The Necessity of Wearing Glasses for Myopic Children

My son is 5 years old and recently had an exam that revealed his eyesight numbers: both eyes are -0.75. As a parent, the question of whether glasses are necessary to wear all the time arises. In this article, I will explore the condition of myopia, discuss treatment options, and provide advice on when and why glasses should be worn.

The Nature of Myopia

Myopia, or shortsightedness, is a condition where the eyeball grows too long optically. It is believed to be a largely genetic hereditary condition that begins during growth and stabilizes between the ages of 17 and 21. Recent trends show an increase in myopia cases, leading to debates about its causes. One theory, which I find compelling, is that myopia development correlates with growth rates. As people grow taller and faster, the incidence of myopia increases. This can be seen in the remarkable transformations of the Japanese population over the past century.

The Evolution of Japanese Myopia

Japanese people were once characterized as small and rarely needed glasses before World War I. However, a shift in diet towards a more Westernized diet led to significant growth and an increase in myopia. Post-World War II, the Japanese became even taller, and almost all individuals are now myopic. One possible explanation for this, although unlikely, is that the population has always been myopic but glasses were not available. However, evidence shows that good distance vision has always been possible, suggesting that something else must have contributed to this change.

Managing Myopia

At present, there is no method to control the growth of the eyes, making myopia untreatable. However, once growth has ceased, surgical options such as LASIK become available. As myopia begins to manifest, it is crucial to determine whether the vision changes are due to pseudomyopia, a condition involving cramping of the focusing muscles. This can be diagnosed by measuring the patient after using dilating drops, which temporarily paralyze the focusing muscles. Some treatments for myopia are likely treating pseudomyopia and mistaking it for true myopia.

Risks Associated with High Myopia

High myopia, defined as -6.00D or more, carries an increased risk of certain complications, which worsen with higher prescriptions. These complications are believed to stem from a stress between the sclera (the tough outer layer of the eye) and the retina (the light-sensitive ‘film’ in the eye), as they develop from different types of tissue in the embryo. The refractive error caused by myopia can be corrected through glasses, contact lenses, or ortho-keratology, where patients wear contact lenses at night to reshape the cornea. Refractive surgery, such as LASIK, is also an option for altering the curvature of the cornea.

Wearing Glasses: A Practical Solution

Once corrective lenses are necessary, a debate arises about whether to wear them all the time or intermittently. Wearing glasses corrects the optics to resemble normal vision. When an object moves from far to near, the eyes naturally focus using muscular accommodation. Therefore, wearing glasses allows the eyes to function normally. This does not affect the progression of myopia, nor does it improve or worsen it.

If you frequently need your glasses, it is advisable to wear them constantly. This prevents the loss of glasses, which can be inconvenient. Moreover, it is harder to scratch or damage them, making it a more practical choice. However, you should not wear glasses when swimming, bathing, or in bed to avoid goggles or sleeping accessories.

Understanding myopia and its treatment options can help parents and children manage the condition effectively. By wearing glasses as needed, you can maintain normal vision and potentially reduce complications associated with high myopia.