The Rise of Pediatric Myopia: Causes and Emerging Treatments
Highlights
- Pediatric myopia rates are increasing on a global scale, making it a top concern for optometrists around the world.
- Pediatric myopia is caused by modern lifestyle factors, such as increased screen time, urbanization, and less outdoor time.
- Genetics and environmental factors also contribute to a growing prevalence of pediatric myopia.
- Optometrists can raise awareness about pediatric myopia by educating parents and the community about risk factors and providing comprehensive eye care to patients beginning at an early age.
Pediatric myopia, or childhood nearsightedness, is a growing global concern, affecting nearly a quarter of school-aged children worldwide. While the condition can be due to genetic factors, modern lifestyle factors contribute to a spike in pediatric myopia diagnosis.
Understanding the prevalence, causes, and emerging treatments of the condition can help educate your patients and help you provide high-level care for pediatric myopia.
The Prevalence of Pediatric Myopia
Global statistics show a current myopia prevalence of 23% of children worldwide and that there will be a significant increase in myopia among children and teenagers. Some estimates indicate that 49.8% of the world’s population may be myopic by 2050. In many East Asian countries, the prevalence of myopia among schoolchildren has surpassed 90%.
In addition to increased myopic prevalence in children, the age of onset for myopia is decreasing, with children as young as five years old being diagnosed.
Untreated myopia can have long-term consequences, including an increased risk of developing cataracts, glaucoma, and myopic macular degeneration. These conditions can lead to permanent vision loss. Diagnosing and managing myopia early is critical to prevent its progression and reduce the risk of long-term eye problems.
Causes of Pediatric Myopia
Pediatric myopia is a complex condition influenced by various factors, ranging from genetics to inadequate exposure to natural light. Some of the most common causes of pediatric myopia include:
Increased Screen Time
Children who spend more time on electronic devices such as smartphones, tablets, and computers are at a higher risk of developing myopia. A 2021 study found that children with high levels of smartphone use had a 30% increase in the risk of developing myopia and an 80% increase due to excessive computer use.
This may be the result of performing extended near-sighted activities on these devices. It may also be due to blue light emissions, which can increase eye strain and myopia development.
Reduced Time Spent Outdoors
Natural light is essential for proper eye growth and development. However, American children spend an average of 4 to 7 minutes playing outdoors each day, compared to over 7 hours in front of a digital device.
The findings of a 2021 study suggest that if children were to increase their outdoor time from 1 to 3 hours daily, they could reduce their risk of myopia by up to 50%. A 2019 study found that sunlight triggers the release of dopamine from the retina, preventing eyeball enlargement and minimizing axial elongation, factors associated with myopia development.
Myopia Genetics and Family History
Pediatric myopia can also be hereditary. Researchers have identified twelve genetic loci as contributing to myopia development, with several of the loci associated with early-onset myopia in children under seven.
This means that children with a family history of myopia are likely to develop the condition. A 2017 study found that the prevalence of myopia increased with the number of myopic parents. Children with no myopic parents had a 7.6% risk rate; those with one myopic parent had a 14.9% risk rate, which increased to 43.6% for children with two myopic parents.
Urbanization and Environmental Factors
Urban environments may offer fewer opportunities for outdoor activities and exposure to natural light, while pollution and high population density may also contribute to the development of myopia.
A 2022 study found that the prevalence of myopia was higher in urban areas than in rural areas in China. The study showed an 82.71% prevalence of myopia among the urban students compared to 71.76% in rural ones.
Educational Pressure and Near-Work Activities
Parental pressure to achieve higher academic performance and the subsequent effect on children’s study habits may contribute to the development of myopia. Spending too much time on near-sighted work tasks, such as reading, writing, and computer use, may lead to hyperopic defocus, which is associated with faster myopic progression.
A 2015 study found that the odds of developing myopia increased by 2% for every one diopter hour of near-work tasks per week.
Emerging Treatments and Techniques
Several emerging treatments and techniques offer hope for managing pediatric myopia and reducing the risk of long-term complications. Optometrists can work with families to develop individualized myopia treatment plans considering the child’s specific risk factors and needs.
Risk Assessment
Optometrists use various techniques to assess a child’s myopia risk factors, including family history, ethnicity, and lifestyle factors such as time spent indoors or on electronic devices. A risk assessment can help identify children most likely to develop myopia and enable optometrists to intervene early.
Peripheral Defocus Contact Lenses
Peripheral defocus contact lenses work by correcting the peripheral refractive error, which is believed to contribute to the development and progression of myopia. These lenses are designed to reduce the stimulus for axial elongation, the underlying cause of myopia progression.
A 2020 review found that peripheral defocus contact lenses can significantly reduce myopic progression and have an efficacy rate of up to 79% compared with just 19% for standard bifocal lenses.
Low-Dose Atropine Eye Drops
Low-dose atropine eye drops reduce myopia progression by slowing the axial elongation of the eye.
A 2022 review found that 1% low-dose atropine reduces myopia progression by up to 77%. While higher doses of atropine can cause side effects such as photophobia and difficulty focusing, low-dose atropine is safe and effective in children.
Pediatric Refractive Surgery
Pediatric refractive surgery, such as laser-assisted in situ keratomileusis (LASIK), can be used for myopia control in children. While this surgery is usually reserved for older children and adolescents, it can be used relatively safely and effectively for younger children not responsive to other treatments.
A 2018 review of a study conducted on patients aged between 1 and 17.4 years old showed a significant improvement in the refractive error following LASIK surgery, and 49% of patients experienced measurable stereopsis after surgery compared with just 18% before the procedure.
Orthokeratology
Orthokeratology (Ortho-K) is a non-surgical treatment for myopia in children that involves wearing specially designed contact lenses while sleeping. The lenses gently reshape the cornea and can significantly reduce myopia progression. Orthokeratology is often combined with atropine drops for greater axial length changes.
A 2020 study found that combination vision therapy using Ortho-K lenses and low-dose atropine was 28% more effective than using Ortho-K lenses alone. However, the study also notes that the long-term effects of this treatment are still uncertain, and there are some potential risks associated with wearing contact lenses overnight, such as corneal infections.
What Optometrists Can Do to Fight Pediatric Myopia
Optometrists can help raise awareness of pediatric myopia and fight against the condition by offering education, incorporating myopia management into routine eye care, and collaborating with other professionals.
By implementing the following strategies, you can contribute to the awareness and prevention of pediatric myopia.
- Conduct community outreach programs or email campaigns to educate parents, teachers, and caregivers about the risks of myopia and the importance of regular eye exams.
- Provide informative brochures, posters, and online resources highlighting the significance of early detection and prevention strategies for myopia.
- Offer interactive workshops or seminars to support parental awareness about lifestyle modifications, such as outdoor activities and reduced screen time, that can help prevent myopia.
- Incorporate myopia management techniques, such as multi-focal contact lenses or orthokeratology, into routine eye care for children at risk of developing myopia.
- Collaborate with pediatricians, educators, and other professionals to create a comprehensive approach to address the issue of pediatric myopia, emphasizing the importance of interdisciplinary care.
- Use integrated optometry practice management software to keep accurate patient records, track potential eye health issues, and optimize scheduling for convenient, targeted eye care treatment.
Support Your Patients’ Eye Health With RevolutionEHR
Optometrists are vital to raising awareness and promoting eye health among their patients. Using cloud-based optometry EHR helps support your efforts with digital patient communication tools and simplified documentation that enables you to provide top-notch care.
Schedule a demo with a RevolutionEHR Specialist today to learn how integrated practice management software allows you to focus on proactive myopia management and better vision for all your patients.
