This document summarizes the key findings from a global meeting on myopia held in 2015. It discusses the definition and prevalence of myopia, which is increasing worldwide and projected to affect half the global population by 2050. High myopia can lead to vision threatening conditions like myopic macular degeneration. Near work and less time outdoors are associated with increased risk of myopia progression. Controlling progression through increased outdoor time, reduced near work, and treatments like low-dose atropine and multifocal lenses may help reduce risks of vision impairment. More research is still needed on causes and management of myopia, especially high myopia.
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
Gives a very brief review of how to evaluate a case of squint in day to day clinical practice. How to diagnose a basic abnormality of the movement of eye.
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
Gives a very brief review of how to evaluate a case of squint in day to day clinical practice. How to diagnose a basic abnormality of the movement of eye.
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
Dear viewers Check Out my other piece of works at___ https://healthkura.com
Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
Dear viewers Check Out my other piece of works at___ https://healthkura.com
Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
Clinical study of fundal changes in high myopiaiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Myopia is considered to be a leading cause of visual impairment. Furthermore, the prevalence of myopia young adolescents has increased substantially over the
past few decades. Although myopia was identified more than two thousands years ago, a consistently effective approach to myopia control for all patients still eludes
clinicians
A lay forum lecture about digital eye strain, dry eye disease in children, myopia and stopping myopia, other refractive errors, common causes of eye consults, some eye myths, the truth about blue light filter in glasses, and a little bit about presbyopia and cataract for parents of Xavier School Nuvali, July 31, 2022
Reducing Uveitic Glaucoma: therapeutic judgement is the keyiosrphr_editor
Abstract: Background: Uveitic glaucoma (UG) due to disease and /or therapeutics is an important reason for reduced vision. Different therapeutic regimen employed in uveitis can alter the course of UG. Purpose: Evaluation of prevalence of UG with different commonly used therapy. Study design: Randomised prospective hospital based study Study Period: 2007-2012 Methods: Baseline IOP; Field and optic nerve head photographs were recorded. Three groups were randomised: 1.topical steroid 2.Systemic steroid +gr 1, 3.Topical synthetic steroids, cycloplegic and periorbital triamcinolone injection. Outcome measure: IOP more than 22 mm/4 mm increase from baseline is marker.
The National Programme for Control of Blindness (NPCB) launched in 1976. The Trachoma Control Programme started in 1963 was merged under NPCB in 1976.
In the beginning, NPCB was a 100% centrally sponsored program (now from 12th FYP it is 60:40 in all States/UTs and 90:10 in hilly states and all NE States).
The nomenclature of the program was changed from National Programme for Control of Blindness to National Programme for Control of Blindness & Visual Impairment (NPCBVI) in 2017
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Light House Retreats: Plant Medicine Retreat Europe
Impact of myopia and high myopia
1. THE IMPACT OF MYOPIA
AND HIGH MYOPIA
Report of the Joint World Health Organization–Brien Holden Vision Institute
Global Scientific Meeting on Myopia
3. Myopia
• Aristotle (384-322 BC)
Credited with first distinguishing myopia
• Galen (131-201 AD)
Derived the term ‘myopia’
• Myopia=myein (“too close”) and ops (“eye”)
• Results when an eye has excessive refractive power for its
axial length.
3Impact of Myopia and High Myopia
5. Global prevalence of myopia
• Global Burden of Disease Estimates: URE the leading cause of
moderate and severe vision impairment (53%) and the second
largest cause of blindness [1].
• 2010: Myopia and high myopia were estimated to affect 27% (1893
million) and 2.8% (170 million) of the world population [2].
• Prevalence : Highest in East Asia (approx. 50%) and lower in
Australia, Europe and north and south America.
5Impact of Myopia and High Myopia
6. Figure 1: Numbers of cases (blue) and prevalence (red) of myopia
worldwide between 2000 and 2050
6Impact of Myopia and High Myopia
7. Figure 2 : Numbers of people worldwide with high myopia
(blue) and prevalence (red) between 2000 and 2050
7Impact of Myopia and High Myopia
8. The WHO Projections 2050
• 2050: Prevalence will be ≥ 50% in 57% of the countries, if current trends
continue.
• 2050: Countries in which the prevalence of myopia has been estimated
and measured as low in the past (e.g. India) will have major increases.
• 2050: Myopia will be much higher in high-income regions of the Asia-
Pacific, in east Asia and in south-east Asia
• 2050: About 30% of Africa will be similar to that in Asia today.
• 2050: The prevalence of high myopia is predicted to increase to 24% in all
the Global Burden of Disease regions
Footnote: The WHO model for projections was based on regional structure
8Impact of Myopia and High Myopia
9. Terminology
• Myopia
“a condition in which the spherical equivalent objective
refractive error is ≤ –0.50 dioptre (D) in either eye”.
• High myopia
“a condition in which the spherical equivalent objective
refractive error is ≤ –5.00 D in either eye”.
.
Examples: 1. -2.00/-6.00 x 180
2. +2.00/-6.00 x 180
9Impact of Myopia and High Myopia
10. Pathologic myopia
• Clinical Definition: Not well defined, with different descriptions
across studies of vision-threatening changes in the retina or the
presence of posterior staphyloma, and various criteria for axial
length and spherical equivalents refractive error.
• Acceptable definition: High myopia with signs of retinal atrophic
changes (5).
• Approximately 1% of whites and 1–3% of Asians
• Causes more VI or blindness in Asians (0.2–1.4%) than in
Caucasians (0.1–0.5%)
10Impact of Myopia and High Myopia
11. Myopic macular degeneration (MMD)
• Clinical definition: A vision-threatening condition in people with
myopia, usually high myopia, which comprises diffuse, patchy
macular atrophy with or without lacquer cracks, choroidal
neovascularization and Fuchs spot.
• It was agreed that the direct ophthalmoscope lens power wheel
should be used in rapid assessments.
• Currently, choroidal neovascularization in MMD is managed by
treatment with anti-VEGF.
11Impact of Myopia and High Myopia
13. Progression of MMD in a group of people
with high myopia (≤ -8.00)
13Impact of Myopia and High Myopia
14. A proposed international photographic classification
and grading system for MMD
14Impact of Myopia and High Myopia
Footnote: No universal grading system for MMD is in use clinically.
15. WHO recommendations for care and
management of pathologic myopia
1. Pathologic myopia: Patient should have access to a full range of eye-care
services.
2. For myopic CNV: Anti VEGF may be considered, but the long-term
prognosis for vision is unknown.
3. Increased risk for glaucoma: Glaucomatous optic neuropathy should be
investigated.
4. Increased risk of RD and cataract: Fundus and anterior segment
examination is essential.
5. If VI is uncorrectable: Patient should have access to comprehensive eye-
care services, including vision rehabilitation and appropriate devices and
surgery if necessary.
15Impact of Myopia and High Myopia
16. Impact of myopia
1. Myopia as a cause of VI and blindness
• Under corrected myopia: The most common cause of VI, as judged by
presentation for poor visual acuity.
• Uncorrected myopia as low as –1.50 D will result in moderate VI, and
uncorrected myopia of –4.00 D can cause blindness [36].
• MMD: The most common cause of VI in myopia. 10% of people with
pathologic myopia develop MMD (due to choroidal neovascularization),
which is bilateral in 30% of cases [16].
• Myopia: Associated with higher risks of glaucoma and cataract but may be
protective against ARMD and DR.
• High myopia: Can cause serious, sight-threatening retinal damage.
16Impact of Myopia and High Myopia
17. 2. Economic Implication
• Global loss of productivity due to URE: I$ 269 billion per annum [14]
• Estimated cost of addressing the problem : US$ 28 billion over 5 years [15]
• Expected 4.9-fold increase in high myopia by 2050.
• The cost of care is also likely to increase significantly.
Singaporean Study [37-38]
• The annual direct cost of optical correction of myopia for Singaporean adults has
been estimated at US$ 755 million.
• The direct cost of myopia in Singaporean children was US$ 148 per child per year.
• If the available data were extrapolated to all cities in Asia, the estimated direct
cost would be US$ 328 billion.
17Impact of Myopia and High Myopia
18. 3. Impact on quality of life and personal development
• Adolescents with myopia: Reported lower scores for total quality of
life, psychosocial functioning and school functioning [39].
• Correction of refractive errors by the provision of spectacles in low
socioeconomic areas markedly improve educational outcomes [40].
• The major contributors to the burden of eye disease at the global
level are refractive errors (27.7 million DALYs) followed by cataract
(17.7 million DALYs) [20].
18Impact of Myopia and High Myopia
19. 3. Burden on global eye care services
Increased prevalence of high myopia
Increase in pathologic myopia
increased VI and blindness
Increased burden on ophthalmological and low-vision services.
19Impact of Myopia and High Myopia
20. Evidence for causes of myopia
1. Optical and environmental influences
• Several optical and environmental factors have been identified as
possible causes of the onset and progression of myopia, acting
either individually or in combination.
1.1 Peripheral hyperopic defocus
• The pattern of peripheral refraction varies with central refraction
(43,44).
– Myope: Have relative hyperopia in the periphery, can increase
ocular growth
– Hyperope: Have relative myopia in the periphery, can cause
slow axial elongation
20Impact of Myopia and High Myopia
22. 1.2. Intensive near work (45,46):
• The mechanism by which near work increases axial length is the
combined influence of biomechanical factors (i.e. extraocular
muscle forces, ciliary muscle contraction) associated with near tasks
in downward gaze.
1.3.Time spent outdoors (47):
• Epidemic of myopia in East Asia is primarily due to changes in
environmental (social) factors, specifically intensive education and
less time spent outdoors.
• Observed seasonal variation in the progression of myopia adds
weight to the argument that time spent outdoors slows the
progression of myopia.
22Impact of Myopia and High Myopia
23. Five-year risk of incident myopia among six-year-old
Australian children
23Impact of Myopia and High Myopia
24. (Dashed lines =
Mechanical Tension
Theory;
Dotted lines =
Accommodative
Lag Theory;
Solid line = common to
both theories)
24Impact of Myopia and High Myopia
25. • Genetics and parental history
• Genetics and the environment play a role in the development and
progression of myopia, but the genetic contribution is considered small.
• There is consensus that genes may determine susceptibility to
environmental factors (50).
• The rapid increase in the prevalence of myopia seen over a short time in
east Asia (54, 55, 56) cannot be explained by genetics.
• In the twin study by He et al., baseline refraction and parental myopia
were found to be risk factors.
25Impact of Myopia and High Myopia
26. Control of Myopia
1. Optical control
1.1 Spectacle methods
• Leaving myopia uncorrected: Does not reduce the rate of progression (65).
• Undercorrection: Shown to increase myopia progression.
– Due to peripheral and central blur, stimulating axial growth
• Progressive addition lenses: Have a small, statistically significant effect.
The reduction is correlated with the degree of relative myopia produced in the
superior retina by near addition (69).
• Executive bifocals: with a +1.50 addition and 3 D base-in prism reduced the rate of
myopia progression by 57% (62).
– Reduces the stimulus for axial elongation.
26Impact of Myopia and High Myopia
27. 1.2 Contact lens methods
• Standard RGP: Do not reduce the rate of myopic axial elongation.
• Bifocal contact lenses: Reduced progression (spherical equivalent of
refractive error and axial length).
– Act by reducing accommodative lag (73)
• Orthokeratology: Consistent reduction in myopia progression of
approximately 45% over a two-year period and 30% over five years, when
measured in terms of axial length (63).
• Extended depth-of-focus lenses: Support the myopic defocus hypothesis
(76).
27Impact of Myopia and High Myopia
28. 2. Time spent outdoors and behavioural influences
• Evidence is emerging that spending more time outdoors can protect against the
onset of myopia.
• Sufficient time outdoors (more than two hours/day): Reduced the risk of myopia,
even when they had two myopic parents and continued to perform near work
(77).
– Indoors playing sports not beneficial.
– The nature of the outdoor activities does not seem to be critical (77).
• The mechanism of action of time spent outdoors remains unknown and requires
further investigation.
– Hypothesized that the sunlight stimulates the release of dopamine from the retina, which inhibit
axial elongations (81, 82).
– Seasonal differences: Progression is faster in winter and slower in summer (83).
• Outdoor activity could be made part of obesity reduction campaigns for children,
and schoolchildren in particular.
28Impact of Myopia and High Myopia
29. 3. Pharmacological and therapeutic control
• 3.1 Atropine
• Atropine reduces myopia progression in children in a dose-related manner,
but a rebound effect (“catch-up”) occurs with higher doses (85).
• Atropine at 0.01% :
– Lower doses, 0.01% , reduce the common side-effects observed with the
higher dose.
– Resulted in a 59% reduction in the rate of progress of myopia, with minimal
adverse effects; however, controversially, it had no effect on axial elongation
(85).
– Recently approved by the FDA for long-term amblyopia therapy in children.
– Currently no regulatory approval for the use of atropine to slow myopia
progression
29Impact of Myopia and High Myopia
30. Clinical guidelines for children aged 6–10 years with myopia >
1.0 D and documented myopia progression > 0.5 D per year
30Impact of Myopia and High Myopia
• Clinical guidelines are needed on who should be treated, when treatment
should begin and cessation and the duration of treatment.
31. 3.2 7–methylxanthine
• A non-selective adenosine antagonist.
• Affects the release of neurotransmitters such as dopamine,
norepinephrine, acetylcholine, glutamate and serotonin (86).
• Danish Study
– 8-years of follow-up of 750 myopic reported no side-effects.
– Dose of 400 mg twice a day reduced myopia progression by 60% (70).
31Impact of Myopia and High Myopia
32. Recommendations for myopia control
1. Access to correction: Essential to avoid VI.
2. Full correction of myopia
3. More outdoor activities
3. Less near work
4. Contact lenses and ortho-k
5. PALs
7. Low-dose atropine
32Impact of Myopia and High Myopia
33. Research
• There is a large body of research on myopia.
• However, few areas requires further research:
– Epidemiology of myopia
– Myopigenesis, environmental, optical and therapeutic factors
– Risk factors and individual heterogeneity
– High myopia, pathologic myopia and comorbid conditions
– Eye examinations in myopia
33Impact of Myopia and High Myopia
34. Key messages
• On the basis of current estimates and demographic trends, myopia is the
main cause of distance refractive error and will probably continue to be so
in the future.
• If the increasing prevalence of myopia is not addressed, a similar increase
in URE can be expected.
• Reducing the rate of myopia progression by 50% could reduce the
prevalence of high myopia.
• On the basis of the evidence, that myopia warrants national and
international synergistic efforts, as the costs and public health implications
are huge and often underestimated [2].
34Impact of Myopia and High Myopia
35. Conclusions
• Documented increases in the prevalence of myopia and high
myopia worldwide are a serious public health concern.
• Data to inform research, clinical practice and public health
policy must be produced urgently.
• Consistent use of international terminology for obtaining
internationally comparable, accurate data on the prevalence
of myopia and high myopia.
• Myopia and high myopia should be included as attributable
causes of vision impairment in epidemiological surveys.
• The term “myopic macular degeneration” should be used to
categorize the blinding retinal diseases associated with high
myopia.
35Impact of Myopia and High Myopia
36. REFERENCES
1. Bourne RR, Stevens GA, White RA, Smith JL, Flaxman SR, Price H et al. Causes of vision loss worldwide,
1990-2010: a systematic analysis. Lancet Global Health. 2013;1:e339–e349.
2. Holden, B.A., et al., Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000
through 2050. Ophthalmology, 2016. 123(5): p. 1036-42.
3. Iwase A, Araie M, Tomidokoro A, Yamamoto T, Shimizu H, Kitazawa Y. Prevalence and causes of low
vision and blindness in a Japanese adult population: the Tajimi study. Ophthalmology. 2006;113:1354–
62.
4. Wu L, Sun X, Zhou X, Weng C. Causes and 3-year-incidence of blindness in Jing-An district, Shanghai,
China 2001–2009. BMC Ophthalmol. 2011;11:10.
5. Wong TY, Ferreira A, Hughes R, Carter G, Mitchell P. Epidemiology and disease burden of pathologic
myopia and myopic choroidal neovascularization: an evidence-based systematic review. Am J
Ophthalmol. 2014;157:9–25.
6. Xu L, Wang Y, Li Y, Cui T, Li J, Jonas JB. Causes of blindness and visual impairment in urban and rural
areas in Beijing: the Beijing Eye Study. Ophthalmology. 2006;113:1134–41.
7. Group TEDC-CS. Risk factors for idiopathic rhegmatogenous retinal detachment. The Eye Disease
Case-control Study Group. Am J Epidemiol. 1993;137:749–57.
8. Younan C, Mitchell P, Cumming RG, Rochtchina E, Wang JJ. Myopia and incident cataract and
cataract surgery: The Blue Mountains eye study. Invest Ophthal Vis Sci. 2002;43:3625–32.
9. Qiu M, Wang SY, Singh K, Lin SC. Association between myopia and glaucoma in the United States
population. Invest Ophthal Vis Sci. 2013;54:830–35.
10. International statistical classification of diseases and related health problems, 10th revision,
version for 2010. Geneva: World Health Organization; 2010.
36Impact of Myopia and High Myopia
37. 11. Resolution WHA66.4. Universal eye health. A global action plan 2014–2019. In: Sixty-sixth World Health
Assembly, Geneva, 20–27 May 2013. Resolutions and decisions, annexes. Geneva: World Health Organization;
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37Impact of Myopia and High Myopia
39. Regions defined in the WHO Global
Burden of Disease programme
39Impact of Myopia and High Myopia
40. Lag of Accommodation
• Lag of Accommodation: The amount by which the
accommodative response of the eye is less than the dioptric
stimulus to accommodation.
40Impact of Myopia and High Myopia