Forum: Evaluate eye-care treatments, check source, seek evidence, consult pros

Myopia, which affects almost 80 per cent of children and young adults in Singapore, can lead to potentially sight-threatening complications later on in life, especially in those with high myopia.

The Singapore Eye Research Institute has been researching myopia for more than 20 years to better understand it and develop treatments; while the Myopia Centre, Singapore National Eye Centre (SNEC), was established to educate and provide clinical care for children and adults.

From these studies, we know that at least two hours of outdoor activity per day, with a reduction in intensive near-work, can help delay or prevent the onset of myopia in children. Over the years, we have worked with the Health Promotion Board to spread this message.

Based on scientific evidence, we also know that atropine eye drops, and some specially designed contact lenses and glasses, can be used to slow myopia progression. Each treatment has its pros and cons, in terms of responses, cost and safety. Our role, as eye-care providers, is to provide parents with fair and balanced, evidence-based information about the options so that they can make an informed decision.

Unfortunately, there are also many myths surrounding myopia treatments. There is no evidence that oral supplements, pin-hole glasses, magnetic or acupressure therapy, eye-relaxing machines, eye massage or exercises, or antioxidant eye drops or medication help to reduce or slow myopia progression. Some (for example, pin-hole glasses and direct massage of the eye) can cause the illusion of temporary improvement in vision; while others may even cause damage (for example, strong prolonged direct pressure on the eyes or intense light shone into the eyes).

More importantly, using these ineffective or unsafe interventions may deprive a child of receiving appropriate, effective treatment, and this can lead to worsening of myopia.

We recognise that it can be difficult for parents to know what is real or not, especially in today's world of online misinformation and unmoderated social media. We encourage parents to evaluate any interventions using the 3 Es:

• Evaluate: Find out the source of information and if it is reliable, such as whether it is World Health Organisation- or Ministry of Health-supported

• Evidence: Are there good quality clinical trials to support the treatment?

• Eye care professionals: If unsure, seek advice from a certified, well-trained optometrist or ophthalmologist.

Audrey Chia (Associate Professor)

Co-Clinical Director

Myopia Centre

Singapore National Eye Centre

Co-Head, Myopia Research Group, Singapore Eye Research Institute

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