Keeping an eye on 'silent epidemic' of myopia

At 65 per cent among Primary 6 pupils and 28 per cent among those in Primary 1, Singapore has one of the highest rates of myopia in the world.

Figures from the Health Promotion Board show that the level has remained stable over the past decade.

But there is another worrying trend: An earlier onset and quicker progression to a higher severity of myopia - 600 degrees and above - which has prompted Dr Ajeet Madhav Wagle to call it a "silent epidemic".

"The earlier the age of onset of myopia, the higher the likelihood of developing high myopia later in life," said the medical director and senior consultant at Farrer Park Medical Centre's International Eye Cataract Retina Centre.

"And the higher the myopia, the higher the risks of sight-threatening diseases associated with myopia."

Myopia is a common eye condition that results in blurred distance vision. It occurs when the eye grows too long from front to back.

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Instead of focusing images on the retina - the light-sensitive tissue in the back of the eye - the lens of the eye focuses the image in front of the retina, explaining why people with myopia have good near vision but poor distance vision.

Worldwide, the estimated prevalence of myopia stands at 23 per cent. Urban populations in east and south-east Asia see a significantly higher prevalence, making myopia a public health concern.

In Singapore, over 80 per cent of young adults are short-sighted, said Dr Ajeet.

The condition can be easily managed with prescription glasses and contact lenses.

In certain specific situations, those with myopia can also opt for alternatives such as corrective laser refractive surgery or implantation of special lenses within the eye, said Dr Ajeet.

Aside from spending more time outdoors, he added, myopia progression can be controlled by the appropriate use of medication, such as low dose atropine 0.01 per cent eye drops, which can reduce myopia progression by 50 per cent.

The use of special orthokeratology contact lenses - designed to gently reshape the curvature of the eye - has also been advocated to slow the process of elongation of the eyeball seen with myopia, he said.

"But there is a need to balance the risk of serious contact lens-related infections among young children," Dr Ajeet said.

The more severe forms of myopia are associated with excessive stretching of the eyeball and an increased risk of other serious sight-threatening eye diseases such as retinal tears, retinal detachment, glaucoma and degeneration of the macula.

The macula is the most crucial central part of the retina's nerve layer and is responsible for sharp reading vision.

This is why those with myopia should go for comprehensive eye checks regularly, said Dr Ajeet. Efforts to prevent the onset of myopia and to slow its progression early in life can help reduce the burden of this "silent epidemic", he added.