Myopia prevalence is on the rise, with projections suggesting that by 2050, nearly one-half of the world’s population will have it. This increase is coupled with earlier onset, faster progression, and greater severity of myopia. It is estimated that over 285 million people in the world have vision impairment and that 42% of this is due to uncorrected refractive errors.
Dr Bindiya Hapani, Consultant Ophthalmologist, Dr Agarwals Eye Hospital, Bengaluru, says, “The projected surge in myopia cases is likely fueled by environmental factors prevalent in urbanised societies, with major contributors being increased near-vision activities and reduced outdoor time. The widespread adoption of digital devices over the past decade has introduced new forms of near-work activity.”
“As children increasingly embrace smart devices at younger ages and spend more time on digital screens, there is an urgent need to better understand the association of digital screen time with myopia,” explains Dr Bindiya.
Additionally, the age at which children begin using smart devices is decreasing, with many 2-year-olds spending up to 2 hours daily on such devices.
Dr Bindiya says smart device screen time alone is associated with a 26% increase in the odds of myopia, while in combination with computer use, the odds increased by 77%. Studies have found that the risk of myopia development is eight times higher when children spent more than four hours per week on computers and video games compared to no screen time.
“Evidence is emerging that spending more time outdoors can protect against the onset of myopia and possibly slow the rate of progression of myopia. When children spend sufficient time outdoors (more than two hours/day), the risk of myopia is reduced,” says Dr Bindiya.
The impact of myopia is not only financial; it also affects quality of life and personal development.
Dr Bindiya further explains, “Myopia is also associated with other sight-threatening conditions including macular degeneration, cataract, retinal detachment, and glaucoma.”
MMD is the most common cause of visual impairment in patients with myopia, as 10% of people with pathological myopia develop MMD (myopica macular degeneration) due to choroidal neovascularisation, which is bilateral in 30% cases. Myopia is also associated with higher risk of glaucoma, cataract and retinal detachment.
Dr Bindiya says, “Epidemiologic evidence suggests that high myopia is a risk factor for the development and the progression of glaucomatous optic neuropathy, the risk of developing glaucoma is nearly 50% higher (or one and a half times as high) in individuals with moderate to high myopia, compared to those with low myopia.”
The risk of developing a retinal detachment is five or six times greater in people with high myopia compared to those with low myopia.
He says, “Higher rates of cataract surgery are seen in individuals with high myopia. Based on the available evidence, they are 17% more likely than those with moderate myopia to need cataract surgery.” Patients with high myopia are 17% more likely to undergo cataract surgery than those with moderate or low myopia.