Prevention and Treatment of Myopia in Children

Dear Colleagues,

Myopia is the most common eye disorder worldwide and is often mis-regarded as a refractive error that can simply be corrected with spectacles, contact lenses, or refractive surgery. However, myopia, especially in higher amounts, is associated with an increased risk of serious ocular complications that can cause permanent visual loss. Eyes with high myopia often develop degenerative changes in the macula, optic nerve, or peripheral retina, and can develop retinal detachment, myopic macular or choroidal degeneration, glaucoma, or cataract.

In recent decades, myopia has shown a rapid increase in prevalence globally. Recent studies estimate that by 2050, the number of myopic people is expected to increase to 49.7% of the world population, with 9.8% having high myopia. Because of this increase in prevalence, as well as the possible serious complications connected with myopia that can cause blindness, the World Health Organization (WHO) considers myopia as one of the five immediate priorities in the “Vision 2020” initiative for the Elimination of Avoidable Blindness.

Myopia is a multifactorial disease whose prevalence depends strongly on ethnicity. While in the European and American populations the prevalence of myopia among high-school children is 30%, in urban areas of East and Southeast Asia, 80-90% of children completing secondary school are myopic. On the other hand, in rural Mongolia, although belonging to the Asian population, the prevalence of myopia is only 5.8%, considered to be due to a connection of myopia prevalence with the lifestyle as well as genetic predisposition.

Prevalence is multifactorial and caused by the profound interaction between genetic factors, such as parenteral myopia and ethnicity, and environmental factors, with genetic predisposition playing only a limited role in the development and growth of myopia. Epigenetic changes as well as environmental factors play a bigger role, which offers the scientific community hope and the possibility to intervene in the progression of myopia in children. Our understanding of the regulatory mechanisms that result in the development of myopia is still incomplete, but interest in the topic is growing enormously.

The supposition that spending time outdoors has a preventive role in myopia development has been investigated in many epidemiological studies. One of the biggest breakthroughs has been made in the discovery that the mechanism of eye growth is influenced by retinal images across a wide area of the retina and not only by the fovea. Nowadays, children all over the world wear glasses that are proved to control myopia. These glasses have different refractive powers (diopter) in the center and periphery, following and adapting to the curvature of the eye so that each point on the retina is equally correctable using separate diopters, regardless of whether it is in the center or on the periphery. Ortho K lenses employ the same principle and are also proved to be helpful. Another interesting discovery is that low doses of Atropine that can be used for myopia control.

Today, the scientific community is alert and active, placing a lot of optimism on the recent findings in the field of myopia control in children. The aim of this Special Issue is to give clinicians and researchers in the field insight into the recent developments, as well as to inform other disciplines that can help in the education and promotion of myopia control in children.

Dr. Ivana Mravičić
Dr. Maja Bohač
Guest Editors

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• myopia control in children
• myopia control glasses
• Atropine for myopia treatment
• DIMS glasses
• HALT glasses