I was encouraged that practitioner concern about the increasing frequency of childhood myopia was high in Australasia – median 7/10. Practitioners in Europe and North and South America reported similar rates of concern. Those in Asia were the most worring – 9/10.There is a reason for concern. In 2010, 1.9 billion people worldwide were myopic and 205 million had high myopia. Assuming current rates of increase, the Brien Holden Vision Institute estimates that:
- Worldwide, presently there are about 2–2.5 billion people with myopia
- By 2050, 5 billion people will be myopic, which will be half the world’s population
- In addition, by 2050 there will be almost 1 billion high myopes, 10% of the world’s population
{{quote-A:R-W:450-Q: Neither of these strategies has been shown to slow progression. Even more concerning however is that, although it has been shown that undercorrection makes myopia progress faster, there are still some practitioners using this strategy. }}Also, we know that myopia increases the risk of blindness due to myopic maculopathy, retinal detachment, glaucoma and cataracts. High myopia (5.00 D or more) significantly increases the risk of these sigh–threatening conditions and is a major cause of blindness or vision impairment.It is encouraging that a 50% reduction in the rate of progression would result in more than 90% fewer high myopes. This would substantially reduce the risks of sight–threatening complications of myopia later in life.How do you know who is at greatest risk?There are two very strong predictors:
- Refraction less than +0.75 D at age 6
- Both parents being myopic
It is recommended that if you see a young child who is less than +1.00 D do a cycloplegic refraction. Then review th every 6 months for at least 12-18 months to see if there is any change.The reason why the article confused me is because it reported that the majority of practitioners prescribed either single vision (full correction) spectacles or single vision contact lenses for progressing or young myopes. Neither of these strategies has been shown to slow progression. Even more concerning however is that, although it has been shown that undercorrection makes myopia progress faster, there are still some practitioners using this strategy.I don’t understand? Controlling myopia progression is essential for long–term eye health.Regarding risk factors, Paul Gifford presented a fabulous lecture at OSO 2016 about a great resource created together with Kate Gifford to help practitioners – myopiaprofile.com. It contains the latest research on myopia development and assists in treatment strategies. They have also created a resource for parents – mykidsvision.org. This simple online survey helps parents assess their child’s risk of myopia.Fortunately, we do have optical and pharmacological treatment strategies – as well as lifestyle interventions – to help delay onset and control progression. Of all the methods available to slow the progress of myopia, orthoK, soft bifocal contact lenses, and atropine, are the most effective.Furthermore, patients should be encouraged to spend at least two hours per day outdoors.The most common reasons given for not providing myopia control were:
- Uneconomical
- Inadequate information
- Outcomes unpredictable or ineffective
- Concerns about safety
I found this very confusing because none of these are true!If you have similar concerns, the OSO will run four boot–camps this year about orthoK and myopia control.US researcher Dr John F. Dartini once said, “Deep inside every human being there is a yearning to do something extraordinary and to be of great, vast service to humanity.”I believe it is of great service to humanity to help prevent avoidable blindness with orthoK and other forms of myopia control.To me it is an extraordinary privilege to tell a parent – “I’m not just going to watch your child getting worse. I am going to do everything I can to slow his or her myopia so they are more likely to have a lifetime of great vision.”
 |
Name: Amanda RungisQualifications: MOptom, BOptom HonsBusiness: Sure Eye CarePosition: OwnerLocation: West Gosford, NSWYears in the profession: 31 years in the industry – 23 as an optometrist |
