Pediatric Myopia: Risk of Retinal Detachment Increases 12-fold if It Progresses to High Myopia

If a child's glasses prescription increases every year, one must be wary of structural changes in the eye beyond simple vision deterioration. Myopia in growing children is caused by a 'overgrowth' phenomenon where the front-to-back length of the eye increases, and if left untreated and progressed to high myopia, it can cause serious eye diseases that may lead to blindness in adulthood.

According to a video from Uihak Channel Biondwi, Professor Seo Young-woo of the Department of Ophthalmology at Korea University Guro Hospital emphasizes that pediatric myopia is not just a matter of simple vision loss. Myopia refers to a state where light cannot focus accurately on the retina because the front-to-back length of the eye has increased, causing the image to form in front of the retina. Since children's eyes grow larger as they grow, once myopia develops, it cannot become smaller again and has the characteristic of progressing continuously. Professor Seo emphasized the importance of management during the growth period, stating, "Once myopia develops, it cannot improve again."

The Risk of Fatal Eye Diseases Caused by High Myopia

Many parents think that if myopia develops, it can simply be corrected later with LASIK surgery, but this is a dangerous misunderstanding that overlooks the risks of myopia. Professor Seo Young-woo explains that when high myopia (usually -6.00 diopters or more) occurs, the front-to-back length of the eye becomes excessively long, causing the retina, which is the neural tissue inside the eye, to thin out.

The major complications that can occur in this process are as follows. First, in the case of 'retinal detachment,' where the retina thins to the point of tearing, the probability of occurrence in high myopia is about 12 times higher than in the general population. Additionally, the probability of 'glaucoma,' where the field of vision narrows as the optic nerve is pressed, is 4.5 times higher, and 'macular degeneration,' where the macula—the core of vision—degenerates, can see its risk surge dozens to hundreds of times higher than in the general population. Since these diseases are difficult to reverse once they occur and can lead to blindness, the key to treatment is slowing down the progression of myopia itself.

Causes of Myopia and the 'Defocus' Theory

The causes of myopia involve a combination of genetic and environmental factors. If both parents have myopia, the probability of the child developing myopia increases by about 7 times. Environmentally, habits such as looking at things close by for a long time, such as smartphones, and a lack of outdoor activities are cited as major causes. Professor Seo expressed regret, saying, "These days, children look at things very close for a long time in kindergartens or academies."

Professor Seo cited a chick experiment case to explain the mechanism of myopia progression. This is the 'defocus' theory, which states that the growth rate of the eye varies depending on where the focus is formed on the retina. As a result of the experiment, in an environment that causes the image to form behind the retina (concave lens effect), the eye grew more rapidly to focus on the retina, causing myopia to progress. On the other hand, when the image was made to form in front, eye growth showed a pattern of being inhibited. This suggests that the position of the image formed on the peripheral retina plays an important role in regulating eye growth.

Lifestyle Habits and Medical Treatments to Slow Myopia Progression

To manage myopia, three approaches are needed: lifestyle improvement, drug therapy, and optical therapy. The most important is outdoor activity during the 'prevention' stage. Professor Seo advises that for kindergarteners or lower elementary school students, who are in the stage before myopia develops, exposure to sunlight through at least 2 hours of outdoor activity per day is very effective in preventing the onset of myopia. If myopia has already developed, the goal is to inhibit its progression.

If myopia is already progressing, medical treatment can be considered. A representative method is using 'low-concentration atropine eye drops.' According to the video, when 1% atropine eye drops were applied, an effect of inhibiting myopia progression was confirmed compared to when plain water was applied. However, if the medication is suddenly stopped, a 'rebound effect' where myopia progresses rapidly can occur, so it must be carefully managed under the guidance of an expert.

In addition to this, various optical treatments such as 'Dream Lenses' worn while sleeping at night or special glasses with myopia suppression functions are being utilized. In terms of lifestyle, it is helpful to limit smartphone use as much as possible and practice the '20-20-20 rule (if you have looked at something close for 20 minutes, look at something 20 feet [about 6m] away for 20 seconds).' Professor Seo added that parents should be careful of behaviors such as children secretly looking at smartphones under their blankets at night.