On average, prescriptions increase the fastest in children between the age of 6 to 14 among Asians

Check for the warning signs of myopia.

Who is Affected by Myopia?

Genetics play an important role in developing myopia. A child where both parents are myopic has a much higher chance of developing high myopia (over 6.00 D) than one with only one or no parent that is myopic(15). Asians also tend to be much more susceptible to developing myopia early in life. The progression of myopia in Chinese according to many studies averages at an 0.8 D increase per year between the ages of 7-14 years old (4), which is in most cases the fastest growth period in terms of the length of the eyeball. It is not uncommon to see an over 2.00 D increase in a single year in Chinese children. These children who are nearsighted at a young age (10 years old or younger) are very likely to become highly myopic (5). Asians also tend to have a higher degree of myopia and the degree of myopia may continue to increase through their early adulthood.

Progression of myopia in Chinese
Sun exposure helps to slow down increases in myopia

The environment also plays a major role in worsening the degree of myopia. Many studies have linked urbanization and education to myopia (7,14). Long hours of reading, computer use and near work, in general, are believed to be negative environmental factors in developing myopia (2). Nearsightedness is twice as common in middle and higher income provinces in China compared to the more rural areas of China with less near-work demands and where children experience less school pressure (9).

There are many studies that show outdoor activities with sun exposure helps to slow down increases in myopia (16). A lack of sun exposure can be a contributing factor to the development of myopia in children (6). A rule of thumb for a good amount of outdoor activities to prevent myopia progression is 12 hours a week for children during their growth years.

Sun exposure helps to slow down increases in myopia
» References

1. Anstice, Nicola S., and John R. Phillips. “Effect of Dual-Focus Soft Contact Lens Wear on Axial Myopia Progression in Children.” Ophthalmology, vol. 118, no. 6, 2011, pp. 1152–1161.
2. Chen, Sheng-Ju, et al. Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2012
3. Chia, A., Lu, Q. and Tan, D. (2016). “Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2.” Ophthalmology, 123(2), pp.391-399.
4. Cho, Pauline, et al. “The Longitudinal Orthokeratology Research in Children (LORIC) in Hong Kong: A Pilot Study on Refractive Changes and Myopic Control.” Current Eye Research, vol. 30, no. 1, 2005, pp. 71–80.
5. Chua SYL, Sabanayagam C, Cheung Y-B, et al. “Age of onset of Myopia Predicts Risk of High Myopia in Later Childhood in Myopic Singapore Children” Opthalmic Physiol Opt. 2016;36(4):388-394
6. Cui, D. Trier, K., Ribel-Madsen, S.M. “Effect of Day Length on Eye Growth, Myopia Progression, and Change of Corneal Power in Myopic Children” Ophthalmology. 2013; 120(5),1074-1079
7. Dandona, Rakhi, et al. “Population-Based Assessment of Refractive Error in India: the Andhra Pradesh Eye Disease Study.” Clinical and Experimental Ophthalmology, vol. 30, no. 2, 2002, pp. 84–93.
8. Flitcroft DI. “The Complex Interactions of Retinal, Optical, and Environmental Factors in Myopia Aetiology.” Prog Retin Eye Res. 2012; 31 (6): 622-660
9. He, Mingguang, et al. “Refractive Error and Visual Impairment in Urban Children in Southern China.” Investigative Opthalmology & Visual Science, vol. 45, no. 3, Jan. 2004, p. 793.
10. Holden, Brien. “The Impact of Myopia and High Myopia.” World Health Organization, 16 Mar. 2015.
11. Kinoshita, Nozomi, et al. “Additive Effects of Orthokeratology and Atropine 0.01% Ophthalmic Solution in Slowing Axial Elongation in Children with Myopia: First Year Results.” Japanese Journal of Ophthalmologyvol. 62, no. 5, Apr. 2018, pp. 544–553.
12. Kothari, Mihir, and Vivek Rathod. “Efficacy of 1% Atropine Eye Drops in Retarding Progressive Axial Myopia in Indian Eyes.” Indian Journal of Ophthalmology, vol. 65, no. 11, 2017, p. 1178.
13. Liu, Y M, and P Xie. “The Safety of Orthokeratology–A Systematic Review.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Jan. 2016
14. Murthy et al “The Prevalence of Uncorrected Refractive Error in Urban, Suburban, Exurban and Rural Primary School Children in Indonesian Population.” International Journal of Ophthalmology, 2017
15. Racella R, McLellan J, Grice K, Del Bono EA, Wiggs JL, Gwiazda JE. “Role of Genetic Factors in the Etiology of Juvenile-Onset Myopia on a Longitudinal Study of Refractive Error.” Optom Vis Sci. 1999;76(6):381-386
16. Rose KA, Morgan IG, Smith W, Burlutsky G, Mitchell P, Saw S-M. “Myopia in Children.” Ophthalmology. 2008;115(8): 1279-1285
17. Sun, Jing, et al. “High Prevalence of Myopia and High Myopia in 5060 Chinese University Students in Shanghai.” Investigative Ophthalmology & Visual Science, The Association for Research in Vision and Ophthalmology, 1 Nov. 2012
18. Sun, Yuan, et al. “Correction: Orthokeratology to Control Myopia Progression: A Meta-Analysis.” Plos Onevol. 10, no. 6, Nov. 2015
19. Tkatchenko, Andrei V., et al. “APLP2 Regulates Refractive Error and Myopia Development in Mice and Humans.” PLOS Genetics, vol. 11, no. 8, 2015
20. Vitale, S. (2009). “Increased Prevalence of Myopia in the United States Between 1971-1972 and 1999- 2004.” Archives of Ophthalmology, 127(12), p.1632.
21. Zhao, Hai-Lan, et al “Role of Short-Wavelength Filtering Lenses in Delaying Myopia Progression and Amelioration of Asthenopia in Juveniles.” International Journal of Ophthalmology, 2017

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