Myopia cases skyrocket among children and young people in São Paulo during the pandemic

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Myopia cases skyrocket among children and young people in São Paulo during the pandemic

It was necessary to go through different stores until I found a pair of glasses in the colors that Rafael, 9, wanted, but when he put the blue and yellow accessory on his face, he didn’t take it off. The fear of “looking ugly” went away and he accepted the diagnosis of myopia, a disease that grew among children and young people up to 19 years old in the city of São Paulo.

According to a survey released this Tuesday (13) by the Municipal Health Department, the municipal network recorded 866 cases of the disease in this population in 2019, when 260,587 consultations were carried out. By September 2022, 2,026 cases had already been identified in a universe of 222,754 queries —an increase of at least 134%, which should grow considering the full year.

For experts, the rise in cases of myopia – the difficulty of seeing from afar, roughly speaking – is related to the use of screens, intensified during the Covid-19 pandemic with remote teaching and isolation. It was like this with Rafael and his sister, Júlia, 6.

“With the pandemic, they were in front of the screen all the time, including at bedtime, at lunch and dinner, and I decided to take them to the ophthalmologist to see if everything was okay. When we got there, he was 1, 25 degrees of myopia and she had 0.5”, recalls her mother, Fernanda Vicola Barbosa.

In the consultation, the ophthalmologist stated that the brothers were more predisposed to the disease because Fernanda and her husband are nearsighted and that screen time was an aggravating factor.

“Our eye continues to be formed in childhood, it is not born ready, and in this development it is influenced by the environment and the activities we do”, explains Ricardo Paletta Guedes, president of the Brazilian Society of Ophthalmology.

In this sense, the reduction in outdoor play and hours in front of video games, tablets and cell phones, which only require close-up vision, are literally changing the way young people see the world.

“When children spend fewer hours exposed to the light of the external environment, the photoreceptor structures are not stimulated and the eye grows more, favoring myopia”, comments physician Luisa Hopker, president of the Brazilian Society of Pediatric Ophthalmology.

The increase in the disease in children and adolescents has been pointed out by the World Health Organization as a challenge and was the subject of a survey released last year by the Brazilian Council of Ophthalmology. At the time, about 70% of the ophthalmologists consulted by the entity said they had identified progression of the disease in children during the pandemic.

Owner of a optician specializing in children, Michel Bernard Claude Lairé also noticed the increase. “Since last year, we have noticed an evolution. We serve children aged five, six years old who are already in two or three grades”, he reports.

The phenomenon is worrying because it has appeared earlier and earlier and because, as the eye grows during childhood, the degree also increases. This progression favors high degrees of myopia in adult life and increases the risk of more serious eye diseases, such as glaucoma and retinal detachment.

“30 years ago it was rare to find children with myopia degrees above six. Today, I see children aged eight and with 11 degrees of myopia”, compares Guedes.

According to doctors, the signs of the disease include headache, itchy eyes, grimacing when trying to see something in the distance and difficulty reading the blackboard in the classroom. But these signs are not always there. Rafael and Júlia, for example, were able to read street signs without difficulty, so they didn’t raise suspicions, recalls Fernanda.

Guedes claims that the child is easy to adapt and, sometimes, he thinks that the difficulty he feels is normal, so he does not comment. Furthermore, there are cases in which myopia appears stronger in one eye than in the other and, if one does not take the trouble to test each one separately, the disease goes unnoticed. Hence the importance of follow-up with specialists.

The recommendation, in addition to the eye test in the maternity ward, is to take the child for a complete ophthalmological examination up to the age of two. Then, at the age of five and, from the age of seven, have an annual consultation.

“It’s not enough to go to the optics to get glasses or just look for the doctor when you’re feeling very bad. The ideal is to do the preventive exam once a year or before, if there is any complaint”, guides the ophthalmologist.

In the public network, the gateway for the evaluation is the Basic Health Unit, which will provide care through the doctor of the Family Health team. According to the need, the patient is directed to the ophthalmologist and, if complex exams are necessary, he is referred to accredited clinics.

care

To minimize the chances of the disease, Hopker points out that children need to have at least about 1 hour and 40 minutes of outdoor activities a day.

The doctor also highlights the need to follow the guidelines of the Brazilian Society of Pediatrics regarding the maximum screen time by age and respect the distance of 33 to 38 centimeters between electronic equipment and the face.

Regarding the diagnosis and use of glasses, she points out that it is important to integrate children in the choice process and encourage them to use the resource. And she recalls that there are new eye drops and lenses that help reduce the speed of progression of the disease and are indicated in some cases.

The frames are also more modern, according to Lairé, and now there are light, resistant and colorful children’s models, like the ones chosen by Rafael.

“Today he doesn’t go without his glasses”, says his mother.


Recommendations on using screens by age

  • Children under 2 years old: avoid exposing younger children to screens, even passively;
  • Between 2 and 5 years: spend a maximum of one hour a day in front of screens, supervised by caregivers
  • Between 6 and 10 years old: screen time should be limited to one to two hours a day, always supervised by parents or guardians
  • For all ages: no screens during meals and disconnect between one and two hours before bed

Source: Brazilian Society of Pediatrics

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