RISKS

ASSOCIATED RISKS OF MYOPIA

Myopia is associated with increased risks to eye health in adulthood.
  • Myopic macular degeneration (MMD)1
  • Staphyloma2
  • Retinal detachment3
  • Primary open-angle glaucoma4
  • Cataracts5
Of these diseases, MMD and retinal detachment are the most devastating and have the strongest relationship to myopia and longer axial lengths (Table 1).6 Among people aged 75 years or older, cumulative risk of visual impairment (decimal VA 0.30 to 0.05 [approx. 20/60 to 20/400]) or blindness (decimal VA worse than 0.05 [20/400]) from all causes increases from 3.8% in eyes with an axial length less than 26 mm to 25% in eyes with an axial length of 26 mm or greater and more than 90% in eyes with an axial length of 30 mm or greater.7

Table 1

Table 1: The increased likelihood (odds ratio) of a myopic person > 60 years developing eye disease versus an emmetrope by degree of myopia6

Table 1 Tips

*Applies to only Myopia of -6.00 to -10.00 D. Odds ratios are 7.8 for myopia of -10.00 to -15.00 D and 88 for myopia more than -15.00 D.
+Decimal visual acuity of 0.30 to 0.05 (approx 20/60 to 20/400).

THREATS

MYOPIA IS THE BIGGEST THREAT TO EYE HEALTH OF THE 21ST CENTURY

Eye care professionals should embrace therapies treating children as soon as signs of myopia appear in order to reduce the risk of sight-threatening complications in later life.

Prevalence of myopia

Prevalence of myopia has nearly doubled over the past 20 years.8

Both Eastern and Western populations

Both Eastern and Western populations exhibit the same troubling trend of increasing myopia.8

No safe level of myopia,

No safe level of myopia, with over 30% of MMD occurring in people less myopic than -6.00 D.9

Every additional diopter

Every additional diopter of myopia increases the risk of MMD by 67%.10

25% of people

25% of people with axial length ≥26 mm will develop visual impariment by age 75.7

Reduce the risk of sight-threatening complications in later life.

Prevalence of myopia

Prevalence of myopia has nearly doubled over the past 20 years.8

Both Eastern and Western populations

Both Eastern and Western populations exhibit the same troubling trend of increasing myopia.8

No safe level of myopia,

No safe level of myopia, with over 30% of MMD occurring in people less myopic than -6.00 D.9

Every additional diopter

Every additional diopter of myopia increases the risk of MMD by 67%.10

25% of people

25% of people with axial length ≥26 mm will develop visual impariment by age 75.7

MANAGING MYOPIA IN CHILDREN:
THE NEED FOR A NEW APPROACH

Myopia is a continuum of disease stages which should be assessed as early as possible. Myopia may continue to progress beyond the teenage years11 and the associated disease risk increases exponentially with severity of myopia,6,10 making early diagnosis and treatment crucial to lifetime eye health.

Children image

EARLY MYOPIA ONSET INCREASES RISK OF HIGH MYOPIA

Myopia progresses more quickly in younger children.12 Because early onset implies more years of progression, myopes younger than 12 are at greater risk of developing high myopia. This is why it’s essential to:
  • Examine all children at least once between the ages of 3-5 years to establish baseline measurements
  • Examine all children at least annually until they reach 18 years of age

Table 2

Table 2 : Classification of myopia by spherical equivalent refractive error13
EARLY MYOPIA ONSET INCREASES RISK OF HIGH MYOPIA

EARLY MYOPIA ONSET INCREASES RISK OF HIGH MYOPIA

Myopia progresses more quickly in younger children.12 Because early onset implies more years of progression, myopes younger than 12 are at greater risk of developing high myopia. This is why it’s essential to:
  • Examine all children at least once between the ages of 3-5 years to establish baseline measurements
  • Examine all children at least annually until they reach 18 years of age

Table 2

Table 2 : Classification of myopia by spherical equivalent refractive error13

REFRACTIVE ERROR PREDICTS MYOPIA ONSET

Numerous risk factors can help predict myopia’s onset, but the best predictor is cycloplegic spherical equivalent refractive error at a given age. A child with low hypermetropic refraction for a given age (Table 3) has greater than an 80% likelihood of myopia onset by age 13.13 This approach provides a simple clinical method to evaluate risk of myopia onset that is just as accurate as more complex algorithms.

Table 3

Table 3 : Cycloplegic spherical equivalent autorefraction threshold by age, for children at high risk of becoming myopic by 8th grade15
REFRACTIVE ERROR PREDICTS MYOPIA ONSET

REFRACTIVE ERROR PREDICTS MYOPIA ONSET