Frequently asked questions....
Why does my child need glasses?
The eye is like a camera. A child needs distance glasses because the length of the eyeball is longer than normal and hence the light from a distant object gets focused in front of the retina, instead of on the retina. So a blurred image of the object is formed on the retina, instead of a focused one.
Myopia has a combination of both genetic and environmental pre- disposing factors. It can run in families. Children of myopic parents have more chance of developing myopia, particularly if both parents are myopic. However myopia can also occur in children, even if parents are not myopic. Different genes have been identified for myopia, which control nerve cell function, processing of light, and eye development. People who have more of these genes have 10 fold higher incidence of developing myopia. Recently, insufficient sunlight exposure has been shown to be an important pre-disposing factor in myopia development. Also excessive near work like reading, writing and working on computer is also an independent risk factor. Thus increased levels of education, ever increasing screen time in children and lack of outdoor activities are causing this disorder to increase in recent days. Can myopia or it’s progression be prevented? Onset of Myopia cannot be totally prevented. However it can be delayed or the progression can be slowed down by limiting screen time (no screen below 2 years, 1 hour per day for small children and 2 hours for older children), decreasing the amount of near activity, paying attention to the illumination in the room and the distance at which books are held when the child is performing near tasks and encouraging 1 hour of outdoor activity and sunlight exposure everyday.
What can I give my child to eat to reduce the spectacle power?
Myopia does not occur due to nutritional deficiency. So nutritional supplementation does not play a direct role in reducing power. However Vit A and Vit D are both important in overall eye health, so eating vegetables, fruits and milk products are essential.
Does my child have to use glasses constantly and will that reduce the power?
Constant use of glasses in children is necessary to prevent lazy eye and eye strain, however it does not lead to decrease in power. Myopia always increases with age till 18 years due to increase in length of the eyeball.
Are their any preventive treatments for myopia progression?
Previous treatments to reduce the progress of myopia like orthokeratology (special contact lenses) and progressive lenses have not been very effective. 1% Atropine eyedrops have been tried but are associated with pupillary dilatation and loss of focusing ability for near and so are not popular. The breakthrough has been with the introduction of the daily use of dilute 0.01% atropine eye drops. This treatment has been proven scientifically to delay the progression of myopia in the age group of 6-12 years. Studies have been done on Asian eyes, as myopia is more rampant in Asian countries. It is not yet US FDA approved, but it is being increasingly used in South East Asian countries and India, and is showing promising results in majority of patients. In India it is being marketed under the trade names of Kidtro, Myatro and Atroped. It is started in children of age 6 years or older, with documented progression of 1D or more per year. It can be used only once a day, either in the mornings or evenings as per convenience. It does any significant side effects and is not associated with significant pupillary dilatation. However as it is a long term treatment, it should be used under proper monitoring by a Pediatric ophthalmologist. The effect is seen more after the first 6 months. If it slows the progression to 0.5D, it is continued for at least 2 years. After discontinuing, if the myopia again increases, it can be restarted and continued till eye growth stops. The mechanism by which it works is not by preventing muscle strain by relaxing eye muscles, but by actually slowing down elongation of the eyeball.
Recently myopia control spectacle lenses have also been launched by Companies like Zeiss, Hoya and Essilor, but clinical experience with them is still limited.
Can myopia cause any other side effects on the eye?
As the eye elongates, the retina in myopes becomes thin. This can lead to development of weak areas called lattice degeneration or breaks in the retina which can lead to the retina getting detached from its position, causing drop in vision. To prevent this a yearly examination of the retina is essential, so that weak areas can be identified and treated with laser before they cause complications.
What kind of glasses are recommended for children?
Children should always wear fibre glasses as they do not break and cause injury to eye during play. Anti-reflective coating can be used to reduce glare from screens.
When can laser be done to remove glass power (Lasik)?
This can be done only after 18 years of age because by that time the elongation of the eye is complete and the power stabilises.
Is it safe to get Lasik done after 18 years?
Yes it is, but only after a complete evaluation of the eye. The pre-requisites are that the cornea should be of sufficient thickness (which is evaluated by a test called occulyser), retina should be healthy (which is confirmed by fundoscopy) and power should be stable over a year. If all this is clear, Lasik gives excellent freedom from distance spectacles. Reading glasses will still be required after the age of forty.