By 2050, half of the world will be nearsighted. More common among children, myopia can have serious consequences, including vision impairment and other eye ailments, thanks to more screens and less time outdoors. Awareness among parents and the target children is the need of the hour, eye experts tell ARCHANA JYOTI

Scene 1: Five-year-old Bunty is hooked on a video game on a mobile phone while his mother Rekha feeds him porridge. “He’s so finicky when it comes to eating. At least, he eats when cellphone is in his hand,” she says.

Scene 2: Sharmila, an MNC executive who works from home has given her 8-year-old Sonia an adroid phone to keep her busy till she completes her official assignments. Her husband, Rohan agrees as he too is busy with office work and have almost no time to take Sonia for outdoor activities.

In both cases, doctors warned that chances are high that the kids will soon be the part of the ‘Myopia Generation’ whose number, in fact is on increase. Myopia occurs when the cornea of the eye is too curved, or the eyeball is too large. The light rays entering the eye are not able to focus on the retina, which results in a blurry vision.

Dr Digvijay Singh, Head of Ophthalmology department, Madhukar Rainbow Children's Hospital, Delhi presented a disturbing yet familiar picture as he said, a visit to any school in the country today will show you a large number of children wearing spectacles in every class with the numbers increasing from junior school to high school at an alarming rate.

He knows better.  “As a Pediatric ophthalmologist, I see a large number of children on a daily basis who have just been diagnosed with myopia or weak eyesight and many of them are aged less than 5 years also. There has been a spike of cases of myopia after the pandemic when these young children have been exposed to screens and prolonged near activity and deprived of outdoor play.”

In most young adults, myopia will eventually stabilize — but the initial progression of myopia, where the eyes stretch and grow too much, can lead to bigger eye problems later in life, such as a myopic macular degeneration, retinal detachment, glaucoma, and cataracts.

“The higher the myopia, the greater the risk,” Singh flags concerns. “Since myopia progresses the fastest in children under age 10, the most important opportunity to slow eye growth is when children are young.”

A study conducted at AIIMS, Delhi a few years ago has revealed that one in eight children in Delhi schools  were wearing glasses and this number was almost one in three in some studies from South India and North East India

Ophthalmologists said that children spending more time  in doors, being exposed to less natural light, and looking at nearby objects such as screens will leave them shortsightedness or myopia. Research has suggested that the percentage of people affected by myopia worldwide could surge from 27 percent in 2010 to 52 percent by 2050. Add to this are minor factors related to height, improper lighting and sleep habits, Dr Digvijay pointed out.

And as the heat waves become a frequent feature, summer may mean children spending more hours on digital devices, video games and televisions – and less time outdoors.

But what is worrying is that just half of parents recognize that screen time has a major impact on their child’s eye health, according to a study following the C.S. Mott Children’s Hospital National Poll on Children’s Health at University of Michigan Health. “Many parents may not be aware of both the short and long-term health issues linked to excessive screen time, including its effect on children’s eyes,” said Mott Poll co-director Sarah Clark.

“Our findings suggest that some parents may have inaccurate perceptions of activities that affect their child’s eye health and vision and how to minimize risks.”

 “Parents should encourage at least one to two hours of outdoor time per day because exposure to natural light benefits eye development,” Clark said.

He added, “Parents should enforce family rules to ensure children have a sustained period of non-screen time during the day. This is especially important during summer months when they’re off from school and may have less structured downtime.”

Dr Mahipal S Sachdeva, Chairman and Managing Director, Centre for Sight, a chain of Eye Hospitals suggested that glasses or contact lenses usually correct myopia. Refractive surgery such as Lasik or Smile can reshape the cornea of the eye and fix myopia, which allows the patients to see clearly again without using any aids for their vision.

There are also some methods that have been suggested to stop the progression of nearsightedness in children like low-dose Atropine eye drops or fitting them with bifocals, gas permeable contact lenses, or progressive lenses.

However, the results of these methods have been mixed, at best, he said.

Various studies say, that Atropine is the most effective medication that has been demonstrated to be consistently effective in slowing myopia progression (40). Atropine is a natural alkaloid occurring in plants of the Solanaceae family and is mostly extracted from Atropa belladonna.

Dr Digvijaya said that myopia is manageable through regular use of glasses,  certain special types of glass lenses to prevent progression, use of special diluted atropine  eyedrops (which reduce progression of myopia) and special contact lenses which can prevent and even improve myopia.

The most important thing is to catch it early and on time to enable timely treatment so I always recommend to parents to get their child's vision screened at least once at the age of 4-5 years and even earlier if there is a strong family history of myopia.

However, top eye experts from Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi have called for more  researches  in the context of India which is seeing uptick in myopia cases but is not being given due importance due to a paucity of scientific literature in Indian set ups.

“Prospective cohort-based studies are  necessary to understand the natural history, progression, genetic influences, regional differences, and various effects of interventional measures.

In addition, standardized methodology including case definition, sampling strategy and measurement protocols are to be followed to prevent potential bias,” they said in their review article published last year in journal Clinical Ophthalmology. .

The authors included leading ophthalmologists  Dr Amar Pujari, Dr Sujeeth Modaboyina, Dr Divya Agarwal, Dr Gunjan Saluja, Dr Rajeswari Thangavel, Dr Vaishali Rakheja, Dr Rohit Saxena, Dr Namrata Sharma, Dr Jeewan S Titiyal, and Dr Atul Kumar.

PREVENTION/MANAGEMENT OF MYOPIA

• Using eyewear to minimize risks to children’s eyes
•  Protect little eyes from intense sunlight: In fact, when children are outdoors, they should wear sunglasses or wide-brimmed hats to decrease the risks of ultraviolet radiation damage, which can contribute to eye problems in older age, Clark says.
• Regular eye checks to detect problems early
•  Last but not the least: “Follow the 20-20-20+2 rule: for every 20 minutes of screen time, take a 20-second break, look at something 20 feet away or more, and spend at least 2 hours outside each day, throughout the day.”
• The WHO recommends no more than 2 hours of recreational screen time per day for children ages 5 to 17 years, and a limit of 1 hour per day for preschool-aged children.