Treat myopia as damage that stays: the stronger the prescription, the more retinal detachment, macular disease and glaucoma later

Cost

Free. There is nothing to do for this item itself; what to do is in §30.4, §30.5 (2 hours outdoors, managing screens by age).

What you get

A systematic review and meta-analysis pooled studies up to June 2019 and sorted them into three levels by prescription: mild (−0.5 to −3.00 D), moderate (−3.00 to −6.00 D), and high (≤−6.00 D, which is 600 degrees or more). Compared with people who are not nearsighted, the odds ratios for myopic macular degeneration were 13.57 (95% CI 6.18 to 29.79), 72.74 (33.18 to 159.48) and 845.08 (230.05 to 3104.34) in turn. For retinal detachment they were 3.15 (1.92 to 5.17), 8.74 (7.28 to 10.50) and 12.62 (6.65 to 23.94). For posterior subcapsular cataract they were 1.56 (1.32 to 1.84), 2.55 (1.98 to 3.28) and 4.55 (2.66 to 7.75). For open-angle glaucoma, mild was 1.59 (1.33 to 1.91), and moderate and high combined was 2.92 (1.89 to 4.52). For visual impairment after age 60, the odds ratios for the three levels were 1.71 (1.07 to 2.74), 5.54 (3.12 to 9.85) and 87.63 (34.50 to 222.58) in turn. The Ten Core Messages on Preventing and Controlling Myopia in Children and Adolescents (《防控儿童青少年近视核心知识十条》) say the same: 600 degrees or more is high myopia, and among these people the rates of blinding eye diseases such as cataract, open-angle glaucoma, myopic maculopathy, retinal detachment and myopic optic neuropathy are clearly higher than in other people, and “myopia can be prevented and controlled but cannot be reversed.”

Notes

All the pooled studies were observational, and the odds ratios are unusually large. For high myopia and macular degeneration the range of plausible values runs from 230 to 3104, which shows the studies underneath differ a lot, so the numbers show only the order of magnitude and shouldn't be used as exact values. Most of these complications don't show up until middle or old age. Myopia itself is not a disability, and the great majority of people see normally with glasses. But myopia is not settled by getting a pair of glasses, and it is worth real effort to delay and control it. For follow-up after diagnosis, see §30.12 (dilated eye exam). Don't buy products that claim to cure it; see §30.9 (curing myopia).

Evidence grade

A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.

Sources

1. Haarman AEG, Enthoven CA, Tideman JWL, Tedja MS, Verhoeven VJM, Klaver CCW (2020). The complications of myopia: a review and meta-analysis. Investigative Ophthalmology & Visual Science, 61(4), 49. https://doi.org/10.1167/iovs.61.4.49
2. 国家卫生健康委办公厅 (2023). 防控儿童青少年近视核心知识十条（国卫办妇幼函〔2023〕278 号）. https://www.gov.cn/zhengce/zhengceku/202307/content_6894284.htm

Translated from the Chinese original. Original book, section 30, tip 6. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer