A new consensus report outlined three strategic priorities to combat the rising global burden of myopia. Developed through a modified Delphi process at the 2024 International Myopia Summit in Singapore, the report called for redefining myopia as a disease, intensifying efforts to prevent high myopia, and developing diagnostics and treatments for pathologic myopia.

Consensus Strategy 1: Redefine Myopia as a Disease

In the review, published in the British Journal of Ophthalmology, an expert panel determined that current classifications—such as the ICD-11’s definition of myopia as a refractive error—don't adequately reflect its clinical and public health burden. The group proposed a redefinition of myopia as a disease with specific phenotypic features and stages, including axial elongation, peripapillary atrophy, lattice degeneration, and risk of retinal detachment. For example, patients with moderate to high myopia (−3.0 D to −5.0 D) have a 10-fold increased risk of retinal detachment, and axial myopia is associated with earlier cataract formation and elevated glaucoma risk. The proposed redefinition aims to guide risk stratification and early intervention for these risks.

Consensus Strategy 2: Focus on Preventing High Myopia

While existing public health campaigns focus on preventing the onset of myopia, the panel advocated for extending efforts to prevent progression to high myopia, which carries a substantially higher risk of irreversible vision loss. Similar to the first strategy, the group detailed the following concerns with high myopia:

• One-third of adults with high myopia have staphyloma, which is a hallmark of pathologic myopia.
• Each 1 mm increase in axial length raises the risk of myopic macular degeneration ninefold, which currently accounts for 3.3 million cases of blindness globally.

Their suggested strategies included increasing daily outdoor time (eg, 120 minutes/day has been shown to reduce myopia onset), implementing school-based screening and referral programs, and educating parents and schools on early detection and eye health responsibility.

However, the panel also noted barriers that should also be considered, such as low government funding, limited access to myopia treatment clinics, and the cost burden falling primarily on families.

Consensus Strategy 3: Address Pathologic Myopia With Targeted Treatment

Pathologic myopia represents the end-stage of disease and often leads to irreversible visual impairment. The panel emphasized the need for an improved understanding of the progression from high myopia to pathologic myopia and investment in treatment innovation.

“Compared with other retinal diseases,” wrote the study authors, led by Leila Sara Eppenberger, of the Ocular Imaging Research Group at the Singapore Eye Research Institute, and colleagues, “pathologic myopia is associated with the lowest quality of life, affecting more and more individuals in their working age.”

The panel recommended conducting economic studies on the health care burden of pathologic myopia to guide resource allocation, as well as longitudinal studies to identify risk factors and biomarkers for progression. They also suggested developing treatments to target scleral health, axial elongation reversal, and complications such as myopic choroidal neovascularization.

They further recognized obstacles in global implementation, including varying health care infrastructure and cultural attitudes, limited access to affordable eye care and myopia control tools, and the need for comanagement models and primary care integration.

Digital health tools, including artificial intelligence–driven diagnostics and risk prediction systems, were identified as opportunities that could enhance detection and individualized care. However, the panel noted that these tools may also present risks related to dependency, data security, and widening disparities. 

“It should be considered that the myopia pandemic itself is being driven by advances in technology and its associated behavioral changes such as excessive screen time,” the study authors noted. “The COVID-19 pandemic accelerated this progression. We are falling behind, and we need to rethink our current approach,” they underscored.

They concluded: “Tackling the multifaceted challenges of myopia necessitates a unified, yet personalized approach. Alignment among experts is crucial; generating robust evidence, particularly regarding cost implications, is essential to garner government and policymaker support. By starting with an agreed, collaborative global approach including defining myopia as a disease with visually significant stages, efforts to focus on preventing progression to high myopia, in addition to preventing myopia as a whole, and finding novel and effective treatments for pathologic myopia, we can drive meaningful changes to alleviate the global burden of myopia and promote visual health for all.”

Disclosures can be found in the published article.