Collaborative Strategies to Address the Myopia Epidemic

by Heidi Wagner, OD, MPH, FAAO, FNAP
Cleveland Clinic

As defined by the American Optometric Association, Doctors of Optometry (e.g., ODs, optometrists) are primary eye care providers who examine, diagnose, treat, and manage diseases and disorders of the eye and visual system.¹  Their clinical expertise extends beyond vision correction and refractive error management; they also diagnose and treat ocular diseases such as glaucoma, macular degeneration, and dry eye syndrome.  In addition, optometrists play a critical role in the early detection of systemic health conditions—including diabetes, hypertension, autoimmune disorders, and neurological disease—by identifying ocular manifestations observable during routine eye examinations.  Early identification of these signs supports timely referral and coordination with other healthcare professionals, ultimately improving patient outcomes and contributing to public health.

One area in which optometrists have assumed a more central role is addressing the global rise in myopia, particularly among children and adolescents.  Epidemiological projections estimate that by 2050, nearly half of the world’s population will be myopic, with about 10% developing high myopia (severe nearsightedness).²  This trend poses significant risks, as high myopia is associated with vision-threatening complications such as retinal detachment, myopic maculopathy, cataract, and glaucoma.³  The increasing prevalence of high myopia places long-term demands on healthcare systems, necessitating expanded access to care, ongoing monitoring, and in some cases, surgical intervention.

Optometrists are at the forefront of clinical efforts to manage this growing epidemic.  They implement evidence-based strategies—such as low-dose atropine, orthokeratology (overnight corneal reshaping lenses), and soft multifocal contact lenses—to slow axial elongation and refractive progression in youth.  These interventions are not curative, but clinical trials have shown them to effectively reduce the rate of myopia progression, helping preserve functional vision and reduce the risk of long-term ocular complications.

However, managing the myopia epidemic requires more than clinical intervention alone.  Myopia has a multifactorial etiology shaped by genetic predisposition and environmental influences.  Although the specific role of environmental exposures is not fully understood, there is consistent evidence that increased time spent outdoors is protective against myopia onset.⁴   In contrast, the impact of digital screen use and prolonged near work on myopia development and progression remains uncertain, highlighting the need for further study.

Fully addressing these factors necessitates coordinated efforts beyond the exam room.  Pediatricians, school nurses, public health professionals, educators, and policymakers help foster visual health by advancing health education and implementing child-centered eye care policies.  Public health campaigns may help raise awareness among parents and educators.  At the same time, policymakers can support early intervention by integrating vision care into child health programs and improving access to eyecare services, particularly in underserved communities. 

Ultimately, effective myopia management will depend on an interdisciplinary approach.  Collaboration across healthcare, education, and public policy is essential to reducing the incidence and severity of myopia, alleviating the long-term burden of vision impairment, and protecting ocular health throughout the lifespan.

References

1. American Optometric Association.  Accessed August 1, 2025.  https://www.aoa.org
2. Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S.  Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050.  Ophthalmology.  2016 May;123(5):1036-42.
3. Haarman AEG, Enthoven CA, Tideman JWL, Tedja MS, Verhoeven VJM, Klaver CCW.  The complications of myopia: A review and meta-analysis.  Invest Ophthalmol Vis Sci. 2020 April 9;61(4):49.
4. Xiong S, Sankaridurg P, Naduvilath T, Zang J, Zou H, Zhu J, Lv M, He X, Xu X.  Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review.  Acta Ophthalmol.  2017 Sep;95(6):551-566.
5. Brennan NA, Cheng X, Jong M, Bullimore MA.  Commonly held beliefs about myopia that lack a robust evidence base: 2025 Update.  Eye Contact Lens.  2025 May 21;51(8):319-335.