Myopia epidemic is “here and now”

Andrzej Grzybowski  and Yuichiro Ogura, two of the chairpersons at the symposium on Myopia:New Perspectives and Treatments Educational pressures and the limited amount of time that children spend outdoors are the two major risk factors behind the rising epidemic of myopia in some parts of Asia, according to a leading expert at the EURETINA symposium on myopia. “There is an epidemic of myopia in the developed countries of East and Southeast Asia, which is linked both to the massive educational demands on children in this region and the limited amount of time that they spend outdoors,” said Professor Ian Morgan. Prof Morgan was one of the first investigators to challenge the dogma that myopia was primarily genetic in origin, and much of his research has focused on the link between environmental factors and myopia development. As early as 2008, his group reported data showing that time spent outdoors worked as a protective factor in young populations. Prof Morgan noted that while the prevalence of myopia does appear to be increasing in Europe, it is still quite a bit lower than in East Asia. “The data is not very clear in Europe. Studies on adults without cycloplegia suggest a prevalence of myopia as high as 40-to-50%, increasing with educational achievements, while other studies on adolescents and young adults with cycloplegia in Northern Ireland, Poland and Australia suggest a prevalence of the order of 20-to-30%. The latter studies with cycloplegia are probably closer to the true picture,” he said. Prof Morgan said that there is a pressing need to collect more comprehensive, methodologically sound and up-to-date data to ascertain a more accurate picture of the prevalence of myopia and high myopia among European populations. Such data, if available, might give European governments pause for thought in their rush to imitate the perceived educational achievements of developed countries in East Asia, said Prof Morgan. “Do they really want to copy the myopia epidemic of these countries with their intensive education systems?” he asked. The link between education and myopia has been well established by several landmark studies, said Prof Morgan. One major population study carried out at Mainz University Medical Centre in Germany reported that the higher the level of education completed, the more severe the impairment of vision. Undertaken as part of the Gutenberg Health Study, the results showed that while only 27% of those without any school graduation were myopic, the figure was 51% for high school graduates and 53% for university graduates. Furthermore, a study of the rates of myopia among boys attending Jewish orthodox schools, where study is very intensive, showed similar rates to the most-affected Asian countries, he said. The growing burden of evidence is finally prompting health authorities and governments in the countries most affected by the upsurge in myopia to take action to counteract the phenomenon. Singapore, for instance, has officially adopted more time outdoors as its myopia prevention strategy, but is approaching this by attempting to influence parental choices through information campaigns. The Chinese government is also considering measures to limit the amount of homework given to children in kindergartens and primary schools.