Mackey, D

Biography:

To follow

Abstract:

It is predicted by 2050 that half the world’s population will have myopia. Recent trials have shown that treatments such as low-concentration atropine drops, peripheral defocus lenses, orthokeratology and red-light therapy are effective at slowing myopia, but these treatments are expensive, long-term, and unavailable to many children. Lack of time outdoors is a major risk factor for children and young adults developing myopia and clinical trials have shown that increasing children’s time outdoors slows progression and delays onset of myopia.

Different countries are taking different approaches to curb myopia. In China, schools have been mandated to have children spend 2 hours daily outside. In Singapore, parents are encouraged to ensure their children spend 2 hours outdoors per day. In Hong Kong, most children with myopia are being prescribed low-concentration atropine drops whereas in France, funding is available for peripheral defocus lenses.

Australia and New Zealand have very high rates of skin cancer and have had decades of recommending sun protection for children with great success. Thus, promoting outdoor time needs to be done judiciously, following SunSmart protective measures or, ideally, early or late in the day when the UV Index is below 3. Whilst European Australian children are at higher risk of skin cancer, South and East Asian Australian children are at risk of tanning and freckling, which many parents want them to avoid. Spending time outdoors is less appealing in bad weather, particularly in winter months but also when there are high levels of air pollution. In Australia, bushfires and hazard reduction burns are problematic for several days a year and individuals are recommended to stay indoors. In many cities in Asia, pollution levels are very high for much of the year, and this is also a challenge in recommending children spend more time outside.

We have many options for preventing myopia onset and further progression of myopia. However, outdoor time will need to be tailored for different locations, even within the same country, e.g., in Australia, Hobart and Darwin have very different latitudes and climates.