Myopia a Public Health Challenge that demands Optometry’s leadership

Myopia is reaching epidemic proportions in our world. It is projected that by 2050 half of the world’s population will be myopic. ⁽¹⁾ Of this number 20% will have high myopia which can cause ocular disease that can result in blindness or vision impairment.⁽¹⁾ The consequences of this increase in prevalence is the pressure on eye health services both in the developing and developed world. The impact will be even greater in the developing world where we know that most countries battle to provide refractive services due to the prohibitive cost of eye wear or the lack of human resources.

The response to this public health challenge has to be led by Optometry which has refractive services as a core aspect of its scope. A multifaceted approach is needed:

• Awareness: Given the fact that time outdoors is seen as an effective prevention of myopia onset, health promotion efforts throughout the world needs to be accelerated. The combined eye and general health benefits of play time outdoors and less near work or screen time, makes this a no brainer. The investment and the tools being developed by the Global Myopia Awareness Coalition provides a good platform for the launching of such efforts at a country level.
• Research: Industry and optometry researchers have responded to this challenge of creating myopia management spectacle lenses and contact lenses. These interventions are promising but we need to focus on creating low cost options as well to ensure that all children throughout the world can access this technology.
• Human Resources: This is an ongoing challenge for the profession. The urgency to reach children once again is forcing optometry to confront the issue of human resource development. Upscaling training as well as using innovation such as teleoptometry has to become core to optometry’s strategy. Encouraging developments in this area needs to be amplified.
• Integration: Optometry’s response to myopia needs to be integrated with Education, Eye health and Health Systems. Currently most of Refractive Services are provided as a standalone vertical system.
• Advocacy and Policy change: Optometry needs to lead efforts to ensure that national policy exists that compels the health system to provide eye exams for all children entering school and for the state to ensure that free spectacles are available to all who cannot afford. National Associations should make this as a cornerstone of their efforts to establish the relevance of optometry in the provision of eye care services. The efforts of the Vision Impact Institute and partners in the US to get state level child eye exam policies are an indication of the benefit of combined advocacy efforts.

Optometry has the ability, the infrastructure, solutions and the responsibility to address this issue. What is needed however a global effort that is coordinated and focused. Should optometrists not respond to this challenge, history will judge the profession harshly for failing at a time when our HIV, Malaria, Diabetes moments have arrived.

References

1. Brien A. Holden, Timothy R. Fricke, David A. Wilson, Monica Jong, Kovin S. Naidoo, Padmaja Sankaridurg, Tien Y. Wong, Thomas J. Naduvilath, Serge Resnikoff. Ophthalmology. Volume 124, Issue 3, March 2017, Pages e24-e25