Consider These Facts
If Your Child
- In Americans aged 12 to 54 years, the prevalence of myopia has almost doubled to over 40% in the past 30 years (Vitale et al, 2009).
- High myopia is strongly linked to a higher risk of cataracts, retinal detachment, and myopic maculopathy (Flitcroft, 2012). Increasing rates of vision impairment and blindness due to the latter are already evident in Asian countries (Iwase et al, 2006; Wu et al, 2011).
- Even 1.00D of myopia doubles the risk of myopic maculopathy (MM) and posterior subcapsular cataract (PSCC) and triples the risk of retinal detachment (RD) compared to emmetropes (not requiring correction).
- At 3.00D of myopia, the risk of PSCC triples, and the risk of RD and MM is nine times that of an emmetrope. Once children reach 5.00D of myopia, they hold a five times greater risk of PSCC, a 21 times greater risk of RD, and a 40 times greater risk of MM; higher levels bring more eye-watering risks. These ratio risks demonstrate that there is no physiological level of myopia that could be considered “safe” in comparison to emmetropia (Flitcroft, 2012)
- However, myopia management is not just applicable to myopes; exhibiting less than 0.50D of manifest hyperopia at age 6 to 7 years is the most significant risk factor for future myopia, independent of family history and visual environment (Zadnik et al, 2015).
- The fastest rate of refractive change in myopic children occurs in the year prior to onset (Mutti et al, 2007), so children who are less hyperopic than age normal should be closely monitored, especially if concurrent risk factors of family history or binocular vision status are evident.
- Children who have one myopic parent have a three-fold risk of myopia development compared to their peers who do not have this family history; two myopic parents double this risk again (Jones et al, 2007).
- On the positive side, a strong family history of myopia has resulted in stronger treatment effects in studies investigating efficacy of progressive and novel spectacle lens designs for myopia managementl (Kurtz et al, 2007; Sankaridurg et al, 2010)
- Initiating a myopia management strategy for pediatric patients should ideally commence before they become myopic, in view of the risk factors described above.