The Myopia Epidemic
There is no question that the prevalence of myopia (nearsightedness) is increasing worldwide. In
the US, it has been reported that 42% of the population is nearsighted, an increase that has
doubled over the past 30 years. In urban areas of China, Taiwan and Japan, the incidence already
approaches 80-90%. We have seen this in our practice as have other Ophthalmologists and
Optometrists. Indeed, it is projected that by 2050 half of the world”s population will be myopic.
While the reasons for this are not entirely clear, genetics obviously plays a role. Myopia tends to
occur in families and studies have shown that if both parents are myopic, up to 70% of their
children will be too. The other factor that appears to be significant is the change in lifestyle that
has occurred with the increased use of smartphones, tablets’ and computers.
While low myopia, if corrected with glasses, contact lenses or lasik is not necessarily
detrimental, high myopia, defined as over 6.00 diopters may be pathologic, causing vision loss
due to:
• Cataracts: clouding of the lens of the eye
• Glaucoma: increased pressure in the eye with damage to the optic nerve and loss of
peripheral vision leading to blindness
• Optic Neuropathy: deterioration of the nerve that conducts vision from the eye to the
brain
• Neovascularization: new blood vessel formation in the center of the retina causing
decreased vision
• Retinal detachment: pulling away of the retina from the back of the eye
So, how do we deal with this impending epidemic? Obviously, selecting sex partners based on
their eye prescription would be problematic and not very feasible!! However, lifestyle changes
could prove significant. Limiting screen time to less than 2 hours a day, following the 20-20-20
Rule (every 20 minutes take a 20 second break and look at something 20 feet away) to relax the
focusing eye muscles, and encouraging outdoor play may help.
Studies are being done on treatments to slow down the progression of or, hopefully in the future,
stop or even prevent the development of myopia. At present, we do have some options:
• Atropine: Used in a low dose, these drops work by relaxing the eye muscles, reducing
their ability to focus on near objects
• MiSight contact lenses: Special contact lenses with concentric rings, redirecting how
light hits the retina. Using a dual-focus design they reduce peripheral defocus, thus
preventing elongation of the eye with progression of myopia
• Myopia management eyeglass lenses: Eyeglass lenses that reduce the need to focus when
looking at near objects to relax eye muscles or those that defocus light hitting the
peripheral retina preventing elongation of the eye.
• Violet light-transmitting lenses: eyeglass lenses than emit violet light to mimic outdoor
light exposure
Of course, we do not recommend these treatments for everyone who is nearsighted, but for those
who are rapidly progressing or those whose parents are high myopes, it may be worth
considering.