.), spending lots of time with their small electronic devices — don’t play with such pictures, at least use larger frames (tablets over smartphones).
If children are becoming myopic, start with treatment as early as possible — the kids do not need to treat their lenses themselves, but let the parents do it for them — do not use anything during the daytime, let the treatments work overnight.
If the child is showing signs of not being able to see well, getting closer to screens, to see something — must remind parents that there is something wrong in the child’s visual activity, and they need to see a practitioner ASAP.