LIFESTYLE NEWS - The global rise in myopia, or short-sightedness, is raising concerns among eye health specialists, who warn that increasing rates of the condition could contribute to more cases of retinal detachment in the years ahead.
More time spent on close-up activities, including screen use, combined with less time outdoors, has been associated with the increasing prevalence of myopia among children and young adults.
Myopia is already considered a major cause of preventable vision loss in developing countries, with estimates suggesting that around half of the world's population - approximately 5 billion people - could be affected by 2050.
Speaking ahead of Eye Care Awareness Month, from 23 September to 18 October, Dr Schalk du Toit, Executive Committee Member of the Ophthalmological Society of South Africa (OSSA), says myopia is the most significant controllable risk factor for retinal detachment.
Why myopia matters
Retinal detachment occurs when the retina - the light-sensitive layer at the back of the eye - separates from the underlying tissue that supplies it with oxygen and nutrients.
It is a medical emergency that requires prompt assessment and treatment.
“Mild myopia triples the risk of retinal detachment, rising to as much as 39 times the risk in cases of severe myopia,” Dr Du Toit says.
While age is another significant risk factor, with retinal detachment becoming more common in the 60s and 70s, the growing prevalence of myopia means some people may enter a higher-risk category earlier in life.
Dr Du Toit says increased close-up screen use can contribute to eye strain, while spending less time outdoors may also play a role in the development of myopia among children.
Why time outdoors matters
Spending time outdoors is particularly important for children.
Dr Du Toit recommends about an hour outdoors each day, noting that looking at objects in the distance can help reduce eye strain. Exposure to natural light has also been associated with a lower risk of children developing myopia.
The issue is becoming increasingly important as the global population ages and myopia becomes more common.
Retinal detachment currently affects an estimated one to two people in every 10 000, but research suggests the incidence could double over the next 20 years.
Who is at greater risk?
Ageing can cause natural changes in the vitreous - the gel-like substance inside the eye. As the vitreous separates from the retina, it can sometimes cause a retinal tear, which may lead to detachment.
Other risk factors include:
- Severe myopia
- Previous cataract surgery
- A direct blow or injury to the eye
- Contact sports and other activities involving a risk of eye trauma
- A family history of retinal detachment
- Pre-existing thinning of the retina
Men are also affected by retinal detachment more frequently than women, with Dr Du Toit estimating that men are affected approximately 1.5 to two times more often.
Know the warning signs
In many cases, retinal detachment is preceded by warning signs.
Dr Du Toit advises anyone experiencing these symptoms to seek urgent, same-day assessment from an eye-care professional:
Sudden new floaters: Small dark spots, dots or thread-like shapes drifting across your vision, particularly when many appear suddenly.
Flashes of light: Sudden flashes, especially around the edges of your vision.
A shadow or curtain: A dark shadow or curtain-like effect spreading across part of your visual field.
Sudden loss or narrowing of vision: A painless dimming or reduction in vision that occurs suddenly.
These symptoms should not be ignored, as delaying treatment can result in permanent vision loss.
Retinal detachment requires urgent treatment
Retinal detachment generally requires surgery, with the appropriate procedure depending on the type, size and location of the detachment.
Treatment may include pneumatic retinopexy, where a small gas bubble is injected into the eye to help reposition the retina; a scleral buckle, which involves placing a silicone band around the outside of the eye; or a vitrectomy, where the vitreous gel is removed and replaced with gas or oil to allow the retina to settle back into position.
Some approaches may be combined.
Treatment is generally performed urgently after diagnosis, and the amount of vision ultimately recovered depends partly on how quickly treatment begins and whether the central part of the retina, known as the macula, remains attached.
Don't ignore sudden changes in vision
Retinal detachment cannot always be prevented, but serious and permanent vision loss may be reduced through early recognition and urgent treatment.
People with severe myopia, a family history of retinal detachment, previous eye surgery or a history of eye trauma should be particularly familiar with the warning signs.
“If they occur, seek urgent same-day assessment at an eye casualty unit or ophthalmology practice,” Dr Du Toit advises.
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