The Impact of Myopia and High Myopia: Report of the Joint World Health Organization - Brien Holden Vision Institute Global Scientific Meeting on Myopia
World Health Organization
University of New South Wales, Sydney, Australia
World Health Organization
The prevalence of myopia and high myopia are increasing globally at an alarming rate, with significant increases in the risks for vision impairment from pathologic conditions associated with high myopia, including retinal damage, cataract and glaucoma.
The impact of myopia is difficult to determine, because there are no standard definitions of myopia and high myopia, and recognition that myopia can lead to vision impairment is limited by the absence of a defined category of myopic retinal disease that causes permanent vision impairment.
A further impediment to progress in this area is insufficient evidence of the efficacy of various methods for controlling myopia.
Scientific and clinical experts in myopia were invited from all six WHO regions. Keynote presentations, working groups and plenary sessions were held to review the evidence on the major issues in myopia. The results of these deliberations were reported to plenary for discussion, and agreement was reached on a series of statements, definitions and priorities for research.
The group agreed on definitions of myopia and high myopia and on a category for and description of the pathologic consequences of myopia.
The epidemiological surveys currently used to measure the status of vision (e.g. the WHO protocol and Rapid Assessment of Avoidable Blindness) do not allow the definition of high myopia as a possible cause of vision impairment, partly because these surveys do not include a description of this condition or any measurement of refractive error. The group agreed that action should be taken to include myopia and high myopia among the attributable causes of vision impairment in the surveys currently used.
Measures for the detection and management of myopia should be an integral part of plans for the provision of eye-care services. They should be part of general health care for vision impairment due to (i) the uncorrected refractive error associated with (the increased prevalence of) myopia; and (ii) the pathologic consequences of myopia.
The term “myopic macular degeneration” (MMD) should be used clinically and in research to categorize the blinding retinal diseases associated with high myopia. Currently, a number of terms are used, including MMD, myopic maculopathy, myopic retinopathy and myopic choroidal neovascularization.
Epidemiological data are lacking on the prevalence of myopia, high myopia and vision impairment associated with high myopia in Africa, Central America, South America and Oceania. These areas should be priorities for future research.