Author: Mary-Russell Roberson
In Asia, up to 80-90% of middle schoolers and young adults are near-sighted and the U.S. isn’t far behind at approximately 42% in urban areas, which has almost doubled in the last three decades.
That’s a problem not only for the present, but for the future — near-sighted people are at higher risk for multiple vision-threatening problems later in life, including macular degeneration, retinal detachment, glaucoma, and more.
The good news? Duke created a unique clinic led by residency trained pediatric optometrists that offers traditional and innovative treatments to slow the progression of myopia in children. “Thirty years ago, doctors could only tell kids to wear glasses, but now we can actually do more to prevent or reduce the lifetime risk of visual impairment for these kids,” said Qiaohui Wei White, OD, MS, FAAO, pediatric optometrist.
The Risks of Myopia
People with myopia often have longer-than-normal eyes. This is because as kids grow and become myopic, the eye’s shape tends to elongate, stretching out the “wallpaper” on the inside of the eye that is responsible for capturing incoming visual information and sending those signals to the brain. This neuro-tissue is known as the retina. If the retina becomes too thin or stretched, it can detach, which can lead to permanent vision loss if not surgically corrected right away.
Severe myopia can also lead to macular degeneration, in which the center of the retina, called the macula, becomes damaged, resulting in the loss of central vision similar to age-related macular degeneration. Near-sighted people are also at higher risk for glaucoma and tend to develop cataracts earlier.
“There is no safe level of myopia,” White said, adding that the longer the eyeball is, as well as the younger the onset, the greater the risk throughout their lifetime.
“At Duke Eye Center, we perform complete, comprehensive testing and discuss with parents which options are suitable for their children, taking into account lifestyle and preference,” White said. “The best method is the one that works for that particular child and that the child will comply with.”
Which Kids Should be Treated for Myopia?
“I always tell the parents, if you want to reduce the risk for your kid in the future, myopia treatment is something extra most kids can do sometimes even before developing myopia,” White said. In many cases, kids can be detected as “Pre-myopia” candidates for myopia treatment, in which cases the kids’ eyes are growing faster than their peers and normative data. She also said the more severe the myopia is, the more important it is to control.
White recommends that children with concerning myopia should be seen at the pediatric myopia clinic to discuss treatments. The team at Duke Eye Center will not only try to reduce the progression as much as we can but we will also distinguish the risk and rule out genetic diseases that may be associated with high myopia. If a genetic syndrome is the underlying cause, the child can be followed more closely by a team of experts, including our pediatric retinal specialists.
“Because of our experience and strongly specialized team, we strive to be the best place to manage myopia,” White said. “[When you visit Duke Eye Center] You are not only seeing me. We can connect you to the strong team behind me.”
