How to prevent myopia

2023-11-21

Myopia is a refractive error in which light from distant objects enters the eye and focuses in front of the retina when the eyes relax their accommodation. Myopia is a highly prevalent disease worldwide. Currently, the global prevalence of myopia exceeds 28.3% and is expected to reach 49.8% by 2050. The prevalence of high myopia will increase from the current 4.0% to 9.8%.

As the degree of myopia increases, the risk of eye complications (cataracts, glaucoma, retinal detachment, myopic macular degeneration, etc.) increases significantly and has been shown to lead to permanent visual impairment and blindness. Therefore, myopia management cannot be ignored.

What are the risk factors that affect myopia?

The main risk factors for myopia include genetic factors and environmental factors.

  1. Genetic factors: Myopia in either parent increases the risk of developing myopia.
  2. Environmental factors: including too little outdoor time, eye load at close range, writing posture, diet and nutrition, light environment in home and school, duration of electronic product use and sleep duration, etc.

How to prevent and manage myopia?

The development of myopia to high myopia is a gradual process. According to the characteristics of different classification stages of myopia (pre-myopia, low myopia, moderate myopia and high myopia), timely and appropriate prevention and control intervention strategies should be adopted to delay the onset of myopia. , control the progression rate of myopia, and strengthen the management of high myopia.

  1. The focus of early stage prevention and management of myopia is: delaying the occurrence of myopia. The target here is: children and adolescents who have not yet developed myopia.
    • Behavioral intervention:

      • Promote increased outdoor activity time and encourage outdoor activities for more than 2 hours a day;

      Strengthen the management of reading and writing postures and strictly limit high-load close learning;

      Eat properly;

      Get enough sleep and control the amount of time you use electronic products;

      Improve the viewing environment and reasonably adjust indoor lighting and height of tables and chairs.

    • Clinical intervention:

      • For people with a family history of high myopia or a sharp decline in eye refractive parameters, genetic screening should be carried out as early as possible to assess the risk of high myopia.

  2. The focus of prevention and management of low-to-moderate myopia is: controlling the rate of myopia progression.

    3. This is aimed at: children and adolescents who are already myopic but have not yet developed into high myopia.

    • Behavioral intervention:Develop good eye hygiene habits, such as maintaining sufficient time for outdoor activities, strictly controlling the total amount of close work, and reducing the duration of a single close work session.
    • Clinical intervention:Clinical studies have shown that orthokeratology lenses, multifocal soft contact lenses, glasses related to myopia prevention and control, and low-concentration atropine have certain myopia prevention and control effects and can delay the progression of myopia by 35% to 80%.
  3. The focus of prevention and management of high myopia is: reducing irreversible visual damage.

    4. Targeted here: People with high myopia (including children, adolescents and adults).

    • Behavioral intervention:

      • Develop good eye hygiene habits;

      Inform patients that pathological high myopia is often complicated by fundus diseases such as macular hemorrhage, choroidal neovascularization, macular atrophy, macular schisis, and retinal detachment;

      Instruct patients to prevent or reduce eye collisions;

      Patients should reduce heavy physical labor and strenuous exercise;

      When you encounter dark shadows, flashing lights, or vision loss, you must seek medical attention as soon as possible to check whether there are holes or detachments in the retina.

    • Clinical intervention:

      • With refractive correction as the main goal, multifocal soft contact lenses, myopia prevention and control-related glasses and low-concentration atropine can be used to control the progression of myopia;

      In order to reduce the object image shrinkage caused by wearing glasses for highly myopic patients, rigid contact lens correction may be considered;

      For patients over the age of 18 who have stable refraction and are willing to remove their glasses, they can choose refractive surgery, such as corneal refractive surgery or intraocular refractive surgery. However, they should go to a standardized medical institution for detailed examination before surgery, and follow the doctor's advice to plan the surgery. plan;

      For patients with high myopia corrected by refractive surgery, they still need to check their fundus regularly and pay attention to the prevention and treatment of fundus complications of high myopia;

      For fundus lesions that are obviously progressive, especially if there are obvious posterior scleral staphylomas, macular degeneration, etc., posterior scleral reinforcement therapy and other treatments can be considered.

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