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Myopia: A Silent and Growing Epidemic

FRANCE — Today, close to 40% of adults in France are nearsighted. Experts say that in 2050, that number could be as high as 60%. The Institute for Medical Education and Prevention (IEMP) has launched a nationwide campaign to raise awareness about myopia, a vision condition that many people still don’t know a lot about.

Screens vs Natural Light

“Myopia is a global epidemic. It affects 2.5 billion people around the world. And if steps aren’t taken, in 2050 that number will be 5 billion,” warned Thierry Bour, MD, president of the French National Union of Ophthalmologists (SNOF). In France, the prevalence of myopia was 15% in 1950. These days, it’s 40%. “In some parts of Asia, 90% of young adults are nearsighted.”

Several factors influence the progression of myopia. There are environmental factors — from the ubiquity of screens and the lack of natural light to studying for long periods of time and engaging in near work. And these factors combine with genetic factors; a child is twice as likely to be nearsighted if he or she has one parent who is nearsighted and three to eight times more likely if both parents are nearsighted.

Furthermore, myopia brings with it an increased risk for glaucoma, cataracts, and retinal detachment. “We must act quickly to put the brakes on this epidemic. And we can do that by using things we already have: glasses, contact lenses, eye drops,” Bour pointed out. “In addition, we can promote prevention, in particular by encouraging people to increase their exposure to natural light.”

Lack of Knowledge

In an Ipsos survey of 3601 people conducted in April, 43% reported that they had myopia. But one out of two participants could not provide a good definition of the condition. And most parents did not know the signs that suggest that a child may be nearsighted, such as excessive blinking, frequent headaches, eyestrain, and tiny handwriting. The Ipsos survey also showed that there was a lack of knowledge about the risk factors for myopia, such as spending a lot of time reading every day and having little exposure to sunlight. And many were not aware that heredity played a part.

Only 23% of respondents knew that the more time a child spends outdoors, the less likely they are to develop myopia. As a result, they didn’t know that to help prevent a child from becoming nearsighted, sufficient light should be provided when activities are being done on a screen, time spent on near work should be limited, and at least 1 hour a day should be spent outdoors. According to the survey, 3- to 6-year-olds spend 3½ hours per day in front of screens. For 11- to 13-year-olds, it’s just a shade under 7 hours, and for 13- to 17-year-olds, it is 7½ hours.

As for screening, there is clearly room for improvement. One third of those questioned did not know the importance of screening children for myopia as young as possible, although two thirds were aware that it’s recommended that children go to an ophthalmologist before starting first grade.

The survey also indicated that there was still not enough public information about the risks for complications from myopia. Eight out of 10 people questioned did not know that the sooner myopia begins, the faster it progresses; nor did they know that it can bring complications, including blindness. And this lack of knowledge turns up among people who themselves are nearsighted, only one third of whom have gotten information about the risks associated with the progression of their condition.

Finally, 9 out of 10 people questioned did not know that refractive surgery cannot prevent myopia-related complications from arising. Many people were not even aware that there are interventions that can slow the progression of myopia: 61% believe that there is not a lot that can be done.

“Various measures need to be implemented to put the brakes on childhood myopia,” said Dominique Bremond-Gignac, MD, PhD, head of the ophthalmology department at the Necker-Enfants Malades Children’s University Hospital in Paris. “First, preventive actions, such as prohibiting children from using screens, promoting outdoor activities, reducing the amount of time spent on near-vision work, and establishing early bedtimes. There are also actions that can be taken to slow the progression of myopia, such as using defocus incorporated multiple segments spectacle lenses or defocus incorporated soft contact lenses. Even wearing rigid gas permeable Ortho-k lenses overnight. And one drop a day of microdosed atropine is very effective.”

National Education and Screening

To raise awareness about this vision condition, the IEMP has just launched a myopia education and screening campaign in France.

Bruno Assouly, MD, is the director of the IEMP. “We have four goals: to raise awareness about myopia-related risks, to urge early screening for at-risk individuals, to encourage people who have high myopia to go for regular checkups, and to get healthcare professionals, ophthalmologists, and pediatricians on board for better educating patients about myopia.” People can get more information online. The site also has a myopia simulator and a questionnaire for parents. There is a special section for physicians. Here they can find thematic dossiers and case reports.

In addition, the 1st Annual National Days of Myopia Education and Screening are scheduled to take place November 21-25. This event will give people across France the opportunity to find out more about myopia. In addition, at-risk individuals will be able to get a screening at one of our partner clinics. “We ask that ophthalmologists and pediatricians join us and take part in this event,” Assouly said. “They can sign up on our website and then they will be added to the map showing those clinics.”

This article was translated from the Medscape French edition.

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