Here is the “conventional” message: The fate of their
eyes’s refractive state is “fixed” in the genes, it cannot not altered by the environment. Their refractive state will not be altered by the way they use their eyes, by how much far- or near-seeing they do, or by anything. The only hope is that someday an effective drug will be approved. That is the message of conventional medicine and optometry.
Conventional Medicine does say that the cause of myopia is unknown. It is associated with (remember, association is not cause) reading, high IQ, higher blood sugar, sedentary lifestyle and an eye shape with peripheral hyperopia. A number of factors are predictors of, or risk factors for, future myopia. These include family history, refraction as a preschooler and eye length at birth. Family history is the best predictor,
These risk factors apply to populations, it is not possible to accurately predict whether a particular individual will become myopic or how myopic he or she will become.
Clinical trials of various methods of slowing myopia progression have not found anything that is effective. Plus at near slows progression by about 0.50D in total no matter how many years it is used — an insignificant amount. Drugs slow it a bit more but with unacceptable side effects. Soft bifocal contact lenses may be more effective, but have only been tested in very small trials.
This is reality. It is not black and white — all genetic or all environment. Like most biology and most human physiology, there is much individual variation.
Dr. Judy, tell us that you do not believe this message. Tell us that you tell your patients of those six year old children that there are things they can do to reduce the chances that they will become myopic. Tell us that if they are already myopic, you let them know there are things they can do to help keep it from progressing, or to get it to decrease.
I wish I could. Unfortunately, there are no ways to decrease myopia that have been shown, in controlled clinical trials, to be effective. Ditto on prevention, I suppose I could tell parents that they can reduce the risk of myopia in their children by keeping their kids illiterate and never letting them read or do near work, but that seems a much greater evil than wearing glasses.
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