It took a few years, but I finally got it.
The topic of myopia has been bubbling away beneath the surface throughout my time since qualification. Indeed, Professor Bernard Gilmartin’s group were laying the grounds for a lot of what we know today even while I was a student at Aston back in the 1980s.
Though the frightening prevalence figures forced even the most sceptical hyperope to accept that the world was steadily becoming myopic, the problem of myopia still seemed a Wuhan-like distant concern, unlikely to affect the UK other than to maintain a healthy market for vision correction. Furthermore, excitement around attempts to limit myopia, where progression over a year was reduced by a fraction of a dioptre, seemed somewhat overblown.
But then I got it. Just as the likely causes of the increased incidence were cumulative, so were the interventions. What limits growth of the eye over one year will have a much greater impact over many years. And when you throw in the figures linking eye disease with extent of myopia, the argument is won. As the always excellent Bruce Evans noted at the Hoya Myopia Symposium, held last weekend during the EAOO conference, we should all be thinking about treating myopia and not simply managing its effect. Indeed, the GOC Standards of Practice suggest, now we have a robust database of evidence, myopic patients should all be advised of the benefits of myopia management.
But the challenge is not just to the researchers. I asked my wife this morning whether she thought myopia was a disease – she thought I was mad (yet again). It is just two years ago when I had a CET article about myopia rejected by CET approvers as, I quote: ‘Myopia is not a disease.’
I think the time has come to adopt the World Council of Optometry proposal and start limiting myopia progression. Reduced refractive error equals less eye disease.
