[염혜리 가톨릭대학교 은평성모병원 안과 교수] Myopia is a refractive error in which the front and rear lengths of the eyeball are usually longer, so that light from an object does not reach the retina of the eye and is focused in front of the retina, making it difficult to see an object. Close objects are clearly visible, but it becomes difficult to see distant objects. It usually occurs before or after elementary school, continues during adolescence, and sometimes progresses into adulthood.
Myopia is one of the most common eye diseases worldwide. According to the National Health and Nutrition Survey conducted from 2008 to 2012, about 20% of Korean children aged 5-6 years, 58% of 7-11 years old, and 80% of 12-18 year olds showed myopia. According to data released in 2016, the number of myopia population worldwide is on the rise, so if the prevalence of myopia increases at the current rate, about 4.7 billion people, 50% of the world population, will have myopia by 2050. predicted that. Among them, the prevalence rate is relatively high, especially in Asia, including Korea.
Various genetic and environmental factors play a complex role in the development and progression of myopia. One of the most commonly known environmental factors is the increase in over-regulation due to short-distance activities in an indoor environment.
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Recently, environmental factors that have been spotlighted in suppressing the progression of myopia are outdoor activities and exposure to sunlight. According to the results of studies in Australia, Singapore, and the United States, it was confirmed that exposure to sunlight caused by outdoor activities increases dopamine production in the retina, which has the effect of suppressing myopia. Also, in China, studies have shown that making the classroom environment in schools well-lit so that children can study while receiving sunlight has an effect on preventing myopia compared to children who studied in a poorly lit classroom. and refractive error correction using contact lenses. In addition to this, occlusion treatment may be required if accompanied by amblyopia. Accurate refractive power measurement in children is only possible after instillation of accommodative paralytic eye drops by an ophthalmologist. The reason is 50% of children aged 2-5 years, about 40% of children 6-9 years old, and about 18% of children aged 10-14 years old. is more than 0.5 diopters (refractive power) apart.
This is because children, unlike adults, have very good control, so they usually live with more myopia than their own. You don’t have to be afraid to put eye drops on your child for a refractive test performed with accommodative paralysis. This is because, while being safe eye drops, the maximum action time is 20 to 45 minutes, and the effect of the eye drops used during the examination disappears after 3 to 24 hours.
There is no way to completely prevent the progression of myopia in all children. However, treatment methods known to be effective in slowing the progression of myopia include low-concentration atropine eye drops, corneal refractive correction lenses, and daily soft contact lenses.
It was in the 1960s that it was first announced that the first mentioned low-concentration atropine eye drops were effective in suppressing the progression of myopia. Since then, research continued in the 1990s, and systematic research results were published in 2006. Until now, various concentrations of low-concentration atropine eye drops have been administered in consideration of the age at which treatment started and the degree of myopia progression. Second, refractive correction lenses have been tried since 1962, and were approved by the FDA in 2002, and are currently prescribed for the correction of myopia. These lenses compress the cornea during sleep, reducing its curvature, thereby helping the retina to focus exactly as in a normal eye. Third, daily wear soft contact lenses are bifocal lenses and are known to suppress the progression of myopia by slowing the growth of the axial length and correcting refractive errors. Although there are differences depending on the target of treatment and the type of treatment, medically, it is reported that the rate of myopia progression is reduced by about 25-50% in children with an average age of about 70%.
As mentioned earlier, it is most important to improve environmental factors to prevent the occurrence and progression of myopia. As a lifestyle habit to prevent myopia, it is recommended to look at electronic devices such as computers and smartphones for less than 30 minutes a day, and it is recommended to take a break while learning using a computer and relax your eyes while looking at distant things. Avoid looking at too small text or looking at it up close, and the brightness of 100-200 lux is suitable for indoor lighting that does not cause eye strain. In addition, it is recommended not to go to bed too late at night, to sleep for at least 8 hours, and to turn off the lights when sleeping so that the circadian rhythm can function normally during sleep. It is also recommended to be outdoors for at least an hour a day.