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What is Myopia?

Myopia, or nearsightedness, is the most common human eye disorder. This is a vision condition in which close objects are seen clearly, but objects farther away appear blurred. Nearsightedness occurs if the eyeball is too long or the cornea has too much curvature. As a result, light entering the eye isn’t focused precisely – right in front of the retina.

The prevalence of myopia in Singaporean children is 27.8 per cent at seven years old, 34.5 per cent at eight years old and 43.4 per cent at nine years old. In Singapore, 80 per cent of 18-year-olds are myopic. These figures continue to increase over time.

Childhood Myopia

Childhood myopia refers to nearsightedness that develops during childhood and typically progresses up to adolescence and adulthood. While myopia experts have not pinpointed an exact cause, it has been observed that genetics, environmental factors and health problems play a part in increasing one’s risk of having the condition.

Lifestyle is also a contributing factor, as evidence points to children who spend most of their time indoors reading, watching television or playing computer games for an extended period are more susceptible to developing or worsening myopia than those who spend more time outdoors.

Myopia treatment usually comes in the form of prescribed eyewear or corrective surgery, based on the severity of the condition and the recommendation of ophthalmologists and optometrists.

Early diagnosis is important so that the child’s vision can be corrected with visual aids as early as possible, thereby slowing the progression of myopia.

Signs and symptoms

Commonly detected during childhood and adolescence, myopia is characterized by blurry vision and the constant need to sit or stand closer to a distant object to see clearly. Those who are nearsighted will typically exhibit symptoms that include:

  • Squinting
  • Headaches
  • Eye strain and fatigue
  • Frequent rubbing of eyes
  • Excessive blinking
  • Difficulty seeing objects while driving or playing sports
  • Blurry distant vision at nights (night myopia)

It’s important to visit a myopia clinic as soon as these symptoms show up, as if left untreated, myopia can have serious effects in the long run.

The earlier the onset of myopia, the higher the myopia becomes. The higher the degree of myopia, the higher the risks of developing complications which can lead to reduced vision and blindness. These include:

  • Retinal detachment - A condition where the inner layer of the eye detaches from the eyeball.
  • Cataracts - A higher chance of developing cataracts at an earlier age - should seek Cataract Treatment early
  • Glaucoma - Severe myopia can lead to increased fluid pressure in the eyeballs, resulting in glaucoma.
  • Macular degeneration - This occurs when the retina degenerates, leading to reduced vision.

In addition, there is a rare condition called myopic strabismus fixus, where there is acquired in-turning of the eye and down-turning of the eye associated with restricted upward and outward movement.

Myopia Control and Treatment

Depending on the severity of nearsightedness, an ophthalmologist will recommend the best myopia treatment to correct a patient’s eyesight and prevent it from worsening.

For mild to moderate cases, the myopia expert will prescribe special glasses or contact lenses. These may be worn at all times or only when necessary, such as when driving or watching a film, depending on the doctor’s advice. Models with anti-glare and high-index lenses are ideal due to their thin and light frame, and ability to reduce eye strain. Photochromic lenses, which automatically darken when exposed to light, will also help protect the eyes from UVA and UVB rays.

Note, however, that prescription glasses and lenses are not meant to restore 20/20 vision. It only corrects the refractive error that causes nearsightedness. More serious and complicated cases require surgery, which can be done at a myopia clinic. While more invasive, tedious and expensive, operations can totally eliminate the patient’s need to wear glasses or contacts. These are suitable for the treatment of myopia, presbyopia and astigmatism.

The most common refractive procedure is LASIK, in which a thin flap is created on the surface of the cornea using a microkeratome or femtosecond laser. The flap will then be lifted to access the corneal tissue and returned to its original position once the cornea has been reshaped using an excimer laser.

Another method done in a myopia clinic is PRK or photorefractive keratectomy, where the cornea is reshaped with an excimer laser to allow light to be focused on the retina precisely, correcting vision. In this procedure, the whole epithelium is removed to access the corneal tissue. The epithelium is left to grow back a few days after surgery.

Atropine drops are also considered a myopia treatment in certain cases. For decades, it has been known that atropine, which is extracted from certain plants, can be used to counter myopia. The drug seems to stop the eyeball from growing longer, a hallmark of myopia.

Myopia Expert - Dr Leo Seo Wei

Dr. Leo Seo Wei is an Eye Surgeon in Singapore specializing in the fields of adult and pediatric ophthalmology, strabismus and advanced cataract surgery. She is one of the few ophthalmologists in Singapore who is certified to perform femtosecond laser-assisted cataract surgery in adults. Other services offered at Leo Eye Specialist include a range of eye screening services and diagnostic procedures for conditions such as glaucoma, presbyopia, diabetic retinopathy and macular degeneration