Predicting childhood myopia and applying preventive measures

Time spent outdoors and education may adversely affect the progression of childhood myopia. Image credit: amornstock.adobe.com

Variations in prevalence indicate a causal relationship between lifestyle and childhood myopia. Understanding these factors creates opportunities for intervention, or ‘myopia control’ efforts. According to lead author Bingjie Wang of the University of New South Wales in Sydney, Australia, one paper shows that these control tactics can halt, slow, or even prevent the progression of myopia.

Since myopia is usually caused by excessive axial elongation, measuring a child’s axial length is a way to determine the condition of pre-myopia. One working definition of antemyopia is based on the 2019 white paper “International Myopia Society: Definition and Classification of Myopia: A Proposed Standard for Clinical Epidemiological Studies”. A child must have a refractive state of +0.75 D or greater and 0.50 D or greater to be eligible for anterior myopia treatment.

Age- and gender-appropriate benchmarks should be considered when measuring axial length and other indicators that may indicate anterior myopia. This provides greater diagnostic accuracy, especially when combined with axial length/corneal radius ratio measurements.

Two main environmental factors appear to have a chance association with childhood myopia. The first is education. Results are difficult to quantify with subjective methods such as questionnaires, but meta-analyses show relationships. For each additional diopter hour of myopia work per week, his chance of becoming myopic increases by 2%.

Although research results on myopia and myopia are inconsistent, there is substantial evidence of a broader relationship between myopia and education. The prevalence of myopia in countries where children receive long hours of education per week from an early age, in countries with well-established national education systems, and among students who attend selected schools and achieve high academic performance increases.

A second environmental factor is time spent outdoors. A systematic examination of this relationship concluded that the incidence of myopia decreased with increasing outdoor time. Children with less light exposure tend to grow in axial length. However, spending time outdoors is not very effective in slowing or halting the progression of myopia.

Among preventive measures, increasing outdoor time is considered to be the simplest, non-invasive option. A clinical trial conducted in China and Taiwan found a reduction in the incidence of myopia among school children participating in the study across the age group of 6 to 14 years. In addition, rebound may occur after stopping treatment, but both test groups in one study showed a significant difference with myopia. In the control group, he had only 26 minutes of outdoor exposure per day.

These environmental factors interact with genetic influences on the development and progression of myopia. Heritability estimates for the identified genes indicate that only a fraction of myopia is heritable, so it is crucial to consider environmental factors, especially in prevention efforts. Risk factors such as rural-urban differences, gender and socioeconomic status also need to be correlated and quantified.

Other therapeutic strategies such as low-concentration atropine and optical intervention may also be successful in some use cases. These treatments reduced myopic transition and decreased myopic progression.

By identifying anterior myopia early and accurately, preventative measures can be taken. Familiar prevention strategies such as increasing time outdoors can have a significant impact on at-risk children, delaying the age of onset and reducing myopia prevalence among young people.

Reference 1. Wang B, Watt K, Chen Z, Kang P. Predicting children who will become myopic – can they be prevented? [published online ahead of print, 2023 May 16].Clin Exp Optom. 2023;1-10. Doi: 10.1080/08164622.2023.2202306

Sources 1/ https://Google.com/ 2/ https://europe.ophthalmologytimes.com/view/childhood-pre-myopia-control-prevention-axial-length The mention sources can contact us to remove/changing this article

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