There is still marketing myopia

Tracking down the causes of myopia

Do you often screw up your eyes and blink to see something in the distance? You are not alone in this. Many younger people in particular feel this way today: In Europe, the rate of nearsighted people between the ages of 25 and 29 is 47 percent. The proportion falls in older age groups; among 65 to 69 year olds, only 16 percent have nearsightedness. However, this phenomenon cannot be explained with genetic causes.[1]

Instead, it is our changed living conditions that are leading to a dramatic increase in the proportion of the nearsighted in the population. More and more activities in our everyday life require the eye to be close at hand, and that starts with the first glance at the smartphone in the morning. On the other hand, we focus less and less in the distance, which our eyes adjust to over time. Read here how myopia develops and what options there are for dealing with the common poor eyesight.

Symptoms: how is myopia expressed?

Nearsightedness, also known as myopia in medicine, makes it difficult for you to see into the distance. So while you can easily see objects at close range, distant objects appear blurry. In everyday life, those affected experience various complaints and they experience symptoms that are often not directly attributed to myopia. Do the following situations sound familiar to you?

  • The further away things are from your eye, the blurrier they appear.
  • You don't recognize people by their face until late, it is difficult to say hello in good time.
  • Reading projected information at work or school is a strain for you.
  • Activities that require concentration (such as driving a car) cause headaches.
  • You can recognize trees, but not their individual branches and leaves.
  • Light sources appear particularly blurred to you.

If such complaints restrict your everyday life, you should not be afraid to visit an ophthalmologist. The examination only takes a few minutes, is not uncomfortable and above all helps to rule out serious diseases of your visual system.

Myopia: Getting to the bottom of the cause

In myopia, the focal point, i.e. the point at which all incident light rays are bundled in the eye, lies in front of the retina - objects therefore appear blurred. The graph shows the refractive error of a nearsighted person compared to a normal sighted person.

Objects that are further away are not shown properly on the retina - they appear blurred. There can be two reasons for this: Either your eyeball is too long or the refractive power of the cornea, vitreous humor and lens system is too high. The doctor therefore speaks of axis myopia and refractive myopia. Both forms can also occur at the same time.

The role of our lifestyle

As a trigger for myopia, in addition to genetic predispositions, increasingly changed lifestyle habits, which require increased near vision, are being discussed. Because our everyday life demands the eye more and more often, just think about the use of the smartphone or computer close to the eye. At the same time, we focus less often in the distance. As a result, the eyes as a whole adjust to increased near vision by lengthening the eyeball.

Researchers conducted the 2014 Gutenberg Health Study[2] found a clear connection between myopia and level of education. Among high school graduates, the proportion of nearsighted people is 50.9 percent, while people who drop out of school after the tenth year are only 26.6 percent nearsighted. According to this, the influence of school education and vocational training on the extent of myopia is much greater than all known genetic predispositions. After all, longer training also means more reading and thus more close-up vision.[3] In addition, the light is also crucial: because a longer training usually means spending more time in closed rooms. The eyes suffer from the often poor lighting conditions: there is a lack of natural, bright daylight, which has a protective effect, especially for children, and can counteract myopia.[4] Various studies have already demonstrated this effect of light on myopia. Sometimes a connection with dopamine-controlled processes is suspected, since bright light favors the release of dopamine (see also the chapter “What to do about the causes of myopia?”).[5]

Visiting the ophthalmologist

If you have visual problems in everyday life or notice the typical symptoms described, an ophthalmologist can determine whether you are actually nearsighted and what correction you need. To do this, he first carries out a routine test of your eyesight: he tests the near and television sharpness (near and far vision) separately for both eyes in order to get an initial indication of any ametropia. Eye test charts are usually used for this. For example, it shows letters of different sizes that you have to read from a certain distance. With the help of the letter size, which you can easily recognize, your ophthalmologist decides whether you need a visual aid.

This is followed by a precise assessment of the required visual acuity. First of all, the myopia is determined objectively with a refractometer (measuring device for determining the spectacle lens). You don't have to do anything here - it's a fully automated computer eye test. Based on the results, it is about your personal perception, i.e. the subjective determination of your values. Ultimately, only you can assess your optimal visual comfort. The ophthalmologist asks control questions in order to rule out misunderstandings and contradictions. The end result is the corrective strength that will give you optimal visual acuity and comfort. Note, however, that the results of the eye test will also depend on other factors. For example, the time of day, the lighting and your form of the day all play a role in the result.

You can also take an eye test in any eyewear store. In some cases, an appointment with the ophthalmologist is also advisable if myopia is detected. The doctor can rule out possible diseases or changes to the eye and confirm the correction values ​​again. Ask your optician for advice, he will explain how to proceed.

When to be especially careful

If you have severe myopia, you should see your ophthalmologist at regular intervals. Because while the simple myopia usually begins between ten and twelve years and usually does not progress from the age of 25, the so-called malignant (high) myopia is somewhat more critical. The cause of malignant myopia is that the eyeball grows excessively in length. This can damage the retina and choroid. As a result, both tissues become thinner. In the further course, it is possible that bleeding and scars form, which make the poor eyesight even worse. In addition, those affected are at increased risk of retinal detachment, which in the worst case can lead to blindness. In general, the risk of disease increases significantly from a myopia of 6 diopters. The glaucoma and cataracts are also more common among those affected. If you would like to know more about this: Our articles provide details on both cataracts and glaucoma.

If you have children who are nearsighted, you should always keep an eye on the values. Good eyesight is very important for the development of your offspring. Here, preventive measures are worthwhile in order to avoid myopia from the outset. Because the earlier myopia begins, the higher are the values ​​that are usually reached in the course of development.

What can be done about the causes of myopia?

The good news: You can effectively counteract the development of myopia. However, this is most effective when it is done in childhood and adolescence. Take advantage of this opportunity and work towards it in your children at an early stage so that myopia does not develop at all or only weakly. Because in addition to hereditary factors, the high proportion of close work plays a very important role in the development of myopia. Seeing into the distance must therefore take an increased part in our habits again. Studies show that being outdoors in particular is good for the eyes.[6] The more often and longer your children are outside, the less likely they will develop myopia. Because through the bright light, the retina releases the happiness hormone dopamine, which not only ensures well-being, but also benefits the eyes. Dopamine prevents the eyeball from growing in length and thus directly addresses the cause of the nearsightedness.

You can do yourself good by taking regular breaks from your computer work and ensuring that the air is good, not too dry, and that there is adequate lighting. With a short eye training session, you can also treat yourself to a little break and relax your eyes in a targeted manner. We have put together the most important information on the subject and a small training plan in our article "Eye training against myopia".

The bad news: Pre-existing myopia cannot be cured by these and other methods. The lack of visual acuity can only be compensated for. The motto is all the more valid here: Prevention is better than aftercare.

Correcting myopia: visual aids and alternatives

The principle behind correcting myopia is simple: the refractive power of your eye must be adjusted so that the incident light rays are focused on the retina. Then you can see clearly again. In the case of myopia, diverging lenses are required. These are concave (arched inwards) and move the focal point back just enough that it lies on the retina.

By the way: The necessary correction of the refractive power is indicated in the unit of measurement diopters. In the case of nearsightedness, there is a minus in front of the diopter value, because the overall refractive power of your eye is reduced by the visual aid.

If you want to correct your eyesight, you have a variety of options. After all, you can wear your visual aid not only as glasses on your nose, but also as contact lenses directly in the eye. Let us advise you on hard and soft contact lenses, their correct handling and the various glasses. A guide on the subject of “glasses and contact lenses?” Is also available at Envivas.Puls.

If you do not want to have to rely on a visual aid every day, surgical methods are an alternative. An artificial lens with the appropriate power can also be inserted into the eye by means of an operation. Most of the time, however, this is only an option for very myopic people whose cornea is also particularly thin. This treatment is also an option for people who are also suffering from cataracts. On the other hand, laser treatment, in which the refractive power of the cornea is specifically changed, is more common. Lasering is possible for people over the age of 18; different laser methods are used depending on dioptric strength and age. For example, the LASIK method, which is considered to be particularly gentle, is popular. Your doctor will inform you in a consultation about the process, the possible result and potential risks of the laser.

Who pays for my visual aid?

Surgical corrections such as the popular LASIK method are not part of the standard treatments and are therefore not covered by statutory health insurance. In the meantime, glasses and contact lenses are no longer subsidized by statutory health insurances, because since 2004 such visual aids have no longer been part of the service catalog.[7] Since then, a (partial) assumption of costs has only been possible in exceptional cases for both nearsightedness and farsightedness. These include astigmatism from 4 dioptres, severe visual impairment (maximum 30 percent vision in the better eye) or ametropia from 6 dioptres. Children and young people under the age of 18 are also an exception and part of the costs are reimbursed.[8]

However, if you belong to one of these groups of people, that does not mean that you will not have any costs. Because the statutory health insurance usually pays for the glasses, but not the frame. A visual aid is therefore always an expensive matter. This can be particularly stressful if the myopia is progressing and new glasses are needed more often. Private supplementary insurance, which regularly pays a subsidy for glasses and contact lenses, protects you from these extra costs. And those who can regularly afford new glasses not only feel comfortable with them, but also benefit above all from optimal visual acuity and wearing comfort - quality of life that should not be underestimated. Depending on the tariff, private supplementary insurance covers a certain part of the costs. The Envivas reimburses, for example PraxisExtra not only the costs for contact lenses and spectacle lenses, but also for spectacle frames - up to 150 euros within two consecutive calendar years.

References

  1. K. Williams et al, Prevalence of refractive error in Europe: the European Eye
    Epidemiology (E3) Consortium, available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385146/pdf/10654_2015_Article_10.pdf.
  2. Press release University of Mainz, myopia increases with higher education and longer school time.
    Scientific study by the Mainz University Medical Center confirms the connection between education and myopia, 2014, http://www.uni-mainz.de/presse/61304.php.
  3. A. Mirshahi et al, Myopia and level of education: results from the Gutenberg Health Study, in: Ophthalmology, October 2014, Vol. 121 (10), https://www.ncbi.nlm.nih.gov/pubmed/24947658 .
  4. L. Jones et al, Parental History of Myopia, Sports and Outdoor Activities, and Future Myopia, in: Investigative Ophthalmology & Visual Science, August 2007, Vol. 48, http://iovs.arvojournals.org/article.aspx?articleid = 2183997.
  5. F. Schaeffel, Myopia Update 2011, http://www.eye-tuebingen.de/fileadmin/user_upload/labs/schaeffel/docs/overview_articles/schaeffel-klimo_2011.pdf.
  6. Pharmaceutical newspaper, myopia: prevent with outdoor games, https://www.pharmazeutische-zeitung.de/index.php?id=57666.
  7. Federal Joint Committee, Directive on the regulation of medical aids in the
    medical care, available at https://www.g-ba.de/downloads/62-492-1352/HilfsM-RL_2016-11-24_iK-2017-02-17.pdf.
  8. Ibid.