Much of this week’s clinical section has been given over to a review paper by Professor Philip Morgan which offers a useful and up-to-date review of the efforts to intervene in the progression of myopia.
The full reference list has been included because this is one of several areas where it is essential to keep to the facts, rather than the more anecdotal or opinion-led, when parents are asked about ways they might help their children when myopia is first discussed.
This is sometimes prompted by an article in the mainstream press that perhaps has tended to the sensational or even erroneous. I remember a feature on breakfast TV a few years ago led viewers to believe that deliberate under-correction of myopia by optometrists had hastened myopic progression.
Accurate correction of the measured myopia is important and this incident was a useful reminder of the ease with which a message can be misinterpreted or misunderstood by the media.
Ultimately, it is perhaps best to consider myopia in terms of genetic and environmental influences. Until gene therapy is completely, ethically and safely available, understanding the environmental influences is useful. So, for example, the role of exposure to natural daylight has been of interest to researchers. So much so, that schools are being built in China with outdoor classrooms in an effort to try and stem the epidemic of myopia.
Other interventions, either through lens design or corneal shape change, can alter refractive influences upon posterior chamber growth and these are showing a reduction in progression, albeit perhaps not as much as many parents would want. Limitations of environmental factors has led one authority to suggest the best approach for a myope to protect their future offspring is ‘to marry a hyperope’.