Latest data shows an alarming surge of myopia cases in Malaysia. We speak to two optometrists to find out how parents can get ahead of this condition.

Myopia represents a growing public health problem in Malaysia, as well as Asia. Refractive errors like myopia are among the most common problems faced by developing countries in Asia, and if left untreated could lead to more serious visual impairments later in life.

A Malaysian study in 2005 demonstrated that about 9.8% of children aged 7 were myopic, with the numbers increasing to 34.4% by the time they are 15 years of age. A 2022 study found that 64% of Chinese school children in the semi-rural area of Bentong, Pahang suffer from myopia.

Combination of genetic, environment and lifestyle factors

Globally, the East Asian populations are associated with higher prevalence of myopia. A study done comparing myopia incidences among the three major ethnic groups in Singapore and Malaysia, showed the highest prevalence amongst the Chinese in both countries, compared to Indians and Malays.

“The same study also found the prevalence of myopia was higher in each of these ethnic groups from Singapore compared to their Malaysian counterparts. This is interesting, as the genetic makeup of the three major races in Singapore and Malaysia are very similar, so it suggests that environmental and lifestyle factors are also at play,” says Woon Pak Seong, optometrist and founder of Vision Space (Kuala Lumpur).

A study carried out on the urban-rural population in mainland China found that the prevalence of myopia in children living in urban areas are higher than those in rural settings.

“This again points to environment and lifestyle factors, such as the intense focus on academic performance and formal education in urban environments, extended hours of schooling and classroom learning, access to digital devices, as well as less time spent outdoors. In fact, studies show spending more time outdoors, even up to 40 minutes a day, can reduce the risk of developing myopia,” says Woon.

From Left: Woon Pak Seong, optometrist and founder of Vision Space (Kuala Lumpur) and Tan Thok Chuan, Optometrist and Director, TC Tan Optometrist and Tan & Ho Child Clinic

More awareness needed

For many parents, myopia is ‘normal’ or not a big deal, and many of them assume putting on a pair of glasses or performing laser-eye surgery (LASIK) when the child is older can resolve the condition. However, children’s eyes grow most rapidly before the age of 10, and slow down during the pre-teen and teen years, so the younger the child is when he or she develops myopia, the higher the likelihood of developing high myopia in their teens.

“High myopia can lead to serious vision impairments such as retinal detachment, glaucoma, macular degeneration and even blindness. Even treatments like LASIK become less effective for those with high myopia. If the child is myopic, the goal is to control myopia progression early and keep the myopia as low as possible,” explains Tan Thok Chuan, Optometrist and Director, TC Tan Optometrist and Tan & Ho Child Clinic.

He highly recommends that eye care professionals educate parents on the latest myopia management solutions in the market, so they can make informed decisions when selecting treatment options for their child.

“Most parents opt for conventional single-vision glasses for their myopic child. But while they are useful in providing clear vision, they do not control myopia progression, so children need to periodically increase their lens prescriptions as their myopia progresses. It’s important for parents to know about the newer treatments, such as dual-focus contact lenses, which have been clinically proven to control the progression of myopia,” says Tan.

Practicing good visual hygiene

In addition to prescribing either one or a combination of treatments to control myopia progression, eye care professionals usually advise children to practice lifestyle modifications as well. According to Tan, these include:

  1. Taking frequent breaks while doing ‘near work’ (any activities within an arm’s length) such as writing, reading, board and card games, and using handheld devices
  2. Reading and doing homework/classwork under adequate lighting
  3. Follow the 20-20-20 rule: for every 20 minutes of near work done, look at least 20 feet away for at least 20 seconds
  4. Spending more time outdoors, at least 40 minutes a day
  5. Minimising screen time
  6. Going for annual eye examinations from the age of two

Woon also stresses the importance of annual eye examinations. “Most parents only take their child to see an optometrist when they complain of headaches, blurry vision, or start moving too close to the television; but by then the child’s myopia has progressed. Early intervention is crucial in controlling myopia.”