ONE OF THE MOST important and meaningful ways for an optometrist to have a positive influence on the health of their community is through advocacy that extends beyond the walls of their office. Helping to raise awareness of conditions that affects the overall wellness of the public directly complements the work of optometrists, since patients who are more informed about their health often have better outcomes. Of the many concerns optometrists have, I believe myopia and controlling its progression is a prevalent one. Myopia is an epidemic, and optometrists should consider focusing their advocacy efforts on this matter.
Myopia progression typically stabilizes in a person’s early twenties and is irreversible, so the condition affects adults by causing them to be reliant on vision correction for the rest of their lives to see clearly. Current myopia control treatments can only delay the advancement of myopia, so in order to advocate effectively to combat this epidemic, optometrists must focus on raising awareness of myopia progression with respect to children.
This is essential for a number of reasons. A child’s world is generally closer to them than an adult’s. They hold things that interest them near their eyes naturally, and they don’t have an immediate need to see perfect clarity at a distance – in order to drive, for instance. They may also unconsciously acclimate themselves to the impairment, as it’s the only world they have ever known. All of this means that they’re not as likely to be aware of the fact they’re experiencing this condition, and they are certainly less likely to communicate it to an adult.
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Developing myopia early in life can have an enormous effect on their future, as a child who develops myopia when young has an increased risk of developing higher degrees of myopia as an adult. Higher degrees of myopia increases the risk of certain eye conditions such as retinal detachments that can lead to vision loss. Another concern is that, if it’s not identified early on enough, amblyopia may occur with high amounts of myopia, which could cause a failure of cortical visual development causing a permanent reduction in the person’s best potential vision. It is crucial to begin treatment as early as possible to ensure the eye develops properly for the child. Not only does this improve eye health overall, but it also removes potential obstacles that may arise for children from undiagnosed vision problems, such as a decline in academic success and/or behavioral problems.
This is why I believe the most important recommendation to advocate for is early eye exams for children. It should be widely known how vital it is for parents to schedule their child’s first eye exam within the first year of their life from ages 6 to 12 months old, as infants are obviously unable to communicate any type of vision impairment at all. No matter how old, however, we want parents to understand that they should bring their children in for regular eye exams even if they miss this first opportunity. School screenings and primary care provider referrals are also vital tools in this regard.
Last, but certainly not least, we want to bring the mindfulness we strive for as adults with respect to our screen time on mobile devices and tablets to our children as well. Screen time has been correlated with increased myopia progression, yet there are limited studies determining specific guidelines for how much is considered too much. In general, I think it would be wise to limit screen time for children to an hour or less per day, and parents can also encourage frequent breaks for their children – not just putting the tablet down, but literally going outside to play, where the larger world employs the child’s vision in healthy ways. It is not outrageous to suggest that this might be a beneficial activity for eye health, no matter what a person’s age.
About the Author
Michael Wong, OD, MS, FAAO, FSLS
Dr. Wong received his Bachelor of Science at UCLA, Master of Science in Global Medicine at USC, and Doctor of Optometry from UC Berkeley. He completed the post-doctoral Michael G. Harris Cornea and Contact Lens Residency at UC Berkeley, then joined as a full-time faculty member in the contact lens department. Afterwards, Dr. Wong joined SCCO faculty with clinical and laboratory teaching responsibilities in the cornea and contact lens service. His clinical interests include keratoconus, scleral lenses, and myopia control. Dr. Wong is a Fellow of the American Academy of Optometry and a Fellow of the Scleral Lens Society. Additionally, he also serves as a board member of the Scleral Lens Society and the Orange County Optometric Society.
