Prof Ian Morgan PhD
The intensive educational systems of the developed countries of East and Southeast Asia are a leading factor in the explosion of myopia in these regions in recent years, Professor Ian Morgan PhD told delegates attending the 17th EURETINA Congress in Barcelona.
“There is an epidemic of myopia in the developed countries of East and Southeast Asia, which is linked both to the massive educational demands on children in this region and the limited amount of time that they spend outdoors,” he said.
Prof Morgan, Australian National University, Canberra, said it was vital to keep a careful watch on trends in education and to challenge the drive to put greater pressure on children.
“Every time a major international education survey is released we hear ministers of education say that we must imitate East Asia. The question I ask is in return is: What is it that you want to achieve – better educational outcomes or more myopia?” he asked.
Young people should spend more time outdoors, as this has been shown to be a protective factor against myopia development. “We also need to watch trends towards less time outdoors, induced by use of computers, smartphones or study, so that we have a warning and can anticipate that the prevalence of myopia will be going up in those regions,” he said.
The Brien Holden Vision Research Institute estimates a worldwide prevalence of myopia of 23%, projected to increase to 50% by 2050. In certain Asian populations, up to 90% of young adults are now myopic, with a prevalence of high myopia of the order of 20%, said Prof Morgan.
In regions that had virtually no education systems some years ago – such as Africa in the 1930s or Eskimo populations – only 1 to 2% of young people had myopia by the age of 17 or 18, said Prof Morgan. Even today, the prevalence of myopia is still low in areas with only limited development of school systems.
“This tells you what the level of genetic myopia really is – that is, myopia that does not appear without environmental exposures. The explosion of myopia in East Asia and Singapore going from 20 to 80% in a few decades correlates with the appearance of intensive education systems,” he said.
Outside of East Asia, there is a trend towards rising myopia, and an epidemic is also seen among Orthodox Jewish males. It has similar characteristics to the epidemic seen in all children in parts of East and Southeast Asia. “It is only the boys who receive an intensive orthodox Jewish education that become myopic. The girls have an education that is much less pressured and they do not become myopic,” he said.
The prevalence of myopia is not well-established in Europe, but is probably in the range of 20 to 30%. “Europe needs to collect more comprehensive, methodologically sound and up-to-date data to ascertain a more accurate picture of the prevalence of myopia and high myopia among European populations,” he concluded. That is the best way to see if and when an epidemic of myopia emerges.
Ian Morgan: ian.morgan@anu.edu.au
