In Singapore, a concerning trend has emerged, with an increasing number of younger adults developing glaucoma, a serious eye condition. This rise in cases is linked to untreated myopia, a condition that has affected previous generations without adequate treatment options. The impact of untreated myopia is significant, as it leads to structural changes in the eye, such as elongation of the eyeball, which can weaken the optic nerves and increase the risk of glaucoma and other eye-related issues.
The establishment of the Myopia Society of Singapore is a crucial step towards addressing this public health concern. The society aims to raise awareness among parents about the early signs of myopia in their children and the importance of taking action to prevent or delay its progression. By doing so, they can potentially avert severe vision loss in adulthood.
Data from the Singapore National Eye Centre (SNEC) highlights the urgency of the situation. The number of glaucoma operations performed on patients aged 40 to 49 has nearly tripled in the last decade, and the number of procedures for those aged 50 to 59 has almost doubled. This is particularly concerning as glaucoma typically affects individuals aged 60 and above. Dr. Foo Li Lian, clinical director of myopia services at SNEC, emphasizes the significance of these figures, suggesting that greater access to screening programs may have contributed to earlier diagnoses and surgeries for younger patients.
The Singapore Epidemiology of Eye Diseases (SEED) Study further supports these findings. According to a 2015 paper published in the JAMA Ophthalmology journal, the prevalence of glaucoma in Singaporeans aged 40 to 49 was around 11.4%, with higher rates in older age groups. These statistics highlight the need for early intervention and ongoing monitoring of myopia.
Myopia, or short-sightedness, occurs when the eyeball grows too long, causing light rays to focus in front of the retina rather than directly on it. This condition affects a significant portion of the population, with high myopia being a severe form of the condition. The SEED study found that 36% of adults aged 40 to 80 have myopia, and 6% have high myopia. Among those with high myopia, approximately 30% suffer from myopic macular degeneration (MMD), a complication that can lead to vision loss.
The excessive elongation of the eyeball in high myopia cases results in the stretching and thinning of the retina, particularly at the macula, which is the part of the retina with the highest concentration of light-sensitive cells. This thinning increases the risk of MMD, a serious condition that can ultimately cause vision loss.
Professor Saw Seang Mei, the principal investigator of the SEED study and an epidemiologist specializing in eye diseases, estimates that approximately 13% of those who had myopia during their national service in 1996 have progressed to high myopia. Considering the MMD rate among those with high myopia, this translates to around 4% of individuals aged 45 to 55 in the Singapore population now having MMD. With over 600,000 residents in this age group, this means there could be at least 24,000 residents with MMD.
The Myopia Society of Singapore recognizes the importance of addressing myopia as a significant public health issue. The society, comprising optometrists, ophthalmologists, paediatricians, general practitioners, and researchers in eye care and vision science, aims to promote early detection and timely interventions. The good news is that Singapore's myopia rate for Primary 1 pupils has dropped from around 30% in the mid-2000s to approximately 26% in recent years, thanks to initiatives such as the Health Promotion Board's annual screening program for children from Kindergarten 1 to Primary 4.
However, Dr. Foo Li Lian warns against complacency due to the lifelong risks associated with high myopia. Eyeball elongation in children with myopia can be arrested or delayed through the use of specially designed myopia-control lenses or atropine eye drops, treatments that have become more accessible in the past decade. Clinical studies have shown that myopia-control lenses can retard myopia progression by at least 50%.
Despite these advancements, there are challenges in ensuring that children receive the necessary treatments. Ms. Adeline Yang, secretary of the Myopia Society and an optometrist, notes that less than 10% of those prescribed myopia-control lenses eventually purchase them due to the higher costs involved. Additionally, the local market is flooded with "copycat" products that claim to control myopia but lack scientific proof of their effectiveness. While these products may appear safe, they do not actually control myopia, as highlighted by Professor Saw.
To address these issues, the Myopia Society plans to release a consumer guide within the year to educate parents on purchasing the right products for their children. They also aim to utilize social media to reach out to young parents effectively. Additionally, the society intends to publish consensus guidelines, in consultation with researchers and hospital clinicians, to ensure that local clinical practice is informed by robust scientific evidence.
The Myopia Society of Singapore's efforts are crucial in raising awareness, promoting early intervention, and providing accurate information to the public. As Dr. Ng Wei Yan, treasurer of the society, acknowledges, it will take time for the public to fully understand the seriousness of myopia and the importance of vision care. However, with persistent messaging and educational initiatives, the society aims to make a significant impact on the prevention and management of myopia and its related complications.
