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Today marks the official launch of The Australia and New Zealand Child Myopia Report – A Focus on Future Management’.  This report, launched by the Australia and New Zealand Child Myopia Working Group, brings together the latest evidence-based data to better understand this looming public health issue facing New Zealand children.

Myopia, or short-sightedness, is forecast to reach epidemic proportions.[1]  Alarmingly, increases in the prevalence of myopia and high myopia (a refractive error*of at least -5.00D in either eye)[2] mean that by 2020, it is estimated that more than 2 billion people worldwide will be affected.[3] By 2050, it is estimated that more than 50% of the world’s population will have myopia and 10% or almost 1 billion will have high myopia.[4]

Andrew Sangster, a member of the Australia and New Zealand Child Myopia Working Group, Optometrist and Board Member of New Zealand Association of Optometrists comments, “Myopia is rapidly becoming a serious public health concern in New Zealand, yet new research[5] shows that 69% of New Zealand parents (with children 0-17 years old) do not know what myopia is, and only 12% of parents recognise the health risk that their children might develop later in life from child myopia. This is of significant concern given that high myopia is also associated with comorbidities including retinal detachment, glaucoma, cataracts and myopic maculopathy. The risk of developing any of these conditions increases along with any increase in myopia.”[6]

Mr Sangster continues, “One reason for the increase in prevalence of high myopia is that the onset of myopia is occurring earlier in life.  In 1983, the typical onset of myopia was at around 11 years of age.  However in 2000, the average onset of myopia was just 8 years of age.[7]  Reducing the prevalence and impact of myopia and understanding influencing factors is critical.”

Myopia is a common condition that causes blurred distance vision and usually starts during childhood and typically progresses until the child stops growing.  There are two main risk factors for a child developing myopia: lifestyle and family history.

Lifestyle: modern lifestyles may influence the development of myopia.  These include:

  • Low levels of outdoor activity[8] and associated factors including:
  • Low levels of light exposure[9]
  • Prolonged near tasks such as reading.[10]

Family history: The likelihood of developing myopia, particularly high myopia increases when one or both parents are myopic.[11]  However, the exact link between a family history of myopia and the development of childhood myopia remains uncertain.[12]

It seems very little is known about lifestyle impacts on myopia. Less than 1% of New Zealand parents of children aged under 12 years say reducing screen time is the best course of action for primary-school-aged children diagnosed with myopia, and less than 1% acknowledged the role of increasing the amount of time spent outdoors.[13]

70% of parents do not know that genetics might influence the development of myopia in children, and 93% are not aware of the role that excessive screen time – TV, computers, mobile devices etc – can play in myopia prevalence and progression.[14]

New Zealand mum, Kirsten Cameron comments, “We first noticed that our daughter, Zara, had a problem with her eye sight two years ago. She was playing netball and struggling to find the ball when it was only metres away from her. We took her to see a local optometrist and she was diagnosed as myopic.

“I found an optometrist who talked to me about the different myopia management options available, and the importance of trying to slow its progression.

“I think awareness is very low when it comes to managing myopia, so it is really important to have a broader conversation with your Optometrist,”concludes Mrs Cameron.

Joe Tanner, Professional Services Manager, CooperVision ANZ says, “The potential for future vision loss is alarming, so initiatives that highlight the rise of child myopia are an important step in reducing its prevalence and impact. The newly established Child Myopia Working Group is an important initiative which aims to set a recommended standard of care for child myopia management in order to slow progression of myopia in children. We would recommend a shift from not only correcting vision but to also include a discussion with parents that explains what myopia is, lifestyle factors that can impact myopia, the increased risks to long-term ocular health that myopia brings, and the available approaches that can be used to treat myopia and slow its progression.”

KEY NEW ZEALAND STATISTICS:[15]

  • 77% of parents of children under 12 years old believe being prescribed glasses is the best course of action if a primary school age child is diagnosed with myopia.
  • Almost half (46%) of New Zealand parents of children aged 17 years and under admit they do not know what causes myopia.
  • Only 10% of parents know of the lifestyle factors that have an impact on child myopia (low levels of outdoor activity, low levels of light exposure, prolonged near tasks such as reading and gaming on portable devices).
  • 28% of New Zealand kids (17 years and under) have never been to have an eye examination.
  • 40% of New Zealand children have not been to an Optometrist to have an eye examination before their ninth birthday.
* Refractive error means that the shape of your eye does not bend light correctly, resulting in a blurred image. The main types of refractive errors are myopia (nearsightedness), hyperopia (farsightedness), presbyopia (loss of near vision with age) and astigmatism.

[1] The Impact of Myopia and High Myopia: Report of the Joint World Health Organization – Brien Holden Vision Institute Global Scientific Meeting on Myopia. University of New South Wales, Sydney, Australia. 16-18 March 2015
[2] ibid.
[3] ibid.
[4] ibid.
[5] CooperVision Australia and New Zealand: Child Myopia in New Zealand – consumer perceptions survey.  Conducted by YouGovGalaxy August/September 2018, conducted by YouGovGalaxy between Wednesday 29 August and Monday 3 September 2018. The sample comprised 500 parents of children at home aged 0-18 years. 
[6] Fricke TR, Jong M, Naidoo KS, Sankaridurg P, Naduvilath TJ, Ho Suit SM, Wong TY, Resnikoff S, Global Prevalence of Visual Impairment Associated with Myopic Macular Degeneration and Temporal Trends from 2000 through 2050: Systematic Review, Meta-Analysys and Modelling. Br. J Opthalmol, April 2018
[7] Lin LL, Shih YF, Hsiao CK et al. Prevalence of Myopia in Taiwanese School Children: 1983 to 2000. Ann  Acad Med Singapore 2004; 33:27-33
[8] He M, Xiang F, Zeng Y et al. Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial. JAMA 2015; 314:1142-1148
[9] Read SA, Collins MJ, Vincent SJ. Light Exposure and Eye Growth in Childhood. Investigative Ophthalmology and Visual Science 2015: 56(11):6779-6787
[10] Ip JM, Saw SM, Rose KA, Morgan IG, Kifley A, Wang JJ, Mitchell P. Role of Near Work in Myopia: Findings in a Sample of Australian School Children. Investigative Ophthalmology and Visual Science 2008:49(7):2903-2910
[11] Lim LT, Gong Y, Ah-Kee EY, Xiao G, Zhang X. Impact of parental history of myopia on the development of myopia in mainland China school-aged children. Ophthalmology and  Eye Disease. 2014;6:31-5
[12] Ip J, Huynh S, Robaei D, Rose K, Morgan I, Smith W, Kifley A, Mitchell P. Ethnic differences in the impact of parental myopia: Findings from a population-based study of 12-year old Australian children. Investigative Ophthalmology and Visual Science. 2007:48:2520-2528
[13] CooperVision Australia and New Zealand, op.cit.
[14] ibid.
[15] ibid.
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