Key strategies to reduce the global burden of myopia: consensus from the international myopia summit

Abstract

In this paper, we describe key strategies to guide global collaborative efforts to further reduce the burden of myopia and myopia-related visual impairment. A modified Delphi method was applied as an iterative multistage process to collect expert and stakeholders' opinions and extract consensus strategies regarding myopia diagnosis, prevention and control. Anonymous pre-meeting preparation rounds, structured discussions for prioritisation and the development of key consensus areas were performed. Consensus was reached on three key areas to collaborate and complement existing frameworks: (1) Myopia defined not only as a refractive error but also as a disease with phenotypic features allowing for risk stratification of significant visual impairment. (2) In addition to preventive strategies, a focus is needed on preventing progression to high myopia (HM). (3) A focus on preventing and treating pathologic myopia (PM), that is, end-stage of myopia disease with irreversible visual impairment. In conclusion, the workgroup suggests a global, collaborative strategy that is needed across public health, healthcare and advocacy sectors to support efforts in reducing visual impairment from myopia. Complementary to existing preventive public health efforts, additional focus on defining myopia as a disease with risk stratification for visual impairment and an emphasis on reducing visual impairment associated with HM and PM should be considered.

Keywords: Child health (paediatrics); Epidemiology; Public health; Treatment Medical; Vision.

Figure 1. Flow chart of the modified Delphi method applied for the 2024 International Myopia Summit.

Figure 2. Three consensus strategies to tackle myopia and prevent myopia-related visual impairment and blindness. Necessary action level and resource allocation according to proposed disease stages of myopia. In the public health space, more health economic studies on the long-term impact of high myopia (HM) and especially pathologic myopia (PM) and myopia-related complications need to be conducted to engage governments and public health authorities for future allocation of resources. Future clinical research needs to involve longitudinal studies to examine the course of progression from HM to PM, allowing for the identification of risk factors and biomarkers to stratify individuals at risk of progression, as well as for the development of novel diagnostic and therapeutic targets. The new knowledge could further provide a basis for introducing screening for future PM in adults aged 30–40 years. Investment is needed in the basic research and development in both the academic and industry realms to develop innovations to treat patients with PM and myopia-related complications.

Figure 3. Overview of the current challenges and the workgroup consensus on the proposed adjunctive strategies, as outlined in this paper.