Guide to Preventing Progression of Myopia in Singapore

Understanding Myopia in Singapore

Myopia, or nearsightedness, is a growing concern in Singapore. The country is often referred to as the “Myopia Capital of the World” due to its high prevalence among both children and adults. Research from the Singapore National Eye Centre (SNEC) shows that nearly 70% of children develop myopia by primary school, and by adulthood, 80-90% of Singaporeans experience some degree of myopia.

The rapid progression of myopia is a significant issue, as unmanaged cases can lead to higher risks of severe complications. Conditions such as retinal detachment, glaucoma, and myopic macular degeneration can develop, potentially causing long-term vision impairment. Taking proactive steps, including lifestyle adjustments and early intervention, is essential to slow down the worsening of myopia.

Many people with myopia wear glasses as a primary method of vision correction. However, in cases of progressive or high myopia, additional treatments such as atropine eye drops and myopia control lenses may be necessary to slow the progression and reduce the risk of severe vision problems later in life.

What is Myopia?

Myopia is a refractive error where the eye grows longer than normal, or the cornea has an abnormal curvature. This causes light rays to focus in front of the retina rather than directly on it. As a result, people with myopia experience blurry distance vision but can see clearly up close.

Why is Myopia Prevalent in Singapore?

Several factors contribute to the high prevalence of myopia in children and adults in Singapore. These include:

• Intense Academic Pressure: Children spend long hours on near work activities such as reading, studying, and using digital devices, which increases eye strain.
• Limited Outdoor Time: Many children do not spend more time outdoors, which is known to reduce the risk of myopia progression.
• Genetics: If one or both parents have myopia, their children have a higher risk of developing it as well.

Without proper management, myopia can worsen over time, increasing the risk of myopia-related complications.

Many children wear glasses to correct their vision, but additional treatments may be needed to prevent further deterioration.

Causes and Risk Factors of Myopia

Genetics and Family History

One of the most significant risk factors for developing myopia is genetics. Children with one or both myopic parents are more likely to develop the condition. However, environmental influences, such as prolonged screen use and insufficient outdoor activity, also play a major role in its onset and progression.

Prolonged Near Work

Engaging in near work activities for long periods can contribute to the progression of myopia. Activities such as using smartphones, tablets, and computers require intense focus at close distances, leading to eye strain and elongation of the eyeball over time.

Children who spend excessive time on near work often need to wear glasses earlier than those who have more balanced screen habits and outdoor activities.

Lack of Outdoor Exposure

Research has shown that spending more time outdoors can help regulate eye growth and slow myopia progression. Natural light plays a crucial role in maintaining healthy vision, and children who do not get enough exposure are at a higher risk of developing myopia.

The Health Promotion Board (HPB) in Singapore encourages parents to ensure their children spend more time outdoors—at least two hours daily—to promote eye health and prevent childhood myopia from worsening.

The Importance of Early Detection

Detecting myopia early allows for better intervention and eye care management. Early diagnosis can help slow down the progression of myopia, reducing the likelihood of serious complications.

Key Methods of Diagnosis

1. Visual Acuity Tests – Measures how well a person can see objects at different distances.
2. Refraction Tests – Determines the correct lens prescription needed to improve vision.
3. Comprehensive Eye Exams – Checks for additional eye conditions and assesses overall eye health.

Children and adults with myopia should have regular eye exams, especially if they experience blurred distance vision or frequently need to wear glasses for clear sight.

Strategies to Prevent Myopia Progression

1. Spend More Time Outdoors

Outdoor activity plays a crucial role in reducing the risk of developing myopia. Studies show that children who spend more time outdoors are less likely to experience rapid myopia progression.

Outdoor activities such as:

• Playing sports
• Cycling or jogging
• Walking in natural light

… can help slow the progression of myopia in children.

2. Limit Screen Time and Near Work

Reducing screen time and following proper eye care habits can help protect vision. Some useful strategies include:

• Following the 20-20-20 Rule: Every 20 minutes, take a 20-second break to look at something 20 feet away.
• Maintaining Good Posture and Lighting: Avoiding dim lighting and improper posture can prevent eye strain.

3. Use Myopia Control Lenses

Specialized lenses help manage refractive errors and slow the progression of myopia. These include:

• Orthokeratology (Ortho-K): Special contact lenses worn overnight to reshape the cornea temporarily.
• Myopia Control Glasses: Lenses like MiYOSMART help slow eye elongation.
• Soft Multifocal Contact Lenses: Designed to manage peripheral defocus and reduce eye strain.

Many individuals with myopia wear glasses daily, but these specialized lenses provide additional benefits for long-term eye health.

4. Low-Dose Atropine Eye Drops

One of the most effective treatments for myopia in children is atropine eye drops. Research from the Singapore Eye Research Institute has shown that low-dose atropine can slow myopia progression by up to 50%.

Children who regularly use atropine eye drops often experience less severe myopia progression and may not need to wear glasses as frequently.

5. Regular Eye Examinations

Routine check-ups with an optometrist or senior consultant are necessary to monitor eye conditions and detect early signs of worsening myopia.

The Role of Parents in Myopia Management

Parents play an essential role in promoting good eye care habits in children. Encouraging outdoor activities, limiting screen time, and scheduling regular eye exams can help slow the progression of myopia.

Children who wear glasses should also have their prescriptions updated regularly to ensure they are getting the best possible vision correction.

The Future of Myopia Control in Singapore

Ongoing research in Singapore, led by the Singapore National Eye Centre (SNEC) and the Singapore Eye Research Institute, is focused on developing better treatments for myopia. Advancements in genetic testing, smart glasses, and peripheral defocus lenses offer promising solutions for the future.

By taking proactive steps today—such as using atropine eye drops, ensuring children spend more time outdoors, and choosing the right lenses—individuals can significantly reduce the long-term effects of myopia in children and adults.

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