India faces myopia surge among children; urgent action needed to combat glaucoma threat

This Glaucoma Awareness Month, we delve into the rising trend of myopia and glaucoma risk in India, and preventive strategies.

ByChetana Belagere

Published Jan 21, 2024 | 8:00 AMUpdatedJan 21, 2024 | 8:05 AM

Glaucoma Awareness Month: Growing Myopia in kids linked to higher glaucoma risk; more wearing glasses

The surge in myopia (nearsightedness) among children in India, particularly in urban areas, has witnessed a noteworthy uptick in recent years.

In an exclusive conversation with South First, Dr Nidhi Jyoti Shetty, a Glaucoma Consultant at Dr Agarwal’s Eye Hospital, Bhandup, Mumbai, highlights the escalating prevalence of myopia in India, emphasising that individuals with moderate to high myopia are three times more likely to develop glaucoma in their later years.

“The prevalence of myopia in urban children aged 5-15 years across the country has increased from 4.4 percent in 1999 to 21.1 percent in 2019. The prevalence is expected to increase further to 31.8 percent in 2030, 40 percent in 2040, and 48.1 percent in 2050, especially among children and working population,” Dr Shetty says.

This ominous trend suggests a potential myopia epidemic in India, mirroring situations in East Asian countries, unless proactive interventions are swiftly implemented.

Dr Agarwal’s Eye Hospital is, incidentally, actively spreading awareness as part of the ongoing Glaucoma Awareness Month.

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What is myopia?

Myopia, commonly known as nearsightedness, is a vision condition where individuals can see nearby objects clearly, but those at a distance appear blurry.

Doctors explain that there varying degrees of myopia, ranging from mild to severe. According to the American Academy of Ophthalmology, mild myopia is when there is a power of less than -3:00 D, moderate myopia is -3:00 to -6:00 D, while severe myopia is more than -6:00 D. D stands for diopter, a unit of magnifying power of a lens.

Symptoms typically include difficulty in seeing distant objects clearly, impacting activities like driving, watching television, or viewing a chalkboard from a distance. Myopia is often diagnosed in childhood and can progress during adolescence.

While the exact cause of myopia remains elusive, it is believed to result from a combination of genetic and environmental factors. Risk factors include a family history of myopia, extensive near work (such as reading or prolonged use of computers and mobile phones), and limited time spent outdoors.

Treatment for myopia usually involves prescription glasses or contact lenses to focus light on the retina. Other options include refractive surgery, like Lasik for eligible candidates. Regular eye examinations are essential for individuals with myopia, as they may face a higher risk of other eye-related issues such as glaucoma and retinal detachment.

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Myopia and glaucoma

Glaucoma, a group of eye diseases causing optic nerve damage, is often associated with increased eye pressure, leading to vision loss or blindness. It primarily affects individuals over 60 years of age and is one of the leading causes of blindness globally.

Speaking to South First, Dr Dinesh P, a diabetologist at Karnataka Institute of Diabetologist, explains myopia and its connection with glaucoma, “Myopia is either simple or compound, based on whether the person has only spherical power or both spherical and cylindrical power.”

“Power more than -6:00 D is termed as pathological myopia. In such cases, there are complications in the retina and these cases are more likely to develop glaucoma,” he says.

Dr Shetty highlights, “The optic nerve head in myopic eyes may be much more susceptible to glaucoma because of the changes in structure of the connective tissue. The increased risk may also be related to the reduction in the thickness of retinal nerve layer in myopic eyes.”

Citing a study that found a strong correlation between primary open-angle glaucoma (POAG) and myopia, with an odds ratio of 2.3 in eyes with low myopia and 3.3 in eyes with moderate-to-high myopia, Dr Shetty explains that myopic glaucoma may be associated with earlier onset of disease and early development of a central vision defect.

Eye pressure is a major risk factor for glaucoma. An abnormality in the eye’s drainage system can lead to fluid build-up, causing excessive pressure that damages the optic nerve, resulting in vision loss.

Dr Shetty notes that the estimated prevalence of glaucoma among Indians ranges between 2.7-4.3 percent, causing blindness in 1.2 million people and accounting for 5.5 percent of total blindness, making it a leading cause of irreversible blindness in India.

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Glaucoma precautions 

Click to enlarge.

Click to enlarge.

To guard against glaucoma and myopia, several precautions can be taken. Dr Shetty advises, “People with myopia can avoid or delay the chances of getting glaucoma by maintaining a healthy lifestyle, especially diet and exercise, as recommended by their doctor. They should also undergo regular follow-up and screening tests to maintain the disease, if diagnosed at early stages.”

She adds, “Once-a-year follow-up is recommended for someone with high myopia. If diagnosed with any retinal disease or glaucoma, this duration can reduce to every three months or even every month.”

“Glaucoma is a disease that does not show any symptoms in the early stages and repeated headaches could be one of the symptoms,” Dr Shetty explains.

Symptoms of myopia in children may include squinting, watery eyes, constant eye rubbing, and complaints about difficulty in seeing distant objects clearly.