Clear Vision Ahead: Strategies for Myopia Prevention and Treatment

Public Health
Written By Rizul Naithani

Editor:

Rachelle Srinivas, DO

Dr. Rachelle Srinivas is a neuro-ophthalmology fellow at Michigan State University.

Myopia is a refractive error caused by the eyeball being too long. Early onset myopia can lead to an increased risk of developing high myopia, myopic macular degeneration, retinal detachment, and glaucoma among other conditions (1, 2). Furthermore, myopia can impact quality of life and educational outcomes, potentially resulting in increased healthcare expenses (3, 4). 

Prevalence

  • The worldwide prevalence of myopia has increased, with 33.9% of the global population found to have myopia in 2020 (5, 6) and an estimated increase to almost 50% by 2050 (6). The prevalence of myopia is highest in Asia with rates rising (60%) and similar trends being seen in other regions around the world (4, 7). 

Barriers to seeking timely care

  • Factors such as cost, accessibility to healthcare and resources, and parental education can be barriers to the diagnosis and treatment of myopia (7, 8), and many patients, especially children, deal with uncorrected refractive errors (4). In addition, patients and families face financial burdens associated with access to care and lost productivity costs. Individuals in low-resource settings also confront barriers such as increased travel expenses and time required to access healthcare (3,4).  

  • Environmental factors have been associated with the development of myopia. In school-aged children, increased near work, dim light exposure, a decreased reading distance, decreased time spent outdoors, and living in an urban environment can lead to an increased risk of developing myopia (7). 

Possible treatments

  1. The use of soft multifocal contact lenses and orthokeratology contact lenses have been found to decrease the progression and development of myopia, although these treatments may be difficult for some patients to obtain due to accessibility and cost (3, 9).

  2. Alternatively, atropine drops have also been shown to slow and decrease the progression of myopia and offer a cost-effective option (3, 9, 10, 11). 

  3. Recent studies have also shown that engaging in regular outdoor activity decreases the incidence of myopia, especially in young children, providing an approachable and low-cost prevention strategy (3,9).  

Conclusion

The rising prevalence of myopia is concerning due to the increased risk of complications. In addition, myopia can affect quality of life and further burden those in low-resource areas. There are promising treatments to prevent and alleviate the progression of myopia in children, and promoting regular time spent outdoors can be an effective and easy-to-implement strategy along with other promising treatment options. 

 

References:

1.     Ikuno Y. OVERVIEW OF THE COMPLICATIONS OF HIGH MYOPIA. Retina. 2017;37(12):2347-2351. doi:10.1097/IAE.0000000000001489

2.     Morjaria P. How myopia develops. Community Eye Health. 2019;32(105):4.

3.     Agyekum S, Chan PP, Adjei PE, et al. Cost-Effectiveness Analysis of Myopia Progression Interventions in Children. JAMA Netw Open. 2023;6(11):e2340986. Published 2023 Nov 1. doi:10.1001/jamanetworkopen.2023.40986

4.     Sankaridurg P, Tahhan N, Kandel H, et al. IMI Impact of Myopia. Invest Ophthalmol Vis Sci. 2021;62(5):2. doi:10.1167/iovs.62.5.2

5.     Jong M, Brennan NA, Bullimore MA; The Role of Myopia in 2020 Uncorrected Global Visual Impairment. Invest. Ophthalmol. Vis. Sci. 2022;63(7):243 – A0097.

6.     Holden BA, Fricke TR, Wilson DA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036-1042. doi:10.1016/j.ophtha.2016.01.006

7.     Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw SM. A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmol. 2020;20(1):27. Published 2020 Jan 14. doi:10.1186/s12886-019-1220-0

8.     Li R, Zhang K, Li SM, et al. Implementing a digital comprehensive myopia prevention and control strategy for children and adolescents in China: a cost-effectiveness analysis. Lancet Reg Health West Pac. 2023;38:100837. Published 2023 Jul 13. doi:10.1016/j.lanwpc.2023.100837

9.     Tariq F, Mobeen R, Wang X, et al. Advances in myopia prevention strategies for school-aged children: a comprehensive review. Front Public Health. 2023;11:1226438. Published 2023 Aug 15. doi:10.3389/fpubh.2023.1226438

10. Morgan IG, French AN, Rose K. Myopia in low-resource settings. Community Eye Health. 2019;32(105):11.

11. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31(6):622-660. doi:10.1016/j.preteyeres.2012.06.004

Rizul Naithani
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