Tuesday, 11 April 2023

MYOPIA; MATTER TO BE ADDRESSED

Myopia or short sightedness is becoming a growing concern all over the world.Clinically, it is defined as spherical equivalent refraction less than or equal to -0.5 Diopter. But for common to understand we could say myopia as a condition where one couldnot clearly see things at far while there is no issue in seeing objects near to eye.Today nearly20% of global population suffers from myopia.Globally there is an expected increase in people suffering from myopiai.e, to rise upto 50% of entire world population by 2050. Currently refractive errors hold the reason for 1/5th of total blindness in the world,amongst it myopia leads the list. 


It is understood that myopia affect the quality of life of the individual, but the intensity varies according to the age of the individual,magnitude of the disease,geographical setting (i.e. rural or urban) as well as political commitment of the country. Regarding the age, for a young child inorder to pursue education the audiovisual spatial integration plays an important role, while for an old aged individual the consequence of such a disease is comparatively low. When in comes to geographical setting, urban areas has tertiary level healthcare facilities which provides quality intervention while primary level healthcare is being the only option for rural residents. Adding to it, there is a huge economic divide between rural and urban population in India.

If myopia is causing learning disabilities for children at one end, the adults suffer with inability to work with maximum potential at the middle while old aged find it difficult to do the activities of daily living at the other extreme.But there are associated symptoms like headache which bother everyone irrespective of age group they belong to. Irritation in the eyes followed by rubbing, frequent blinking of eyes, blurred vision, eye straining are some of the concomitants of myopia which are often left unnoticed. Apart from these symptoms dry eyes, foreign body sensation are also found to be reported by patients. Rarely some patients also presents with squinting.

Proper maintanence of eye health is essential for preventing myopia though it cannot not completely help to attain it. Studies suggest there is a genetical background that could be traced back to the cause of myopia atleast in some cases. Consanginous marriage, X linked chromosomal disease pattern etc are being reported as causes for myopia in some regions of the country. There are some eye diseases which found to be associated with myopia such as glaucoma,retino-choroidal diseases etc.Syndromic relationship with thalassemia also seen with myopia.

Though these kind of genetic influence are there for myopia, more common risk factors are environment related. People who stay indoor regularly found to have more chance for having the disease. On the other side people who stay outdoor often presents with myopia less in number. Researchers suggest this is due to indirect relationship i.e, people who stay indoor use near sight frequently more than people at outdoors. Near work is another main reason contributing to refraction errors like myopia. People engaged in tailoring, gold smith and similar jobs which require frequent involvement of near sight increase the burden of myopia. When it comes to computer or screen based jobs too, continous near sight being regarded as the main reason.

 

An interesting finding related to myopia is that of with education. The higher a person getting educated, the chances that individual become myopic increases. The other important risk factor for myopia is increased screen time. In this digital era, people use screen for education as well as entertainment. This will make an upshoot in the number of people becoming myopic unless properly eye health is maintained.

 

Preventive measures regarding myopia is far easy to follow yet frequently neglected. There are measures like Bates excercises, Periodic Near to far shifting , palming , solarization , eye squeezing ,eye circling , eye massaging etc . Apart from that traditional measures like Trataka Yoga Kriya are also found to be useful in preventing myopia. These measures help in muscles relaxation in and around eye. Once diagnosed with myopia too, people could follow these measures inorder to control rapid prognosis of the disease.

Another challenge to decrease the rapidity of myopic eye is the stigma towards spectacles. Often people believe wearing glass has got cosmetic disfigurement. Though government provides spectacles through national health programme to prevent blindness, this act as a barrier to achieve the goal of preventing blindness. Poor people cannot afford switching to contact lens as an alternative to spectacles while rich people do so. In case of contact lens too, measures should be taken to keep the hygiene as well as to be distant from inflammable environment.

There are measures like Photo Refractive Keratectomy (PRK), Laser InsituKeratomilensis (LASIK) and Femtosecond laser assisted small incision lenticular extractions which are used for avoiding spectacle usage. Though these procedures wont cure per se rather help to focus light by manipulating lens structure.

The rate at which people presents with short sightedness would be very rapid in this digital era , if proper eye health is taught at schools, home and offices. There should be regulations from the side of parents regarding screen usage of small kids, as increased screen time not only causes refractive errors, but psychological conditions like Attention Deficit Hyperactivity Disorder, Addiction tendency too. With organized efforts greater public action could be initiated in order to control the rapid increase in the number of myopia patients of the country. On Regular basis HEEALS organize Eye Care Campaign in schools. Where Volunteer and Interns show how to protect eyes and eye care importance.

DR THAREEKH BASHEER

MPH SCHOLAR

UNIVERSITY OF HYDERBAD

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