INTRODUCTION: The prevalence of myopia has increased to 90% of the young adult population in some Asian countries, and according to the recent studies, fifty percent of world population will become myopic by 2050. Some studies believe that this recent increase in prevalence of myopia is a manifestation of sedentary lifestyle and poor diet. Myopia has already become a public health issue for the world population.
PURPOSE: The purpose of this paper is to examine the mechanisms responsible for the development of myopia, identify the public health recommendations to modify modern lifestyle behaviors, review the literature that provides a basis for the recommendations and identify the knowledge gaps.
METHODS: A systematic literature search was performed using Web of Science and Ovid Medline, with Population, Intervention, Control and Outcome (PICO) search strategy.
RECENT FINDINGS: Myopia can be corrected or controlled by conventional or custom designed eye glasses or contact lenses, or even with eye drops. However, myopia may reoccur if these interventions are discontinued. Moreover, they may not be suitable for some people due to their complications and need of consistent compliance. Myopia may be prevented or controlled through lifestyle changes.
Exposure to sunlight has been shown to lead to normal eye growth. Prevalence of myopia is lower in children who spend more time outdoors. The location of eye growth cues appear to be in the periphery in the retina.. Hyperopic peripheral defocus stimulates eye growth and myopic peripheral defocus retards eye growth. If a child spends a sufficient amount of time outside, the whole retina will be in focus and the eye appears to grow normally. The modern lifestyle is also a risk factor for myopia. Children spend more time indoors performing near tasks. As a result they are in a constant peripheral blur state which may lead to excess axial length growth. In the past thirty years has seen the introduction of highly processed foods. Refined sugar and starches are the main elements of the diet which may lead to excess insulin secretion. Insulin is a known growth factor which has cell receptors in the sclera potentially leading to unregulated eye growth.
CONCLUSION: We conclude that a natural approach to a myopia prevention strategy should be implemented which emphasizes spending time outdoors, promoting full spectrum indoor lighting, encourage proper reading and writing ergonomics, and increasing consumption of a nutrient dense diet.
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