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      IMI Impact of Myopia

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          Abstract

          The global burden of myopia is growing. Myopia affected nearly 30% of the world population in 2020 and this number is expected to rise to 50% by 2050. This review aims to analyze the impact of myopia on individuals and society; summarizing the evidence for recent research on the prevalence of myopia and high myopia, lifetime pathological manifestations of myopia, direct health expenditure, and indirect costs such as lost productivity and reduced quality of life (QOL). The principal trends are a rising prevalence of myopia and high myopia, with a disproportionately greater increase in the prevalence of high myopia. This forecasts a future increase in vision loss due to uncorrected myopia as well as high myopia-related complications such as myopic macular degeneration. QOL is affected for those with uncorrected myopia, high myopia, or complications of high myopia. Overall the current global cost estimates related to direct health expenditure and lost productivity are in the billions. Health expenditure is greater in adults, reflecting the added costs due to myopia-related complications. Unless the current trajectory for the rising prevalence of myopia and high myopia change, the costs will continue to grow. The past few decades have seen the emergence of several novel approaches to prevent and slow myopia. Further work is needed to understand the life-long impact of myopia on an individual and the cost-effectiveness of the various novel approaches in reducing the burden.

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          Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050.

          Myopia is a common cause of vision loss, with uncorrected myopia the leading cause of distance vision impairment globally. Individual studies show variations in the prevalence of myopia and high myopia between regions and ethnic groups, and there continues to be uncertainty regarding increasing prevalence of myopia.
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            Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis.

            Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment.
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              The epidemics of myopia: Aetiology and prevention.

              There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90%, and an accompanying high prevalence of high myopia in young adults (10-20%). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of "acquired" high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important.
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                Author and article information

                Journal
                Invest Ophthalmol Vis Sci
                Invest Ophthalmol Vis Sci
                iovs
                IOVS
                Investigative Ophthalmology & Visual Science
                The Association for Research in Vision and Ophthalmology
                0146-0404
                1552-5783
                28 April 2021
                April 2021
                : 62
                : 5
                : 2
                Affiliations
                [1 ]Brien Holden Vision Institute, Sydney, Australia
                [2 ]School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
                [3 ]Save Sight Institute, Sydney Medical School, The University of Sydney, New South Wales, Australia
                [4 ]Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
                [5 ]Johns Hopkins Carey Business School, Baltimore, Maryland, United States
                [6 ]Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
                [7 ]Glaucoma Center of Excellence, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
                [8 ]Duke - NUS Medical School, Singapore; Singapore Eye Research Institute, Singapore
                [9 ]The Ohio State University College of Optometry, Columbus, Ohio, United States
                [10 ]Health Promotion Service, Population Health, Liverpool Hospital, SWSLHD, Health - New South Wales, New South Wales, Australia
                Author notes
                [* ]Correspondence: Padmaja Sankaridurg, Brien Holden Vision Institute, Level 4, North Wing, Rupert Myers, Building Gate 14, Barker Street, University of New South Wales, Sydney, New South Wales 2052, Australia; p.sankaridurg@ 123456bhvi.org .
                Article
                IOVS-20-32033
                10.1167/iovs.62.5.2
                8083082
                33909036
                36994dab-2adb-41c3-a1dc-23c5ef27794e
                Copyright 2021 The Authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 26 December 2020
                : 21 December 2020
                Page count
                Pages: 14
                Categories
                Special Issue
                Special Issue

                myopia,high myopia,direct costs,lost productivity,quality of life,economic impact,disability,utility

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