Covid-19 Home Confinement causes progression of myopia in
school children
 |
| SUSHMITA SARKAR , 1st Year , B.OPTM , Pailan College of Management And Technology |
Abstract :
Object :
Myopia,
or nearsightedness, is the most common human
eye disorder in the world and is a significant global public health concern.
Myopia
is one of the most important causes of visual impairment worldwide. Severe or
high-grade myopia is a leading cause of blindness.
Introduction :
Due to the high magnitude of uncorrected
refractive errors, myopia is considered as one of the important public health problems,
especially in the urban population in India. It has been given high priority
under the National Programme for Control of Blindness.
More
than 32% of the world's population has myopia. The population suffering from
myopia in India in 2010 was just over 28% is expected to rise to 34% by 2020
and approximately 50% in 2050 which is a major concern. According to a study
done by AIIMS, 17% children or 1 out of 6 children aged between 5-15 years are
suffering from myopia.
Importance
Time spent in outdoor activities has decreased owing to home confinement
for the coronavirus disease 2019 (COVID-19) pandemic. Concerns have been raised
about whether home confinement may have worsened the burden of myopia owing to
substantially decreased time spent outdoors and increased screen time at
home.
In
this condition one can see near objects clearly but objects farther away are
blurry.The causes of myopia can be- increase in axial length of the eyeball,
increase in curvature of cornea, increase in thickness of crystalline lens,
absence of crystalline lens (aphakia) or subluxation of lens, absence of
Vitamin A.
Although myopia is a prevalent disease, little
is known about the risk factors that lead to the development and progression of
myopia. Genetics appear to play a role in determining a child’s refractive
error status.
Higher amounts of myopia increase the risk of
ocular complications such as glaucoma, cataracts, and retinal detachment and
atrophy. Due to these sight-threatening complications and the high worldwide
prevalence, research scientists have attempted many methods to reduce the
progression of nearsightedness, including undercorrection of myopic refractive
error . Bifocal or multifocal spectacles, gas permeable contact lenses, topical
pharmaceutical agents, orthokeratology
contact lenses, and soft bifocal contact lenses.
Keywords
: Myopia , lock down ,
pandemic , children's .
Methods :
Review of studies focused on digital device
usage, near work, and outdoor time in relation to myopia onset and progression.
Public health policies on myopia control,recommendations on screen time and
information pertaining to the impact of COVID-19 on increased digital device
use were presented. Recommendations to minimize the impact of the pandemic on myopia
onset and progression in children were made.
Diagnosis :
Testing for myopia may use several procedures
to measure how the eyes focus light and to determine the power of any optical
lenses needed to correct the reduced vision. As part of the testing, you will
identify letters on a distance chart. This test measures visual acuity, which
is written as a fraction, such as 20/40. The top number of the fraction is the
standard distance at which testing is performed (20 feet). The bottom number is
the smallest letter size read. A person with 20/40 visual acuity would have to
get within 20 feet to identify a letter that could be seen clearly at 40 feet
in a "normal" eye. Normal distance visual acuity is 20/20, although
many people have 20/15 (better) vision.
In some cases, such as for patients who can't
respond verbally or when some of the eye's focusing power may be hidden, a
doctor may use eye drops. The eye drops temporarily keep the eyes from changing
focus during testing. Using the information from these tests, along with the
results of other tests of eye focusing and eye teaming, your doctor can
determine if you have myopia. He or she will also determine the power of any
lens correction needed to provide a clearer vision. Once testing is complete,
your doctor can discuss treatment options.
Treatment :
People
with myopia have several options available to regain clear distance vision.
They
include:
Eyeglasses : For most people with myopia, eyeglasses are
the primary choice for correction. Depending on the amount of myopia, you may
only need to wear glasses for certain activities, like watching a movie or
driving a car. Or, if you are very nearsighted, you may need to wear them all
the time. Generally, a single-vision lens is prescribed to provide clear vision
at all distances. However, patients over age 40, or children and adults whose
myopia is due to the stress of near vision work, may need a bifocal or
progressive addition lens. These multifocal lenses provide different powers or
strengths throughout the lens to allow for clear vision in the distance and up
close.
Contact lenses :
For some individuals, contact lenses offer clearer vision and a wider field of
view than eyeglasses. However, since contact lenses are worn directly on the
eyes, they require proper evaluation and care to safeguard eye health.
Ortho-k or CRT : Another option for
treating myopia is orthokeratology (ortho-k), also known as corneal refractive
therapy (CRT). In this nonsurgical procedure, you wear a series of specially
designed rigid contact lenses to gradually reshape the curvature of your
cornea, the front outer surface of the eye. The lenses place pressure on the
cornea to flatten it. This changes how light entering the eye is focused. You
wear the contact lenses for limited periods, such as overnight, and then remove
them. People with mild myopia may be able to temporarily obtain clear vision
for most of their daily activities.
Laser procedures : Laser
procedures such as LASIK (laser in situ keratomileusis) or PRK (photorefractive
keratectomy) are also possible treatment options for myopia in adults. A laser
beam of light reshapes the cornea by removing a small amount of corneal tissue.
The amount of myopia that PRK or LASIK can correct is limited by the amount of
corneal tissue that can be safely removed. In PRK, a laser removes a thin layer
of tissue from the surface of the cornea in order to change its shape and
refocus light entering the eye. LASIK removes tissue from the inner layers, but
not from the surface, of the cornea.
Other refractive surgery procedures : People who are highly nearsighted or whose
corneas are too thin for laser procedures may be able to have their myopia
surgically corrected.
Conclusion :
The findings of this study suggest that home
confinement dur- ing the COVID-19 pandemic was associated with a substantial
myopic shift for younger school-aged children (6-8 years) ac- cording to the
2020 school-based photoscreenings. Younger children’s refractive status may be
more sensitive to environ- mental changes than older children, given the
younger indi- viduals are in an important period for the development ofmyo-
pia. Further studies are needed to assess the generalizabilit of these findings
and the long-term follow-up of these children.
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