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Professor David Mackey & Dr Samantha Sze-Yee Lee
August 2021

Many people think that myopia (short-sightedness) is a harmless condition that simply requires wearing glasses or undergoing laser surgery to help with eyesight. However, myopia is linked with an increased risk of several eye conditions and visual impairment. The lifetime risk of visual impairment increases by 3 times if you have high myopia (worse than -6 dioptres) and by 22 times if you have very high myopia (worse than -10 dioptres).

Image of older man and woman trying on glasses at an optometrist

Having myopia, especially high myopia, also doubles the risk of glaucoma. Myopia is becoming more common in Australia and around the world. By the year 2050, 50% of the world population may have myopia, including 10% with high myopia – up from 23% and 3% in the year 2020!

More people will also be at increased risk of glaucoma and other myopia-related complications. It is unclear why people with myopia are at increased risk of glaucoma. We believe that it may be due to changes in the structure of the optic nerve as the eyeball grows longer in myopia.

Since myopia cannot be reversed, only controlled, we need to find effective myopia control methods. Myopia typically develops and progresses fastest during childhood. Thus, controlling myopia at a young age is promising. Several myopia treatment methods have been proposed, including atropine eye drops or orthokeratology (OK) contact lenses (special-designed contact lenses that are worn overnight). However, none of these proposed treatment methods has been proven effective in non-Asian children, whose eyes tend to be lighter and thus may react to various treatment methods differently. Moreover, because OK contact lenses are meant to be worn overnight, when the tears in our eyes are unable to wash away debris and protect us from infection, wearing OK lenses carry a small risk of infection. Atropine eye drops seem more promising in controlling myopia. Our WA Atropine for the Treatment of Myopia (WA-ATOM) Study is underway to explore its effectiveness.

The best myopia prevention method may be sunlight, or increased time spent outdoors. However, we don’t know if spending time outdoors can help control myopia that has already developed. A lack of time spent outdoors has been established as the major reason for the myopia epidemic. With increased city living and years of education, children are spending less time in the sun and more time indoors. Something as simple as encouraging children to spent at least 2 hours a day outdoors (with appropriate sun-protection habits) may enough to slow down this epidemic, and thus lessen the burden of glaucoma in the future generations.

Article by Professor David Mackey
Genetics and Epidemiology Group at the Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia.
Article by Dr Samantha Sze-Yee Lee
Postdoctoral Research Fellow
Genetics and Epidemiology Group at the Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia.