The long view on short-sightedness

Ensuring equal access to myopia management options is a question of public health

Week 21 myopia

British flags are ubiquitous approaching the Queen’s Platinum Jubilee weekend – in the supermarket aisles, decorating window displays, landmarks on the miniature arctic terrain of frozen cocktails.

As an outsider, from New Zealand, I have observed the different facets of British culture, from your wonderful baking shows, to your elaborate Christmas jumpers, excellent queuing protocol and wry sense of humour.

But when I reflect on what the country is proud of, I come back to that public-serving institution that is unique internationally – the National Health Service.

The idea that you do not need your wallet when you make a trip to the GP still seems remarkable to me, five years on from reading my first polite notice (‘Please keep quiet and respect our neighbours when leaving the premises’).

At the heart of the NHS is the concept that someone should not be denied medical care because of their postcode or their bank balance.

This principle has remained in the back of my mind as I have observed discussions of myopia management gain momentum within optometry.

Optometrists have heard that the global prevalence of myopia will close to double by 2050 – with one in two people experiencing short-sightedness.

The evidence behind different management options is building, from soft contact lenses to orthokeratology, myopia control spectacle lenses and pharmaceutical solutions, such as low dose atropine.

Researchers have highlighted that slowing the progression of myopia can reduce an individual’s lifetime risk of developing potentially sight-threatening pathology – such as retinal detachment, glaucoma and myopic maculopathy.

For optometrists, this has the potential to raise a conundrum when they have a myopic child before them in the chair.

Should they explain the implications of myopia for the health of the eye, even if the parent cannot afford to embark on a course of treatment?

As research supporting the safety and effectiveness of myopia management grows, scientists, industry and the profession should prioritise making the case for proven interventions to be funded under the NHS.

Everyone deserves a right to sight as they get older – for the big moments like seeing a grandchild for the first time to the more mundane things such as critiquing the outfits on Strictly Come Dancing.

Only when we centre the myopia management conversation around public health can we truly protect the vision of future generations.