WeeklySA_AdminCLOSE-UP: Increasing levels of short-sightedness among children and young adults are placing more people at risk of retinal detachment—an eye emergency that can cause permanent blindness without urgent treatment…
By WSAM Reporter
Growing levels of myopia among children and young adults are increasing their risk of retinal detachment, a medical emergency that can result in permanent and irreversible vision loss if not treated quickly.
Myopia, commonly known as short-sightedness or nearsightedness, is rising globally as people spend more time doing close-up work, including using digital screens, and less time outdoors.
Eye health specialists estimate that about half of the world’s population—approximately five billion people—could be affected by myopia by 2050. This is expected to increase the prevalence of serious associated eye conditions.
Speaking ahead of Eye Care Awareness Month, observed from September 23 to October 18, Dr Schalk du Toit of the Ophthalmological Society of South Africa warned that myopia was the greatest controllable risk factor for retinal detachment.
The condition occurs when the retina—the light-sensitive layer lining the back of the eye—pulls away from the tissue that supplies it with oxygen and nutrients.
“This is one of the most time-critical eye emergencies and, without prompt surgical intervention, can cause permanent, irreversible vision loss,” Du Toit said.
“Mild myopia triples the risk of retinal detachment, rising to as much as 39 times the risk in cases of severe myopia.”
Although retinal detachment occurs more frequently among people in their 60s and 70s, the growing prevalence of myopia means younger people could enter the high-risk category much earlier in life.
Du Toit said the increase was linked partly to prolonged periods spent focusing on close objects, including screens, and insufficient time outdoors.
Spending about an hour outside each day could benefit both children and adults. Focusing on distant objects helps relax the eyes and relieve eye strain, while exposure to natural daylight has been shown to have a protective effect against children developing myopia.
Retinal detachment
Retinal detachment currently affects between one and two people in every 10,000. However, its incidence is projected to double over the next 20 years because of increasing myopia and ageing populations.
Among people older than 60, normal age-related changes may cause the vitreous—the gel-like substance inside the eye—to separate from the retina. This can sometimes produce a retinal tear and lead to detachment.
Other risk factors include previous cataract surgery, a family history of retinal detachment, thinning of the retina and a direct blow or injury to the eye. Trauma is estimated to be responsible for between 10% and 15% of cases, with people participating in contact sports facing a particularly high risk.
Men are affected about 1.5 to two times more frequently than women. Du Toit said most retinal detachments produced noticeable warning signs before substantial vision was lost. Anyone experiencing these symptoms should seek assessment by an eye-care professional on the same day.
The warning signs include the sudden appearance of new “floaters”—small dark spots or thread-like shapes drifting across the field of vision—particularly when many appear simultaneously.
Other symptoms include flashes of light, especially at the edges of vision; a shadow or curtain spreading across part of the visual field; or a sudden, painless dimming or narrowing of vision.
Treatment options
Retinal detachment requires surgery, with the procedure determined by the type, size and location of the detachment.
Treatment may involve injecting a small gas bubble into the eye to reposition the retina, a procedure known as pneumatic retinopexy. Doctors may also place a silicone band around the outside of the eye to reduce the pulling force on the retina.
Another option is a vitrectomy, during which the vitreous gel is removed and replaced with gas or oil, allowing the retina to settle back into position. These procedures may be combined and are generally performed within days of diagnosis.
The extent to which vision is restored depends heavily on how quickly treatment begins and whether the macular —the central part of the retina responsible for detailed vision—remains attached.
Du Toit said retinal detachment generally could not be prevented, but severe vision loss could often be avoided through early recognition and urgent treatment.
People with severe myopia, a family history of retinal detachment or a history of eye surgery or trauma should familiarise themselves with the warning signs.
If symptoms appear, they should immediately seek help at an eye casualty unit or ophthalmology practice rather than waiting to see whether their vision improves.
