Understand how aging and underlying conditions may impact myopia and vision. And why we need more than just vision correction.
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From childhood to adulthood, myopia is a condition that can affect many of us. So what are the risk factors for developing myopia? How does it change from childhood to adulthood? Why is keeping myopia from progressing important?Â
In this blog post, we'll explore these questions to understand myopia better and answer the question: Does myopia get worse with age? So grab your glasses, and let's dive in!
What are the risk factors for myopia in children and adults?
Myopia is a condition that affects both children and adults and is influenced by a combination of hereditary and environmental factors. A meta-analysis study found that children with one myopic parent were 1.5 to 2 times more likely to develop myopia, with the risk increasing to 3 times if both parents have myopia.
The key environmental risk factors associated with myopia include reduced time spent outdoors, increased years of education, and near-work activities, such as reading and screen time. These activities have been linked to abnormal eye axial length growth.
Vision may fluctuate in adulthood due to natural progression or other risk factors. For example, the early development of cataracts can improve near vision, but it eventually worsens over time. Systemic diseases, such as diabetes, can also change how the eye focuses the light, or a refractive shift, ultimately leading to a change in vision. And certain medications, including anti-glaucoma drugs and pain control medications, have also been associated with myopic or hyperopic shifts.
‘During early cataract development, people with refractive errors may experience improved vision. This is also called “the second sight of the elderly.Â
When does myopia begin or stop worsening in children?
Myopia can begin at any age, but most cases start at school age, typically between 6 and 14. While there is no firm consensus on when myopia stops progressing, a 2013 myopia study found that the mean age at which myopia stopped worsening was 16 years, with most, 96%, at the age of 24.
While myopia tends to stop worsening in early adulthood, there is still a possibility for myopia to progress with age. In fact, studies have found that some people, after their 20s, will continue to worsen by at least one diopter over a decade. This progression may be attributed to various factors, including lifestyle changes, environmental factors, or hereditary factors.
Does myopia get worse with age?
As we grow older, our eyesight can change in different ways. A recent study on the effects of aging on myopia found that age had an impact on refractive errors.
A study explored the relationship between age and the refractive power of the eyes. The results showed that refractive errors change with age and are affected by factors such as the severity of cataracts and diabetes.
- Age 43 to 59, an improvement of +0.48 DÂ
- Age 60 to 69, +0.03 D
- Age 70 and older, a worsening of -0.19 D
Cataracts, a common age-related condition affecting the eye's lens, were also found to be strongly related to the amount of change in refractive errors. People with mild cataracts at the start of the study showed an improvement of +0.35 D. At the same time, those with severe cataracts showed a worsening of -0.53 D. Another study also found that diabetes was related to a change in refractive errors toward hyperopia.
Why is myopia control important?
Myopia is characterized by the elongation of or structural changes in the eye, which contributes to an increased likelihood of vision-threatening complications. People with high myopia (> 6.00 D) had a higher likelihood of severe eye complications, such as myopic macular degeneration, retina detachment, cataracts, and glaucoma.Â
While corrective lenses or surgery such as LASIK or intraocular refractive surgery can correct the refractive error, it's important to note that these treatments do not address the underlying structural change of the eye that drives vision-threatening complications. Therefore, it's crucial for people with or parents with children living with myopia to take steps to prevent abnormal eye elongation, reducing the risk of severe eye complications.
(Learn more about how to prevent myopia from worsening)Â
Can myopia be reversed?
Even with all of the treatment options available today, myopia can't be reversed. But the refractive error can be corrected.
Myopia control treatments can sometimes lead to a slight improvement in the axial length of the eye initially. This was observed in studies and real-life cases, such as orthokeratology, Ortho-K, atropine, and emerging red-light-based treatments.Â
In an Ortho-K study published in 2019, during the first month of Ortho-K treatment, the axial length of the eye was found to decrease slightly, but it returned to pre-treatment length after. A publication that studied atropine found that children with axial length shortening at initial revisit might be associated with a good long-term response.Â
The silver lining is that even though such shortening of the eye is not the reversal of myopia, it is a sign of possible better myopia progression outcomes.Â
Some individuals and health centers are promoting visual training as a cure for or can reverse myopia. Visual training, also known as eye exercises, may involve muscle relaxation techniques, eye yoga, biofeedback, eye patches, eye massage, or using under-corrected prescription lenses.Â
According to a report by the American Academy of Ophthalmology published in 2013, there is convincing evidence that visual training does not affect myopia.Â
In some cases, visual training may lead to an improvement in subjective visual acuity, but this could be due to changes in mood, motivation, tear film layer (acting like a contact lens), constriction of pupil size (pinhole effect), or an improvement in interpreting blurred images. There is no evidence to support the claim that visual training impacts the progression of myopia or reduces the risk of vision-threatening complications.
How to correct eye vision in myopia?
There are two general corrective options for children: eyeglasses and contact lenses. And there are more options available for adults.
Glasses or contact lenses are popular and effective vision correction options. There are many types of glasses available, including single-vision glasses, bifocals, and progressive lenses. Of the different types of contact lenses, soft contact lenses are more popular for their comfort, while hard contact lenses are more durable and provide better visual acuity. Lastly, Ortho-K involves wearing special rigid contact lenses at night to reshape the cornea for correcting myopia. The effect is that vision can be temporarily corrected the day after. It is important to note that all contact lenses require proper hygiene and care to avoid eye infections and other complications.Â
Keratorefractive or laser eye surgery, such as LASIK or PRK, can correct vision by surgically reshaping the cornea to focus light on the retina better. However, they should be considered carefully due to the risks and potential complications associated, such as vision correction issues, dry eyes, corneal scarring, and ectasia.
For severe myopia, intraocular lenses (IOLs) may be an option to correct vision up to -20.00D. But, IOL surgery is more invasive than any other treatment option mentioned.Â
(Learn more about surgical options for correcting vision in adults)Â
Key takeaways
In conclusion, the state of our vision is a delicate and intricate aspect of our overall health and well-being, shaped by factors such as age and underlying health conditions.Â
Babies are born with hyperopia, which often resolves by school age. Myopia may develop during school years and stabilize in adulthood. Some people may experience improved vision in their 40s, followed by worsening in their 70s. However, regardless of how it changes, a sudden worsening of vision should always warrant a visit to the doctor.
And who knows, in the unfortunate event of getting an intraocular lens surgery for cataracts might just be the ticket to 20/20 vision again!
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