Myopia is becoming more common, as knowledge on detection and management increase. When should you start myopia control? Here we present an overview of when you might start myopia management across the spectrum of patient presentations. Since every child and their family are unique, we also point you towards more information for each situation.
This new systematic review and meta-analysis has evaluated use of smartphones and tablets separately to computer use and other non-screen based near work. Results are still mixed but overall there was a trend for a slightly increased risk with mobile device use alone, which increased when combined with computer use. More objective measures of screen time are needed to further explore this link.
The COVID-19 pandemic saw widespread home confinement, increased screen time in children with home-based learning, and decreased time spent outdoors. Several recent publications have explored the impact of this period of time on the incidence and progression of myopia, lifestyle behaviours, digital eye strain, myopia treatment efficacy and more. What should we now monitor and discuss with our young myopic patients in the post-COVID world?
A vision-screening program was able to provide data before and after Chinese schoolchildren were confined to home learning during the COVID-19 pandemic. Overall, more hours were spent indoors and less time was spent outdoors during this time, across all age groups. The younger schoolchildren had increased incidence of myopia and faster progression, whereas an increase in the prevalence of high myopia was found in the older children.
Children aged 6 to 8 years old in China were found to experience a mean -0.30D myopic shift and a significant increase in myopia prevalence during a 5-month long COVID-19 home confinement period. Due to their age and corresponding critical stage in visual development, the change in the children’s environment and lifestyle may have been more responsible for their increased myopia than the increased online learning.
Adults with myopia may not understand that they have more than just a problem seeing clearly. We discuss genetic risk in glaucoma and macular degeneration – are you doing the same for myopia? How can we talk to myopic adults about risks for their children and support them to take action?
Will China’s new regulations restricting online gaming in children reduce the myopia crisis? Is there evidence that less screen time increases outdoor time? We explore the links and impacts, positive effects of gaming and advice for parents.
During the COVID-19 pandemic, governments imposed home confinement and school-based learning was the normal. Has this caused more myopia? In this clinical case, the unique environment of lockdown is explored in view of myopia management outcomes.
The simplest lifestyle intervention we can advise for both our at-risk pre-myopes and myopia development is to spend more time outdoors.
Young adults wearing the spectacle-mounted Clouclip device to measure viewing behaviour and light exposure also kept an activity diary. Mean daily near work and outdoor time were subjectively reported at about 150% of the objectively measured hours. This indicates the value of objective measures in research, as well as for clinical education and behaviour modification tools in future.
