Myopia, a global phenomenon, can be filtered at 3-year-olds' health checkups

Myopia has recently emerged as a new health topic worldwide, with the number of people with myopia growing rapidly at home and abroad.

There are reasons for this.

Myopia, a refractive error that occurs when the image of an object is formed on the front of the retina due to the long length of the eyeball, is known to increase the risk of developing serious eye diseases that can appear in adulthood. The more severe the myopia, the higher the risk of developing these diseases.

“There are many very worrying reports that at the current trend, by 2050, more than half of the world's population will be myopic, and 10 percent of them will reach pathological high myopia,” said Professor Paik Hye-jung of the Department of Ophthalmology at Gachon University Gil Medical Center who also chairs the Korean Society for Pediatric and Adolescent Myopia Research, on the YouTube channel “I Am a Doctor.”

There are reports that by 2022, 70 percent of the Korean population will be myopic, and more than 50 percent of those myopes occur in adolescence, Professor Paik added.

Myopia was not included in the definition of “disease” in the past, but it has been categorized as a disease that requires treatment and management since the last decade.

“There was a much longer period when myopia was not considered a disease. The concept of myopia as a disease has changed within the last 10 years,” Paik said. “We are now focusing on myopia because it is a risk factor for the development of all serious adult eye diseases.”

High myopia (minus 6 diopters or more) is considered a particularly dangerous condition, as it is associated with a significantly increased incidence of various serious eye diseases, including retinal detachment, retinal tears, myopic macular degeneration, glaucoma, and cataracts.

“If we can reduce the number of glasses by just one diopter in adults, we can reduce the incidence of retinal degeneration by more than 40 percent and glaucoma by more than 20 percent,” Professor Paik said.

Because myopia is the leading cause of serious eye disease in adulthood, and high myopia is the leading cause of serious eye disease in adulthood, myopia is now a condition that needs to be treated to maximize progression. “Myopia should be treated,” Paik said. “However, strictly speaking, the concept of myopia treatment is not to cure myopia (restore normal vision) but to detect myopia early, suppress the progression of myopia, and control its pace.”

Currently, no cure for myopia can restore normal vision. That explains why it's important to find myopia early and treat it to slow its progression. Children are an important age group for myopia treatment. That’s because most myopia develops and changes during growth. A newborn child’s vision is very weak. Vision improves as the child grows, but at some point, genetic and environmental factors interfere with this process.

“Myopia develops as the child enters the growth spurt, and it increases throughout the growth spurt when the length of the eyeball grows along with the overall body growth,” Professor Paik said. “Because myopia progression occurs in children, age is the pacemaker that controls the rate of myopia progression, and ultimately, what degree of myopia a person will have as an adult and how much risk they will have for other eye diseases.”

Diagnosing myopia is crucial because the idea is to treat children expected to progress preemptively.

“For treatment, the most important thing is to check whether it is myopia with a precise eye examination,” Paik explained. “We put eye drops in the eye, examine various eye structures and functions, and diagnose whether it is myopia considering the child's age, and then differentiate whether it is progressing.”

What are the preventive treatments for advanced myopia?

There are two main types: optical treatments, such as glasses, and non-optical treatments, including eye drops.

“There are a lot of optical treatments, whether it's glasses or contact lenses, that use the principle of slowing the progression of myopia in the lens,” Paikk said. “However, the non-optical treatments are becoming more popular worldwide.”

The non-optical method involves daily eye drops of atropine.

“There are reports that daily instillation of atropine has been shown to inhibit myopia progression,” Professor Paik said. “Whatever the method, it is important to choose a method that the caregiver can do well and adhere to for a long period, and to follow up with the caregiver to control the rapid deterioration of myopia.”

For optical treatments, it is also recommended that lenses be made at an optometrist's office based on the exact numbers from the eye examination.

“If the first pair of glasses in a child's life starts with a mistake, there is a reluctance to wear glasses, and there are various problems caused by overcorrection or under-correction,” Paik said. “The best answer is to have an eye examination and prescription for glasses in children with a prescription tested by an ophthalmologist using antibiotics.”

In Korea, there is a quick way to detect myopia, which can cause major vision problems in the future: take advantage of the free eye examination for infants at the age of three.

“If you comply with the age of the first eye examination, you can catch a (normal) child when he or she is unable to see, squinting, getting closer, and feeling uncomfortable,” Professor Paik said.

However, she recommended early eye examinations before the age of one for premature babies and those with genetic diseases.

“In the medical field, all normal children are fine when they first come to the hospital at age three. However, children with problems need to be checked earlier, and the prognosis of vision at a later age is different because of the detection time,” Paik said. “If the child was born prematurely, has a problem with birth history, or has a genetic disease, it is recommended that the child visit a pediatric ophthalmologist before the age of three and get the necessary tests even before the age of one.”