High myopia risk

“IF there is an onset of myopia before age 13, there is a much higher risk of high myopia,” said Caroline Klaver, Erasmus University Medical Center, Rotterdam, The Netherlands. Dr Klaver gave her presentation on epidemiology and genetics of myopia, to delegates at an ESCRS clinical research symposium at the 36th Congress of the ESCRS. “This is significant because the risk of bilateral visual impairment and blindness is strongly correlated with the degree of myopia, particularly as represented by axial length,” she said. The risk of developing high myopia is multifactorial. “But myopia is really all about lifestyle in children, as far as modifiable factors are involved. Those that have high genetic risk and higher education are prone to myopic risk. The combination of high genetic risk plus high environmental risk is also significant for pathological myopia,” said Dr Klaver. Environmental risk refers to too little time spent outside. “Two hours or more outside per day is protective,” she said. According to the Rotterdam Eye Study, myopes spend more time indoors, have lower vitamin D levels (vitamin D is a proxy for time spent outdoors) and spend more hours on near work. There are, however, no good data regarding smartphone use, “although studies are currently ongoing.” Dr Klaver informs paediatric patients of the 20-20-2 Rule: take a 20-second accommodation break after 20 minutes of near work, and spend 2 hours per day outside.