The myopia epidemic: why it is so dangerous.

Myopia, also called nearsightedess, is increasing in the population at an alarming rate.  According to the National Institutes of Health in 1972, the frequency of myopia was 25% in Americans aged 12 to 54. By 2004, it had increased to 41.6%. (Roan,2010).

Even worse than the increasing frequency of myopia is that for affected individuals it has a tendency to get worse over time.  Some of you may say, "Who cares? People can wear glasses."  Corrective lenses may fix a myope's blurry vision but myopia is far more dangerous than blurry vision.

The danger of myopia is that it can lead to blindness due to the adverse ocular changes associated with it.  Myopia causes abnormal stretching or elongation of the eye which can cause thinning and weakening of the retina (the thin membrane at the back of the eye that contains the cells that send visual information to the brain).   This elongation may pull on the vitreous (the gel substance that fills the eye) which in turn pulls on the retina.  This proces can cause a retinal detatchment - a  medical emergency requiring immediate surgical attention.  A detached retina can lead to blindness.

Another problem with myopia is glaucoma.  Moderate to highly myopic people are twice as likely to develop glaucoma. (Mitchell 2000).  Threfore, it is important for myopic individuals to see thier optometrist regularly to ensure that glaucoma is not developing.

Because of the dangers of myopia, scientists have been working on ways to stop myopia progression.  Orthokeratology is one solution that has been shown to be effective in a number of studies from around the world.  Orthokeratology is a treatment where the patient wears a night-time retainer lens while sleeping.  The retainer changes the shape of the cornea so that the patient experiences clear vision during the day.  In addition to being an alternative to glasses, contacts and laser surgery, orthokeratology retainers can slow or stop the progression of myopia. 

NHL should require visors after Manny Malholtra's eye injury

At least one optometrist is telling National Hockey League players to wear visors.  She happens to be engaged to one of them. Andrew Ladd's fiancee has tried unsuccessfully to convince Ladd to wear a visor while playing for the Atlanta Thrashers, reports the Candian Press.  Visors are already required in international hockey rules.

Ladd is rethinking his stance on a visor after the horriffic injury to Canuck, Manny Malholtra, "Just seeing what happened to Manny Malhotra and those types of injuries, it's scary," Ladd told the Canadian Press. "It can end pretty quickly if you take one in the eye."  This is what happened to Malholtra:



An injury like this can lead to permanent blindness.  Under NHL rules, no player with one blind eye can play.  However, I don't think a rule is even necessary.  A player with one blind eye will probably not have the peripheral vision and necessary depth perception required to succeed at the NHL level.

The Canucks have not disclosed exactly what kind of eye injury Malhotra suffered, but there are a few possibilities.  Dr. Harbir Sian has a list of the possible injuries here, which include detached retina, corneal abrasion, cataract, glaucoma and fractured orbital bone.  In my opinion, the most likely injury is the dreaded retinal detachment.

UFC Fighter escapes retinal detatchment

UFC welterweight champion Georges St-Pierre had to take a break from competition because of an eye injury.

Following a fight that left him unable to see out of his left eye, he went doctors who suspected a detached retina. This is a serious condition that requires emergency surgery or else permanent blindness may result.

Luckily, Mr. St. Pierre's retina was not detached and he will fully recover in a short time.

This story highlights the importance of taking sports impact injuries seriously when they happen to the eye or the head generally. Detached retina due to impact can happen to anyone.

(But remember that retinal detachment can occur even without an impact. Go see an optometrist immediately or go to the ER if it is after business hours if you experience any sudden changes in your vision)

People who are highly myopic are at increased risk of retinal detachment and they need to be extra careful. Even if you have had laser surgery to correct your myopia, your risk level is still high. This is because the surgery merely alters the cornea at the front of your eye and does not change the physiology at the back of your eye where the retina is located.

I frequently have patients who come in to have their retina examined after being hit in the head or near the eye with a baseball or have suffered some other impact. I'm always pleasantly surprised that these patients know about the risk and take their health seriously!

Read more about Georges St. Pierre's injury here.