Managing High Myopia: Causes, Prevention, and Treatment Options - Ophthalmology

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High myopia, or severe nearsightedness, is a condition where the eyeball is elongated, causing light to focus in front of the retina rather than directly on it. This condition can lead to various complications, including retinal detachment, glaucoma, and cataracts. The progression of myopia, especially in individuals with high myopia, can be influenced by several factors, including genetics, environmental factors, and visual habits.


Causes of High Myopia
1. Genetics: A family history of myopia significantly increases the risk of developing high myopia. If both parents are myopic, the likelihood of their children developing myopia is higher.

2. Environmental Factors: Increased near work activities, such as reading, using computers, and playing video games, can contribute to the progression of myopia. Conversely, spending more time outdoors has been associated with a reduced risk of developing myopia.

3. Age: Myopia typically stabilizes in early adulthood, but in some cases, it can continue to progress into the late twenties or even thirties.


Prevention and Management Strategies
1. Regular Eye Exams: Regular check-ups with an eye care professional are essential for monitoring the progression of myopia and adjusting prescriptions as needed.

2. Optical Interventions:
- Contact Lenses: Rigid gas permeable (RGP) lenses are often recommended for high myopia as they can provide clearer vision and may help in slowing down the progression of myopia compared to soft lenses.
- Orthokeratology: This involves wearing specially designed RGP lenses overnight to reshape the cornea temporarily, which can help reduce myopia during the day.

- Multifocal or Bifocal Glasses: These lenses can help reduce the strain on the eyes during near work.

3. Atropine Eye Drops: Low-dose atropine drops have been shown to slow the progression of myopia in children. However, their use should be discussed with an eye care professional, as they may have side effects.

4. Visual Hygiene: Encourage good visual habits, such as taking regular breaks during prolonged near work (the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds) and ensuring proper lighting while reading or working.

5. Outdoor Activities: Increasing outdoor time can help reduce the risk of myopia progression. Studies suggest that exposure to natural light may play a role in eye health.


Role of Dilating Drops
Dilating drops, or cycloplegics, are typically used during eye exams to temporarily paralyze the ciliary muscle, allowing for a more accurate assessment of refractive error. While they do not directly prevent myopia progression, they can help in determining the correct prescription and assessing the overall health of the eyes.


Conclusion
If your myopia continues to progress despite reaching adulthood, it is essential to consult with an eye care professional to rule out any underlying conditions and to discuss the best management strategies tailored to your specific situation. The use of rigid contact lenses, regular eye exams, and possibly atropine drops may be beneficial in managing your condition. Always ensure that any new treatment or intervention is discussed with a qualified eye care provider to ensure safety and effectiveness.