An article review by Dr. Thomas Aller, OD, FBCLA
Original article was published under the title "Looming myopia problem: an ophthalmologist's perspective" at www.optometry.org.au June 23, 2017.
This is a well-written article by an Australian retinal surgeon dealing with the real consequences of an increasingly myopic world. Dr. Sharma shows great empathy and concern about his young patient with a retinal detachment and how this detachment, the surgery and recovery and the lifetime risks associated with an eye which has progressed to -10.00, will continue to affect this young man’s life.
As an ophthalmologist on the front lines of the war against myopia, Dr. Sharma points out that the ocular pathologies associated with myopia such as retinal detachments, myopic macular degeneration, cataracts, and glaucoma will be largely faced in the future, but there are real opportunities to begin to lessen those future consequences simply by acting to control myopia now. I would point out, though, that the risks associated with these pathologies increase with any level of myopia, so I would suggest that we get serious about any level of myopia.
He correctly points out that optometrists will be largely responsible for reducing the future burdens from myopia, and I sense he would be quite happy if his retinal practice doesn’t get too busy in the future dealing with myopia related pathologies.
The only slight correction I might add is that while he correctly points out that atropine and orthokeratology are effective means to control myopia, he failed to mention multifocal contact lenses and outdoors activities. If a society wishes to dramatically lessen the future costs of myopia, it really has to adopt strategies that can be used on a great majority of patients. Orthokeratology requires specialty level care and not everyone will be willing to take an off-label medication, but there are a wide range of multifocal contact lenses which can fit a very large percentage of the population. Spending more time outdoors is inexpensive, can be done by most anyone and the evidence is fairly strong that it will delay the onset of myopia, so it should always be part of the advice that we give.