Monday, 29 June 2009

Truths and myths about myopia...

Or maybe plausible answers to the toughest questions. I’m not a specialist so treat it only as casual considerations which are in fact meant to summarise everything I’ve read and found out about that eye defect.

Bartek’s story
My struggle with refractive errors began when I was six, during obligatory examinations in the nursery. That was when astigmatism was diagnosed and astonishingly as it once came up it never progressed – I still need to have additional cylindrical lenses – minus 0,25 dioptres in both eyeglasses. The problem with myopia set on at the age of fourteen. That time I reported to the ophthalmologist without any referral from school nurse or GP. The sentence wasn’t heavy indeed – those were the very beginnings of myopia – minus 0,25 dioptres in the left eye, minus 0,50 dioptres in the right one – I could easily live without glasses at that time. Three years later both eyes worsened by 0,25 dioptres and I still managed to get by without second pair of eyes. At the age of eighteen I got the temporary driving licence by virtue of poor eyesight, however I took all the driving lessons and passed exam without spectacles. My eyesight deteriorated during the studies and within the last year it was increasingly hard for me to go without spectacles. In the middle of June I gave in and made an appointment with an ophthalmologist – error reached minus 1,00 in both eyes, within the last four years progressing by 0,50 dioptres in the left and 0,25 dioptres in right eye. It was the end of fending off myopia by living without specs, it’s simply gone too far to confine to using them only when driving a car.
Compared to the people who have impeccable sight I’m unlucky…
Compared to the people whom started having problem with myopia at the same age or later and now are glasses-ridden I’m extremely lucky – the progress was very slow…

When does it begin?
According to most of the studies it appears in the school age, what more or less means age ranging from six to eighteen. The biggest progress is reported at puberty. I dare to give lie to that generalised theory as I know a few people who started studying with me before three years with perfect eyesight (they were around nineteen) and now have minus 1,50 or minus 2,00 and can’t exist without glasses or contact lenses.

When does it end?
According to most of the studies the error should level off when person or their eye stops growing, what occurs around the age of twenty one. However, more and more ophthalmologists move the boundary-age up to twenty five, thirty. It might be seen as a result of civilisation changes (more time spent reading, in front of computer screen, etc.) and for sure is not reassuring for me. My doctor told me it indeed has changed over past years, however in my case the progress should be diminutive. In the past myopia used to stabilise earlier – in my mother’s case it stopped when she was seventeen and in spite of the studies (Polish philology) which required a lot of reading it has never increased. (my mother’s case is worth telling for another reason – she showed up at ophthalmologist’s after she botched up her test in Russian cause she couldn’t read the letters from the blackboard – her error was… minus five. My grandmother (also nearsighted, but only a bit) allegedly passes out. Later on her defect reached minus 7,00 and minus 9,00, she couldn’t make a driving license because of it). On the other hand my ex-girlfriends father had his myopia diagnosed when he was eighteen, his sight deteriorated until he turned forty and reached minus 5,5 dioptres! Hopefully that scenario is out of question for me.

Does it recede?
In theory not, doctors say the simple mathematical calculations with pluses and minus don’t apply to human eyes and after one hits forty myopia doesn’t back off. I know a few people who needed less powerful glasses with ageing. My mother switched from her minus 7 and minus 9 to minus 6 and minus 8 in her late forties, few moths ago, facing increasing problems with reading and stabbing pains in eyes she switched to even less powerful spectacles – minus 5,5 and minus 7,5 and as I checked she can read everything what I can read in my glasses.
My father, in turn hasn’t had any problems with eyes until the age of forty five. Then, as it usually happens, he had to start using reading glasses, but about two years ago it turned out he has to use positive glasses to see distant things clearly, so now he must use one pair of glasses for reading and another to drive a car, watch TV, etc. Once again, astonishing that a man in his fifties had to resort to glasses to see distant objects sharply.
Any conclusions for me – if I took some eye genes after my parents and my eyes will be prone to get positive with time maybe in thirty years I won’t be nearsighted, although the medicine doesn’t reckon it. If not, it’s quite possible I won’t have to use reading glasses as majority of our population do.

What influences myopia?
Hard to tell it – it’s said that hundreds of hours spent staring at the computer screen, reading books with poor lighting, etc. contribute greatly to progress of myopia… I read a lot, spend too much time before computer, but try not to overtire my eyes, so I can’t prove that theory. The more probable for my is the theory of genetic factors (mostly in a version of replicating some traits in second generation). In line with that theory I took it after my grandmother, I don’t want to speak out what threatens my children… It’s even quite common that the nearsighted’s children are also bespectacled… Bad genes?

What do the ophthalmologists do?
Their basic fault I’ve noticed is the standard approach when a patient shows up for the first time. I had that luck that I didn’t end up at such doctor’s, but many of my friends claimed they had had their first glassed prescribed by a typical quack. The doctors of that kind without thorough examination prescribe minus 0,5 glasses for both eyes and that’s the beginning of the end – imprecisely corrected myopia thrives. Scientists have been bending over backwards to establish, whether the less powerful glasses can clamp down on error’s progress. Some of the doctors prescribe a bit less powerful spectacles to let the eye work, some say when myopia is fully corrected the eye doesn’t get tired and the error doesn’t go up. I’ve even read a study in which there was an attempt to prove that wearing stronger glasses can cure myopia. I can’t believe it at any rate.
I can add two things. Firstly, eye adjusts to the corrective lens, undeniably, every short-sighted person notices it after they take off their glasses, it’s nevertheless very hard to determine it’s influence on eyesight’s deterioration. Secondly, it’s impossible to match up ideal glasses, for one simple reason – refractive power of an eye changes, that’s why sometimes I see in my minus one glasses ideally, sometimes I could do with a bit stronger, sometimes I see better with my left, sometimes with my right eye…

I’ve applied Bates method some time ago, it didn’t bear coveted results – very little improvement, maybe they slowed down worsening?

For the ones who can’t come to terms with myopia the only way out is a laser surgery. It supposedly carries very little risk, but costs about five thousand zlotys and isn’t reimbursed. The candidates should rather turn to the best clinics and do not shun the more expensive ones which guarantee higher quality or safety. Also watch out for contraindications and don’t try to conceal anything what could result in complications when being qualified for the surgery. Personally I didn’t consider it for my myself, maybe in some time, if myopia progresses more?

It is estimated that up to two billion people might suffer from myopia, in the future more than a half of world’s population may be afflicted by it.
It’s very sad – it’s a very common disorder but still didn’t find any cure for it and still know very little about.

Can anybody enhance what I’ve written?

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