Asia’s Myopia Epidemic and the Race to Save Our Children’s Vision

May 3, 2024

By Tacy Song, Head of Professional Affairs, Myopia, APAC, Cooper Vision

Myopia, often dubbed as near-sightedness, has ignited global concern as its prevalence steadily escalates, affecting both adults and children worldwide. The condition is the most common refractive error among adults and children worldwide. ¹ In 2010 alone, a staggering 1.9 billion individuals – 27% of the global population– grappled with myopia, with an additional 170 million plagued by its severe form, high myopia. ² Fast forward to today, the numbers have surged exponentially over the past 14 years, painting a daunting projection for the future. Projections of myopia prevalence trends, as demonstrated in a study by Holden et. Al. (2016), found that by 2050, an estimated 52% of the population will have myopia while 10% will have high myopia. ³ However, the condition is especially acute in Asia. An estimated 80% to 90% of young adults in the region are grappling with the condition. ⁴ The economic burden of correcting myopia in adults is an estimated $328 billion annually. ⁵

Myopia is a multifactorial condition that impairs people’s ability to perceive objects at a distance. This occurs when the axial length is greater than normal causing the eyeball to be elongated or the cornea may be steeply curved. ⁶ Environmental factors such as inadequate outdoor time, prolonged near work, deficient exposure to light, and poor dietary habits compounds the issue. Genetic predisposition also plays a pivotal role in the development of myopia, further complicating the landscape.⁷

Asia’s growing myopia predicament

The epicentre of this myopia epidemic resides in Asia, where children bear the brunt of its impact. The disease has reached epidemic proportions as the prevalence of high myopia among Asians is higher (6.8% to 21.6%) than non-Asians (2% to 2.3%). ⁸ In Singapore, 65% of children develop myopia by the time they turn 12. ⁹A study in Taiwan found that the prevalence of myopia was 21% among seven-year-old children, over 60% among 12-year-olds, and over 85% among 18-year-olds in high school. ¹¹ Among late teenagers and young adults in Korea, Taiwan, and China, the prevalence of myopia is between 84% and 97%.¹⁰

There are several reasons for this unprecedented increase. The biggest reason is educational pressure due to which children spend long hours reading or studying in front of computer screens or poorly lit surroundings. This has also led to a drastic decrease in the time spent outdoors and getting enough sunlight. ¹¹

Complications of myopia

Myopia is often overlooked as it seems like a minor condition. However, if left untreated, it can lead to dangerous complications. It can progress to high myopia, necessitating a spherical correction of -5 diopters or more. Individuals who have high myopia are at a much higher risk of developing conditions that can lead to blindness as compared to those with low or moderate myopia. For instance, the occurrence of retinal detachment is five or six times greater in those with high myopia versus those with low myopia. Similarly, those with high myopia are 17% more likely to need cataract surgery as compared to those with moderate myopia. Additionally, those with high or moderate myopia are at a 50% greater risk of developing glaucoma compared to those with low myopia. Myopia maculopathy, a complication of myopia, is the main cause of irreversible blindness in Japan, China, and Taiwan. ¹²

Myopia can adversely impact the lives of children and adults. A study involving parents, teachers, and students revealed that poor vision or uncorrected visual impairments negatively affected their attention span, diligence, and participation in class activities, and caused psychosocial stress. ¹³Furthermore, vision impairments can lead to low academic grades, disruptive classroom conduct, an unfavorable school atmosphere, stress, decreased test performance, disengagement, and an increased dropout rate. ¹⁴In adults, the loss of productivity translates to an estimated loss of US$244 billion. As it is a lifelong condition, it can also adversely affect individuals’ quality of life. ¹⁵

Halting the progression

Treating myopia requires a multi-pronged approach. Eye Care Professionals need to focus on controlling and preventing its progression. Research has shown that slowing the progression of the disease by one diopter in childhood reduces the risk of developing macular retinopathy by 40%. ¹⁶ Several treatment modalities such as orthokeratology lenses, myopia control soft contact lenses, and atropine drops, have been shown to effectively slow the progression of myopia in children. ¹⁷ Parents too need to encourage children to spend time outdoors more often and get their eyes checked from time to time. Regular screenings are essential to detect myopia at its onset and take corrective action swiftly.

Soft contact lenses for kids

For children, wearing corrective glasses can be an inconvenience given how active some of them are. Soft contact lenses such as MiSight 1 day have shown immense potential in correcting vision and slowing down the progression of myopia by approximately 50% in children. ¹⁸These easy-to-use lenses are disposable and there is no hassle of cleaning and storing them. It is a safe and effective option for children between the ages of 8 and 12.¹⁹

Eye on the horizon

The ramifications of unchecked myopia extend far beyond impaired vision. Individuals need to understand that myopia is not just an inconvenience but a disease that requires management. Reducing the rate of myopia progression by 50% could reduce the prevalence of high myopia by up to 90% ²⁰ .Eye care professionals need to adopt innovative treatment modalities for children to prevent its progression from the onset. Implementing these modalities and proactive strategies in childhood can prevent high myopia and the associated complications. By fostering a culture of proactive eye care, empowering individuals with knowledge, and harnessing innovative interventions, we can help manage myopia and preserve children’s long-term vision, ensuring a brighter, clearer future for generations to come.

Sources:

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Tags: Eyecare, myopia, SaveOurChildrensVision