This IMI Report discusses the prevalence of myopia and its impact on both the individual and society. It highlights gaps in our understanding of myopia and provides evidence to support and advocate for developing appropriate approaches and policies to manage myopia. Read the summary here.
A vision-screening program was able to provide data before and after Chinese schoolchildren were confined to home learning during the COVID-19 pandemic. Overall, more hours were spent indoors and less time was spent outdoors during this time, across all age groups. The younger schoolchildren had increased incidence of myopia and faster progression, whereas an increase in the prevalence of high myopia was found in the older children.
This study investigated the accuracy of the Brien Holden Vision Institute (BHVI) myopia calculator in predicting myopia progression. The extent of myopia progression over 1-2 years in children corrected with single vision spectacles was accurately predicted by the BHVI myopia calculator in 32-38% of 7-13 year old Hong Kong children. Around one-third progressed more and one-third progressed less than the range predicted by the calculator.
The Low-Concentration Atropine for Myopia Progression (LAMP) Study has provided invaluable data on comparisons between 0.05%, 0.025% and 0.01% atropine treatment. The three year data has shown 0.05% to be most effective for continued treatment, while children discontinued showed a small, ‘clinically insignificant’ rebound effect. Learn more about the one, two and three year LAMP data here.
Children aged 6 to 8 years old in China were found to experience a mean -0.30D myopic shift and a significant increase in myopia prevalence during a 5-month long COVID-19 home confinement period. Due to their age and corresponding critical stage in visual development, the change in the children’s environment and lifestyle may have been more responsible for their increased myopia than the increased online learning.
This multi-ethnic study found that parental myopia was a risk factor for myopia development in pre-school age children. The age the parents became myopic themselves had a dose-dependent effect in their children if both parents had onset of myopia before age 12. Eye care practitioners can use this to identify which children may benefit from early myopia treatment intervention.
This systematic review of 9 studies confirms that under-correction of myopia does not slow progression; rather, at least half of the studies have shown the myopia progression is accelerated. There was no benefit found in overcorrection, and the evidence for un-correction was equivocal. Clinically, this advocates for the full correction of myopia.
The Erasmus Medical Group in the Netherlands set out four steps in their myopia management protocol: providing visual environment advice, identifying high-risk myopes by axial length and treating them with atropine 0.5%, managing other myopes with optical treatments or lower-concentration atropine, and ceasing treatment in the late teens once axial length is stable. The described use of axial length percentile growth charts for diagnosis, choice of treatment, monitoring and cessation is a world-first.
Considering even emmetropic eyes elongate, what are the limits of myopia control efficacy? This novel analysis explores the absolute axial elongation of treated and untreated myopes in the MiSight 3-year clinical trial in comparison to previously published models of myopic and emmetropic eye growth. The results indicate a potential limit to the short-term percentage efficacy of myopia control treatments.
Previous multi-ethnicity studies have shown ‘normal’ axial elongation in emmetropic children to be around 0.1mm / year. In this study, 700 Chinese schoolchildren with stable emmetropia showed 0.2mm per year axial elongation from age 7-11, which reduced with age and ceased at age 15. This appears higher than measured in Singaporean Chinese children in the SCORM study, 20 years ago.
