Myopia incidence piques control efforts, initiatives

It doesn't take a fortune teller to divine that the future is blurry at best; a striking report on global eye and vision health already forewarned that predicament.

By mid-century, it could be just as common to encounter someone needing corrective eyewear as it would be to find someone with brown eyes. In other words, half of the world's population will be myopic by 2050, and one-fifth of those will be at a significantly increased risk of blindness, according to the latest World Health Organization report on the condition.  

Published in the Journal of the American Academy of Ophthalmology in 2016, this international meta-analysis determined a seven-fold increase in myopia from 2000 to 2050 will affect nearly 5 billion people—1 billion at risk for high myopia—and become the leading cause of permanent blindness worldwide.  

Uncorrected refractive error, largely caused by myopia, already affects some 108 million people globally and causes a financial burden of nearly $202 billion dollars annually in lost productivity, the study notes. In the U.S., myopia affects nearly 33% of the population, but in some east Asian countries, the toll is much higher. High myopia in Taiwanese college freshmen increased from just 26% of all myopia in 1988 to 40% by 2005, and South Korea saw myopia rates in 19-year-olds jump from 18 to 96% in the past 50 years.  

Although myopia's incidence is well-known, it's pathogenesis remains theoretical. Researchers suspect there's more to it than simply genetics, positing a combination of factors, including environmental, could lead to increases in myopia.  

"(Myopia) seems to be increasing too fast to be explained by genetics," Jeffrey J. Walline, O.D., Ph.D., AOA Contact Lens and Cornea Section (CLCS) past-chair was quoted as saying in a CNN article earlier this year.  

"Nobody really knows why the prevalence of myopia is on the rise."  

But that hasn't stopped clinicians and eye health experts from pushing ahead with treatment and prevention measures to control myopia's progression.  

AOA, optometry strive to eliminate avoidable vision loss  

Given the profession's depth of knowledge and expertise, optometry is well-positioned on the forefront of myopia control, and the AOA and its members are intimately involved in initiatives to curb avoidable vision loss.  

This past September, the AOA sponsored a landmark undertaking with the U.S. Food and Drug Administration (FDA) and other members of the eye health community to investigate myopia and develop clinical trials to analyze the efficacy of devices that slow myopia's progression. From this workshop, experts hope to inform premarket evaluation of contact lenses and other devices designed to control myopia progression.  

"As a profession, optometry has been trying to slow the progression of myopia through science for many years," Dr. Walline said in a June 2016 interview with AOA Focus.  

"Most of the scientific experts in myopia control are optometrists, so it is important that we help companies be able to market successful myopia control modalities, because that will allow us to provide more patients with myopia control benefits."  

Optometry also advised the National Academies of Sciences, Engineering and Medicine (National Academies) on a 2016 report that examines the toll of poor eye and vision health through public health strategies. The report set a roadmap toward improved, equitable vision health through recommendations that focus on expanding care, bolstering clinical evidence to support policy decisions and enhance public health capacities to support vision health, among others.  

"The AOA has been one of the strongest voices advocating for better public eye health and vision care," commented Andrea P. Thau, O.D., AOA president, at the time. "We hope this report spurs other stakeholders to follow our lead and convinces policymakers to act and improve access to needed eye health and vision care."  

AOA members can to find clinical practice guidelines, including Care of the Patient with Myopia.