Myopia or nearsightedness is a problem of the eye growing too long for its optical power. Myopia has also become increasingly common the world over, at least in part due to our change in visual habits and increased time devoted to near activities.
The Myopia Control Clinic specializes in the care of children. In addition to providing conventional glasses for clear vision, more importantly, our services include options for controlling the progression of myopia. The latter options are likely to benefit mostly those with early-onset, i.e., whose nearsightedness developed before the age of 7 years, and/or fast progressing myopes, who are at greatest risk of developing high myopia. A positive family history of high myopia represents another risk factor.
Myopia arises from the excessive growth with the elongation of the eyeball. This results in light rays from distant objects focusing in front of the retina instead of on the retina. Distant objects are thus seen to be blurred but near objects remain clear.
Studies suggest that 60 minutes of outdoor activity per day decreases the chances of developing myopia by 9%. Your grandparents will tell you that it was much less common to see someone wearing glasses back then, probably due to the fact that they were not cooped up indoors all day long.
You probably thought that it’s because being outdoors makes you focus on objects in the distance. However, this effect has been shown to be a weak one. The actual reason is that bright out¬door light stimulates the release of retinal dopamine, which slows down the growth of the eyeball and inhibits myopia.
Atropine eye drops have been used to treat myopia for children in Singapore since 2000 and in India for the last 1 year. However, do note that Atropine doesn’t reverse the effects of myopia. As such, it will not work for you if you’re an adult, as your myopia will have been fully developed.
The idea of using Atropine came about because of its ability to relax the near-focusing eye muscles. Since too much near work is related to prolonged contraction of this muscle and shortsightedness, it’s thought that relaxing the muscle has the opposite effect on myopia progression.
But according to recent studies atropine prevents myopia via a non- accommodative mechanism. Atropine is a muscarinic acetylcholine receptor antagonist and there are two theories
1. Atropine functions at a relatively low dose via a neurochemical cascade that begins in the retina, at the amacrine cell level. The amacrine cell is a neurotransmitter in the retina where the sign of defocus is found.
2. Atropine has a direct effect on sclera as it inhibits glycosaminoglycan synthesis, which is a marker for scleral expansion. Scleral expansion is natural to occur in myopia progression.
0.01% Atropine is used; the eye drops must be used once a day until up to 12-13 years of age. The idea is therefore to use Atropine during the period of time when the shortsightedness is increasing fastest. Thus, most children who use eye drops would be using them for several years.
Studies have shown that it slows myopia progression by 80% over a two-year period, but is sometimes associated with uncomfortable but reversible side effects like glare and blurring of near vision due to dilation. It’s important to note that these side effects are not very common at all but are known to occur.