Wednesday, January 28, 2009

Refractive disorders: Myopia or Nearsightedness (1). Vision and Symptoms

Enlace a entrada en español

As I wrote two posts ago, myopia is the best known refractive disorder worldwide. And that’s why, I have many things to tell you about this, so, I will need more than one post…

Myopic person’s vision

The typical complaint in myopia is “BLURRED VISION WHEN TRYING TO VIEW DISTANT OBJECTS”.

DISTANT vision:

Therefore, a myopic person placed next to this lamppost in Gran Via at Madrid, looking at distance, she will be able to focus (see clear) this nearby lamppost, but as her eyes look further, she will see in a blurred way more and more. Of course, it will depend on the degree of myopia or quantity of myopia that she does not wear (assessed in DIOPTERS –D-); a myopic person with a little refraction, will be able to see clear further than other that has more myopia.


CLOSE vision:

As with distance vision, this also depends on the degree of the eye refraction:

- If it is compensated (she wears corrective lenses -eyeglasses or contact lenses-), she sees well, but, in the case of a low degree myopia (lower than -3.00D), she will be doing an unnecessary effort with them. In the case of a medium degree myopia (between -3.00 and -6.00D) or a high degree myopia (higher than -6.00D), the optical effect of the lens will decrease the size of the letters very much, and she will need to bring the text very close.

- If it is not compensated, a person with low degree myopia will read without any problem and much more relaxed. In the case of a young person with a medium degree myopia, she will have to do much more effort than any person, but she will be able to do it; and an adult person with medium degree myopia or any person with a high degree myopia, she will see it probably blurred.


Appearance of myopic eye

- The nearsighted eye is usually longer than normal, because of the eye axial length is greater than normal (> 24 milimeters).

- In the other hand, the power of its lenses (cornea -1- and crystalline lens -8-) is higher than normal (cornea: >43.05 diopters and lens: 19.22 diopters), being its surfaces more curved.

According to these two features (and/or others), the image is not focused on the retina, but in a point in front of it, so that the image of the distant object (placed at 20 feet -6 meters-), is seen blurred.



Prevalence

Some data:
- In Spain, as well as in USA and UK, up to 25% of the population is myopic.
- In some Asian areas, such as China or Malaysia, up to 41% of the adult population is myopic to -1.00 dioptre and up to 80% to -0.50 dioptre.
- In Australia, the overall prevalence of myopia (worse than −0.50 dioptres) has been estimated to be 77%.
- However, in countries such as Brazil and India, the prevalence is estimated at 10% or lower.

In general, approximately a quarter of the adult population from Western Countries and 80% of children during school-age years, have myopia.


Behavior of a myopic people (symptoms)

Without wearing her refraction correction:

- She sees blurred at distance.

- A myopic person sees better at distance when squeezing the eye lids making a narrow opening.
- She can not see at distance but she does see very well at near: It is difficult for her, for instance, seeing the chalkboard at school or seeing a sign while she drives; however, she sees very well a book or the directions for using a medicine.

- She sits very close to watch television, computer or chalkboard.

- She brings the writing, reading, painting, drawing, etc., very close to her eyes; it is like if she were eating the paper or what she is looking at, mainly if the myopia is high.

- If the myopia is low, she can work at near in a more comfortable way and for more number of hours without getting tired.

That’s why, they prefer activities as reading, drawing or handicrafts, that is, any activity at near.


- They are shier and more absent-minded, since they are very “focal”, that is, they are not very aware about what surrounds them; they are able to concentrate very much and to be many hours performing a task, so that the world can fall surrounding them and they do not realize, neither whether it gets dark or not, nor whether anyone has arrived at home or not, nor whether it is already the dinner time,… This ability to concentrate (that others, as a hyperopic people, envy), acts against themselves, because, it favors the increase of the myopia, since they do not rest even to have a glass of water. This ability allows them to be good workers and to have a good school/labor performance.

- Related to all previous, they have a reduced peripheral awareness, due to as the “excessive” concentration, as well as to the close working distance that they use sometimes without realizing.
For instance, when they are reading a book, they bring it closer more and more, because, this way, the letters seem bigger. But, in one specific moment, the eye movements are not enough and they need to move their head to be able to read a whole line. If they try to get away from the text, the letters “seem smaller” (therefore, more uncomfortable for them), but the visual field increases and they are able to read faster, because they can cover a whole line just by having a look.

- Sometimes they suffer headaches (mainly in forehead and temples) or eyestrain, and sometimes, they might even squint noticeably when they are physically tired.



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