Why are the eyes important? The moment we wake up, our eyes are the first to tell our brains what we see. They also keep us away from any potential danger because we can see what or who they are since 80 percent of what we perceive comes through our sense of sight.
We use them in the way we live, play, work or learn. Most of the time, people neglect caring for them by staying up very late, and with the advent of digital devices during the pandemic, they are one of the most used—and abused—of our body’s senses. Community lockdowns also deprived the eyes of natural light, especially among children who learned from home and stayed long in front of computers and other digital devices, thus contributing to more eye problems.
Among these problems include myopia or near-sightedness, now a common eye-related disorder globally. Sadly, many were undiagnosed in both developed and developing countries and was noted to be prevalent in East Asian countries, where it affects 80 to 90 percent of high-school graduates, with 10 to 20 percent having pathologic myopia.
The Philippines’ national average is only at 10 percent compared to neighbors Singapore and Taiwan, but is a scary 20 to 30 percent in poor, disadvantaged urban areas. The World Health Organization (WHO) even said that there are at least 2.2 billion people globally who have a near or distance vision impairment, and sadly, almost half of them could have been prevented or have yet to be addressed, with the leading causes being uncorrected refractive errors and cataracts.
Visual impairment
According to Dr. Leo Cubillan, Director of the Philippine Eye Research Institute, National Institutes of Health, UP Manila, the Philippine Eye Disease Study (PEDS), a randomized, population-based study done in 2018, revealed that the National Prevalence of Visual Impairment was at 1.98 percent among Filipinos, where the major cause of visual impairment was cataract that affected 1.06 percent or 1.18 million Filipinos and 393,000 needed surgery. Glaucoma was at 0.27 percent or around 300,000 Filipinos, while 0.38 percent or 423,000 Filipinos have uncorrected errors of refraction (EOR), and 0.2 percent or 223,000 Filipinos have maculopathy or diabetic retinopathy.
Compared to around 21 regions around the world in terms of blindness and visual impairment, the Philippines was at the Top 30 percent in Southeast Asia, Dr. Cubillan said during the webinar “Ilang taon dapat magpa-check-up ng mata ang isang bata?” organized by the University of the Philippines together with the UP Manila NIH National Telehealth Center and UP Philippine General Hospital (UP-PGH).
Myopia progression, prevention
In the Philippines, EOR prevalence among children is at 8.9 percent, but this changes when children reach high school, where prevalence reaches 16 percent, and 90 percent of the 16 percent are myopic. Prevalence is increasing not just in the Philippines but also globally, where children who reach to as high 600 in eye grade can have complications that can lead to blindness.
“It was learned that outdoor exposure can reduce myopia progression and since there are medicines already, it is still imperative that increased outdoor exposure be included in the school curriculum,” Dr. Cubillan explained.
Data in 2016 projected the prevalence of myopia by region, where in Southeast Asia, this will increase from 39 percent to 62 percent, East Asia from 47 percent to 65 percent, and Asia Pacific from 50 percent to 66 percent. The projection estimates that by 2050, around 4.76 billion people or about 50 percent of the global population are expected to become myopic.
Preventing myopia progression
During the Philippine Eye Health Summit held in 2019, the Philippine Eye Research Institute (PERI) suggested three hours daily or about 15 hours weekly of outdoor light exposure for children. “I believe it is best that the Department of Education can allow at least one additional hour of different outdoor activities for kindergarten and high school children. This was shelved due to Covid-19 so we hope this could be implemented this year or next year,” Dr. Cubillan said.
There is also Republic Act 11358 or the “National Vision Screening Act” that was signed into law by former President Rodrigo Duterte in July 31, 2019. This act calls for mandatory eye screening for children, particularly those in kindergarten, where teachers and school health personnel are trained to conduct a very quick testing on kids using the “pass fail” method.
Why is eye screening important? Uncorrected vision problems may have a dramatic impact on kids’ learning capabilities and academic potential, a negative impact on a child’s social growth and maturity, and of course can lead to permanent visual loss.
The country’s K-12 system may have a good impact on eye screening in the country since the age for kindergarten students is five years old, and a child’s eyesight undergoes development until they are about seven to10 years old so if in case there will be problems, it can be treated earlier.
During the pandemic, Dr. Cubillan said that PERI conducted an online vision screening program that involved the parent and child at home, a trained screener, remote screen sharing through Messenger, Zoom or Viber. “Hopefully in the next five years when the pandemic is gone, we can reach more kids of our target, which is about 80 percent.”
He said that it is also advisable to let students with slight visual impairment sit in the front row to improve learning and must already be referred to eye professionals for proper management.
The WHO also prescribed a new set of guidelines regarding “screen time,” especially if non-school related, among kids of only 60 minutes (less is better) for kids two to five years old, while children below two years old should have no screen time at all. “This is more about giving kids the opportunity to have social interaction by having them play outside for the eyes, and of course, for their mental health,” Dr. Cubillan concluded.
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Image credits: Antoni Shkraba _ Pexels.com