Let Sun be your child’s friend to prevent Myopia progression

Mediawire
New Delhi [India], July 31: These days many of us must have come across the term called ‘Progressive Myopia’. So, what is it? Progressive Myopia is a type of Myopia or near-sightedness in which the correction to clear the vision increases in a time period of less than a year and increases by more than -0.5 dioptre of power. This type of Myopia typically affects teens and children. It is observed that the earlier the Myopia develops, the faster is its progression. Hence children who develop Myopia in early years of life are prone to have Progressive Myopia and finally high Myopia. Early intervention in developing Myopia is found to halt the Progression of Myopia effectively and protect the children from its adverse complications.
Children are the future of the nation. Taking care of their vision today will have great impact on their well-being in future and thereby the nation. We all know that India has the maximum youngest population. So, special attention and policies should be made to early detection and timely treatment for this precious vision of children. Myopia adds to the socio-economic burden to the county as well.
Dr V. Rajesh Prabu - Consultant Paediatric Ophthalmologist, Sankara Eye Hospital, Coimbatore quoted “Myopia is becoming more common amongst school children due to less outdoor activity & more digital strain. Luckily, Newer modalities of treatment are available in recent times to arrest the progression of Myopia. Timely intervention in the form of drugs, special glasses & contact lenses help to control the progression of myopia. Periodic consultation with the pediatric ophthalmologist is mandatory”.
Myopia develops in childhood and is found to affect more East Asian children. With this rising trend in cases of Myopia, it is estimated that half of the world will be myopic by 2050. The situation in India is worrisome too. As per a study conducted recently, it is estimated that around 40% young population in the country is at risk of developing Myopia. It is not a simple refractive error but a vision-threatening disorder and has become a leading cause of blindness in Asia. High myopia implies irreversible vision complications like retinal detachment, cataract, glaucoma and macular atrophy etc.
Genetic factors play a significant role in the development of myopia, but some environmental and lifestyle factors are known to be responsible for its progression. Studies have found the interaction between environmental factors like near work, outdoor activities, sun exposure etc. and Myopia progression. With the change in lifestyles and habits, young children of the current generation are spending less time outdoors. Playing outdoor games in sunlight has also reduced significantly. But some studies suggest the protective role of time spent outside in the progression of Myopia. A study conducted in India has found a statistically significant negative directional relationship between outdoor activity and Myopia.

Dr. Soumya R MS, FMRF, FAICO (ped ophthal), FICO (UK), FAICO (Neuro ophthal), Consultant and DNB Faculty, Sankara eye hospital, Bengaluru quoted “Environmental modifications play an important role in controlling progression of myopia. Sunlight exposure of 60 -90 min daily, increased outdoor activities and minimising near gadgets have a protective effect”.
It has been found that each hour increases in outdoor activity per day had a protective effect on the progression of Myopia. Time spent outside is not only beneficial for halting the progression of Myopia but also for the range of disorders like ADHD, Hyperactivity, asthma etc. Public health measures aimed to prevent the progression of Myopia could be based on increasing hours of outdoor activities for children targeting not only parents but also the decision-making authorities of the curriculum.

Dr Amit Gupta, MBBS.MS DNB, Kapil Eye Hospital, Ambala City quoted “Myopia or short sightedness is a condition which the near objects appear clear, but the distance objects appear blurry. The proportion of children suffering from myopia is increasing at an alarming rate. Up to 25% of children are affected by myopia in India and it is expected to reach roughly 50% of population worldwide by the year 2050.
Lifestyle modification: The children should be encouraged to spend at least a couple of hours outside daily and refrain from using screen devices like mobile phones, laptop etc. They can be taken to parks or to make them join sports or any other activity which provides them outdoor exposure. The classrooms need to design in a way to allow exposure to outdoor light. Artificial light is no substitute for natural light”.
In India there has been observed a constant rising trend in cases of Myopia in all age groups and in rural as well as in urban set up. As per a study, cases of Myopia had risen from 4.6% to 6.8% in a decade in rural children. Myopia prevalence in urban India has been projected to spike to 48% by 2050. Though Indians are a low progressing cohort (-0.3 D/year) as compared to the East Asian (-0.6 to -0.8 D/year), the rising numbers of Myopes cannot be ignored. As per the guidelines published by All India Ophthalmological Society 40 to 120 minutes of outdoor time is associated with reduced incidence of Myopia. 
Thus, schools should include the specific period for outdoor activities in their curriculum for children. Also, parents should encourage their kids to play more outside than playing indoors and reduce screen time on playing with gadgets.

Dr Elizabeth Joseph, HOD Ophthalmology and chief of Pediatric Ophthalmology & Strabismus at Little Flower Institute of Ophthalmology, Angamaly, Kerala quoted “The number of people with myopia or shortsightedness is increasing in alarming proportions worldwide. Recent studies have shown that the incidence of myopia can be significantly reduced, and progression of myopia can be arrested by several methods. The teachers and parents are to be made aware of the preventive measures and schools should enforce strategies to control the myopia epidemic. Most effective method to reduce myopia is by increasing the exposure to sunlight.  There is strong evidence that more outdoor activity provide protection against myopia development in the human eye. Outdoor activities prevent progression of myopia because of the beneficial effects of spectral composition and intensity of lighting, strengthened circadian rhythm, less Dioptric demand due to small pupil and increased Vit D. A minimum of 8-15 hrs. of outdoor activity per week is recommended for school age children. Use of low dose atropine eye drops is found to be effective in controlling the progression of myopia”.

Dr Leila Mohan, Paediatric ophthalmologist, Comtrust Eye Hospital, Calicut, Kerala quoted “Progressive myopia in children can be considered a 'lifestyle disorder or disease's which can be partly modified by increasing outdoor activities especially under sun and reorganising near work activities.Proper refractive correction with spectacles, proper lighting conditions during near work, restricting the use of digital gadgets (especially mobile phones) at less than one foot distance and encouraging breaks every 30 minutes are the essential lifestyle modifications to prevent progression of myopia. Now, pharmacological and modified optical specs or contact lenses) methods are available in fast progressive myopia especially in those with genetic predisposition (myopic parents)”.
Simple interventions like outdoor activities and decreasing duration of near work and screen time are found to be effective interventions to delay onset of Myopia. However, to reduce number of cases of Myopia and improve the vision of children more efforts and work is needed from parents, teachers and eye health organizations.
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