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Treat myopia as a disease, speakers say
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NEW YORK – Myopia is a disease, two speakers here at Vision Expo East said, and myopia progression should be managed.
“It’s not just refractive error,” S. Barry Eiden, OD, FAAO, told attendees during the Global Contact Lens Forum. “There’s a greater risk for a host of ocular health problems –glaucoma, retinal detachment, earlier cataract development and development of myopic macular degeneration. It’s the leading cause of visual impairment for many countries.”
Myopic macular degeneration is the seventh leading cause of blindness in U.S., he added.
Jeffrey Cooper
S. Barry Eiden
The incidence of myopia has dramatically increased, Eiden said, and is currently more than 50% of the U.S. population. Some countries, such as South Korea and China, are nearing an incidence of 100%.
The Brien Holden Vision Institute estimates that in 2020 there will be 2.5 billion myopes in the world, he said.
“It’s a lifetime economic burden,” Eiden continued, “with glasses and contacts, treatment of secondary diseases, reduced quality of life and reduced productivity.”
“When I started practice, [the cause of myopia] was genetic or due to a near environment,” Jeffrey Cooper, MS, OD, FAAO, said. “It was one or the other. Early experimentation showed that (in animals), if the eye was occluded, the axial length grew.
Animal models showed you could change the axial length by putting certain lenses on the eyes. The peripheral portion was found to regulate growth.”
Studies are showing that outside exposure reduces the development of myopia, he said.
“However, once you’re myopic it has no effect,” Cooper said. “If you have someone with two parents who are myopic and they’re young and not myopic, get that kid outside.”
Computers are driving children indoors to do close work, he said.
“It’s making us much more myopic,” Cooper said.
He referred to recent research where scientists identified a gene in mice that affected myopia.
“If they had the gene and you altered their environment, the mice became myopic. If they didn’t have the gene, they didn’t become myopic,” Cooper said.
They also found that humans who had the gene and did a lot of close work became myopic, he added.
Both clinicians noted that managing the progression of myopia with contact lenses or pharmaceutical agents is off-label treatment. – by Nancy Hemphill, ELS, FAAO
Reference:
Cooper J, Eiden B. Global Contact Lens Forum: Management of myopia progression with contact lenses. Presented at: Vision Expo East. April 14-17; New York.
Disclosures: Cooper is the inventor of Computer Orthoptics and HTS, office and home computerized vision therapy programs. Eiden is a consultant, lecturer or conducts research for or has a financial interest in Alcon, Alden, Bausch + Lomb, Brien Holden Vision Institute, CooperVision, Paragon, EyeVis Eye and VisionResearch, SpecialEyes and SynergEyes.