The epidemics of myopia: Aetiology and prevention

Ian G Morgan, Amanda N French, Regan S Ashby, Xinxing Guo, Xiaohu Ding, Mingguang He, Kathryn A Rose

Research output: Contribution to journalReview article

54 Citations (Scopus)

Abstract

There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90%, and an accompanying high prevalence of high myopia in young adults (10-20%). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of "acquired" high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important.

Original languageEnglish
Pages (from-to)1-16
Number of pages16
JournalProgress in Retinal and Eye Research
Volume62
Early online date22 Sep 2017
DOIs
Publication statusPublished - Jan 2018
Externally publishedYes

Fingerprint

Myopia
Causality
Young Adult
Degenerative Myopia
Pressure
Low Vision
Southeastern Asia
Far East
Israel
Blindness
Randomized Controlled Trials
Learning
Organizations
Education

Cite this

Morgan, Ian G ; French, Amanda N ; Ashby, Regan S ; Guo, Xinxing ; Ding, Xiaohu ; He, Mingguang ; Rose, Kathryn A. / The epidemics of myopia: Aetiology and prevention. In: Progress in Retinal and Eye Research. 2018 ; Vol. 62. pp. 1-16.
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abstract = "There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90{\%}, and an accompanying high prevalence of high myopia in young adults (10-20{\%}). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of {"}acquired{"} high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important.",
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The epidemics of myopia: Aetiology and prevention. / Morgan, Ian G; French, Amanda N; Ashby, Regan S; Guo, Xinxing; Ding, Xiaohu; He, Mingguang; Rose, Kathryn A.

In: Progress in Retinal and Eye Research, Vol. 62, 01.2018, p. 1-16.

Research output: Contribution to journalReview article

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AU - Morgan, Ian G

AU - French, Amanda N

AU - Ashby, Regan S

AU - Guo, Xinxing

AU - Ding, Xiaohu

AU - He, Mingguang

AU - Rose, Kathryn A

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