Myopia rise raises retinal detachment risk

A rise in myopia among younger people is drawing renewed attention to the longer-term risks to eye health, with specialists warning that retinal detachment can become a sight-threatening emergency when symptoms are not recognised quickly.

The concern comes as Eye Care Awareness Month approaches in South Africa, running from 23 September to 18 October. The focus is particularly relevant to children and young adults, as global research points to a sustained increase in myopia and links severe short-sightedness to a substantially higher risk of retinal complications.

Why myopia is becoming a bigger concern

Research published in Ophthalmology Times Europe in June 2025 estimated that myopia could affect almost half of the world’s population, close to 5 billion people, by 2050.

The publication also notes that myopia among children and adolescents has increased markedly over recent decades, with reduced outdoor exposure and increased near-work activities among the environmental factors associated with the trend.

The South African warning centres on what that change could mean beyond the need for glasses or contact lenses, as Dr Schalk du Toit, an Executive Committee member of the Ophthalmological Society of South Africa (OSSA), identifies nearsightedness as a major controllable risk factor for retinal detachment.

Retinal detachment occurs when the retina, the light-sensitive tissue at the back of the eye, separates from the tissue beneath it. Without timely treatment, it can result in permanent vision loss.

A recent review published in Epidemiologia found that myopia is associated with a threefold increase in retinal detachment risk in milder cases, while severe myopia can increase the risk by as much as 39 times.

The same review identified age, previous cataract surgery, trauma and male sex among other established risk factors.

Screens, outdoor time and younger eyes

The changing balance between indoor and outdoor activities is another part of the discussion, as the global myopia review found that reduced time outdoors and greater exposure to near-work activities, including screen use, are associated with the development and progression of myopia.

It also notes that children who develop myopia at a younger age can face faster progression and a greater lifetime risk of high myopia.

Du Toit said spending time outdoors can play a role in protecting children’s eye health.

‘Time outdoors, about an hour a day, is important for both children and adults as focusing on distant objects helps to relax the eyes and relieve eye strain and has been shown to be a protective factor against children developing myopia due to the positive impact of natural sunlight on eye growth and health,’ he highlighted.

Know the warning signs

Retinal detachment can develop with little or no pain, making changes in vision particularly important to recognise.

Du Toit said warning signs can include a sudden increase in floaters, flashes of light around the edges of vision, a shadow or curtain-like effect across part of the visual field, or sudden dimming or narrowing of vision.

Anyone experiencing these symptoms should seek same-day assessment from an eye-care professional, particularly where there is a history of high myopia, retinal detachment in the family, previous eye surgery or eye trauma.

Treatment depends on how quickly it is found

Once retinal detachment has occurred, treatment generally requires surgery. The appropriate procedure depends on the nature, size and location of the detachment and may involve a gas bubble, a scleral buckle or vitrectomy.

Du Toit said the amount of vision ultimately recovered depends substantially on the timing of treatment and whether the macula, which is the central part of the retina responsible for detailed vision, remains attached.

‘Retinal detachment can generally not be prevented, but severe vision loss can be avoided through prompt recognition and same-day treatment,’ he said.

As Eye Care Awareness Month begins, the practical takeaway is centred on recognition rather than alarm: people with myopia and other known risk factors should be familiar with sudden changes in their vision and seek urgent professional assessment when they occur.

For retinal detachment, early recognition can be critical to protecting the vision that remains.

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**Picture: **Supplied/Royalty free

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