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Optometrists should lead effort to mitigate myopia
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Myopia. Perhaps no other ocular malady – at least in the public’s eye – is more synonymous with optometry, and for good reason. For millions of people worldwide every day, a few clicks of the phoropter is a life-enhancing, if not life-altering, experience. In fact, for some of our colleagues, developing myopia as a child and remembering vividly their first eye examination is the very reason they became an optometrist. The simple act of correcting myopia is powerful and gratifying for patient and optometrist alike. Quite simply, it is an act that never gets old.
Over the past century optometry has honed the art and science of correcting myopia. We have perfected the time-honored manifest refraction and we have embraced newer technologies, all in the spirit of providing a better outcome. We have also incorporated spectacles, contact lenses, corneal reshaping therapy and laser vision correction strategies, again, all in the spirit of providing our patients with a better visual experience. In many respects one could argue we have perfected myopia correction and that, quite frankly, our job here is done. The reality is that nothing could be further from the truth.
Maybe I am being an alarmist. After all, it is just myopia. Prescribe some minus lenses and the problem is solved, right? Well, if you consider the facts, myopia is not such a benign entity. Over the past 30 years the prevalence of myopia has soared globally, resulting in a staggering societal economic burden. This does not even consider the millions of myopic individuals around the world without access to eye care. Myopia’s impact on their collective quality of lives is immeasurable.
While we still lack a complete understanding of myopia development, we do know certain things. Escalating educational mandates, longer screen times and fewer outdoor activities seem to be taking its toll on our youth – with no sign that these trends are reversing any time soon. Most disturbing is the reality that with increasing myopia comes a commensurate increase in the number of individuals with moderate to severe myopia, conditions we have long recognized as being anything but merely refractive, with their increased risk of retinal detachment, maculopathy, glaucoma and early cataract. While these trends are not necessarily cause for alarm, they are certainly cause for action.
In this “new era of myopia,” it is only appropriate that optometry take a lead role. Rather than tag along for the myopic ride – dishing out more minus along the way – it is really incumbent upon us to be more proactive in mitigating myopia. Perhaps this involves counseling patients regarding behavioral and environmental risks. Maybe this involves adopting treatment options ranging from atropine therapy to myopia-controlling contact lenses. While we do not yet have all the answers, we certainly have enough knowledge to begin effecting change. Now.
In this issue of Primary Care Optometry News, our feature article, “Concern for myopia progression increases with alarming rise in global prevalence” provides a timely and insightful overview of this very subject. Read it, and I am pretty sure you will agree we all need to be a little less myopic with respect to myopia.