Our eyesight is one of our most important senses: 80% of what we perceive comes through our sense of sight5.
It is important to develop good eye care habits from young to protect eye health and prevent deterioration of eyesight.
The prevalence of myopia or short-sightedness in Singaporean children is among the highest in the world.
65 percent of children are myopic¹ by Primary 6, and 83 percent of young adults are myopic. It is projected that 80 to 90 percent of Singaporean adults will become myopic, of which, 15 to 25 percent of them will have high myopia by 2050².
We ask Ken Tong, President of the Singapore Optometric Association, to answer some questions we have about our eyesight.
1. What are some good practices for eye care?
Spending more time outdoors has been shown³ to help prevent myopia. Try to spend more time each day outdoors.
Outdoor time has been shown to delay myopia onset. Hence, it is important to plan more outdoor activities. This will also take time away from near work like reading, writing and playing with digital devices.
It is important to develop good eye care practices by taking frequent breaks in between near-work activities.
Always ensure that there is enough light in the room for reading and writing, as well as when using the computer. However, avoid excessive light to prevent glare. Adjust the brightness of computers and screens to reduce glare and avoid having sources of light that can cause unwanted reflections.
Importance of regular eye check
Children with myopia should wear eye glasses with appropriate lenses. There are lenses available that can slow down the progression of myopia.
It is a good practice to visit the optometrist at least once a year, better every 6 months6.
Early detection of any refractive error (myopia, astigmatism, and hyperopia) can help to prevent amblyopia, also known as lazy eye and help the child to see clearly during their growing up years. In amblyopia or also known as lazy eye, there is reduced vision in one eye due to abnormal visual development early in life
Any early signs of vision problems can also be detected and referred to an ophthalmologist for treatment. The optometrist may prescribe special lenses that are proven scientifically to slow the progression of myopia. They should also be taught how to properly wear and maintain their glasses or contact lenses.
2. Do contact lenses have negative repercussions on the eye in the long-term?
Contact lenses are actually a very safe form of vision correction, provided the wearers adhere to the cleaning regimen and the optometrist’s instructions. There are contact lenses that are gas-permeable that do not have long-term negative repercussions on the eyes.
There are always safe and recommended ways of wearing both spectacles and contact lenses. Improper care and extended usage of contact lenses may result in negative repercussions on the eye.
According to Ms Adeline Yang, Professional Development Manager, Johnson & Johnson Vision, contact lenses are medical devices and are therefore subject to strict oversight and regulations. This is why it is important to visit a board-certified optometrist to undergo assessment and fitting in person so that your eye health is attended to by an eye care professional.
3. If a parent has a family history with severe shortsightedness and astigmatism but the other half’s family has perfect eyesight, what are the chances that the children will be diagnosed with shortsightedness and/or astigmatism?
Both severe shortsightedness and astigmatism have hereditary tendencies.
If both parents suffer from myopia and astigmatism, the child could be at a higher risk⁴ of suffering the same issues.
Parents have to be mindful of whether their child is suffering from myopia and arrange for regular checks.
Today we have solutions like Ortho-K lenses, which can slow down the progression of myopia7 by gently changing the profile of the cornea. Children can wear these lenses while they sleep and won’t need to wear glasses or contact lenses during the day.
This is because, when worn overnight, Ortho-K lenses temporarily reshape the cornea, allowing kids to see clearly the next day. This is a great option for school children as they can see clearly for school, sports, swimming, and other activities without the inconvenience of glasses.
4. What is the recommended treatment for eye twitching (especially excessive blinking)?
Excessive blinking in a young child could be due to trichiasis (ingrown eyelashes), dry eyes, or psychological issues (stress!). If the child “squints“ (makes the eyes smaller) to see things, he/she may suffer from refractive errors (myopia, astigmatism, hyperopia).
It will be good to bring the child to an optometrist or ophthalmologist for a thorough check-up.
While the cause of minor eyelid twitching is unknown, a slight spasm of the lower eyelid or even both eyelids is common and generally of no concern. Minor eyelid twitches require no treatment as they usually resolve naturally.
Some solutions include reducing stress, using warm soaks, or correction of any refractive error. However, it is advisable to see an optometrist or ophthalmologist for a full eye screening before undergoing any treatment.
5. Are eye exercises really effective?
There is no harm in the eye exercises, however, there is no evidence to show that eye exercises can reduce myopia. If the exercises can help the eye to relax, it may reduce eye strain.
6. What are the risk factors to consider for an operation on droopy eyelids for a 15-month-old?
As in all surgeries, droopy eyelids surgery carries a risk of infection. In some cases, it may result in impaired lid functions (e.g. cannot close the eye completely).
If the droopy lid covers the pupil, that eye may develop amblyopia (lazy). If left untreated, the child may lose vision permanently.
It is advisable to see the ophthalmologist soon and surgery may be warranted to prevent/cure amblyopia.
7. What will happen if a person has cataracts but refuses to go for surgery? Is there an alternative besides surgery?
The person with cataracts will slowly lose his or her sight as the cataract matures. In early cataract, changing the prescription of your spectacles helps to improve vision. There is no alternative treatment other than surgery. Fortunately it is a very safe procedure and vision can be restored after the surgery. It is rare for children to have cataract but it is important to get them treated in children as soon as possible as it may deprive the child from developing normal vision and may impair learning in the future.
If the cataract becomes hypermature, the surgery becomes more complicated.
Cataract affects a person in two ways – blurred vision and lens tinting.
Clumped up protein clouds the lens and reduces the light that reaches the retina. When a cataract is small, the cloudiness that affects only a small part of the lens may go unnoticed.
Cataracts tend to “grow” slowly thus worsening the vision gradually. Eventually, the severe clouding may cause blurred vision due to a larger cloudy area in the lens and cataract.
The other situation is when the clear lens slowly changes to a yellowish/brownish colour, it adds a brownish tint to vision. Although the initial tinting may be small and may not cause vision problems, increased tinting may make it more difficult to read and perform routine activities.
This article is presented by ACUVUE® Abiliti™ Overnight Therapeutic Lenses. If you are concerned about your child’s vision, head over to https://www.seeyourabiliti.com/sg/ to do a risk assessment now. You can also book an eye health check-up with an ACUVUE Ability™authorised eye care practitioner, and find out more about how ACUVUE® Abiliti™ Overnight Therapeutic Lenses control the progression of myopia in children.
¹ Karuppiah, V., Wong, L., Tay, V., Ge, X., & Kang, L. L. (2021). School-based programme to address childhood myopia in Singapore. Singapore Medical Journal, 62(2), 63–68. https://doi.org/10.11622/SMEDJ.2019144
² Holden, B. A., Fricke, T. R., Wilson, D. A., Jong, M., Naidoo, K. S., Sankaridurg, P., Wong, T. Y., Naduvilath, T. J., & Resnikoff, S. (2016). Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology, 123(5), 1036–1042. https://doi.org/10.1016/j.ophtha.2016.01.006
³ Cao, K., Wan, Y., Yusufu, M., & Wang, N. (2020). Significance of Outdoor Time for Myopia Prevention: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials. Ophthalmic Research, 63(2), 97–105. https://doi.org/10.1159/000501937
⁴ Morgan, I. G., Wu, P., Ostrin, L. A., Tideman, J. W. L., & Yam, J. C. (2021). IMI Risk Factors for Myopia. Imi, 12–15.
5 D. L. Ripley and T. Politzer, “Vision Disturbance after TBI,” NeuroRe-habilitation, vol. 27, no. 3, pp. 215–216, 2010. DOI 10.3233/NRE-2010-0599
6 CODE OF PROFESSIONAL CONDUCT AND PROFESSIONAL PRACTICE GUIDELINES FOR OPTOMETRISTS & OPTICIANS, revised 2018 on frequency of eye check, page 12: https://www.healthprofessionals.gov.sg/docs/librariesprovider6/default-document-library/english-ver–moh-oob-code-of-professional-conduct-(oct2018).pdf
7 Effect of Orthokeratology on myopia progression: twelve-year results of a retrospective cohort study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721542/