Article

The Consequences of Myopia: Impact on Individuals and Society

Overview for the eye care professional’s practice

14 May 2024 · 4 min read
Author Prof Padmaja Sankaridurg

Head of Global Myopia Management | ZEISS Vision Care

Around 30 percent of the world's population suffers from myopia. And it is expected that this number will grow in the future.1 Myopia, and in particular high myopia, not only impacts the individual but the society as a whole. And as the prevalence rises globally, the consequences will also increase. Here are some of the ways in which myopia affects various aspects of life.

  • Everyday aspects of life

  • Academic performance

  • Eye health

  • Economic impact

Myopia influences everyday aspects of life

Uncorrected myopia can pose a significant challenge to children and affected individuals in everyday life. Simple tasks such as reading signs, recognizing people, reading words on boards in classroom etc. can become difficult. Participating in sports or driving with uncorrected myopia can be a safety issue. Objects in the distance may appear blurry and it might be difficult to judge distances accurately. These challenges are likely to affect a person’s productivity in their environment.

The impact of either uncorrected or corrected myopia on quality of life is typically evaluated using qualitative and/or quantitative measures, such as questionnaires containing items on symptoms, limitations of activity, emotional and social impact, inconvenience etc.2  Evidence suggests that myopia involves restrictions on everyday activities, economic, emotional and social well-being.3 Overall the more severe the myopia, the greater the likelihood of having a poorer quality of life.3 For example, those who suffer from high myopia may have concerns related to the appearance of their spectacle lenses and might have financial impact related to the need for specialized lenses such as lighter and thinner lenses that cost more.2  On a positive note, appropriate management of myopia is likely to improve quality of life4  across certain domains.
 

Myopia affects eye health

All levels (low, moderate or high) of myopia are associated with a risk of developing ocular complications that may be sight-threatening, with the risk increasing for higher levels of myopia. While some complications can occur at any age (for example, retinal detachment), myopia predisposes the eye to develop certain other complications in later adult life (for example, myopic macular degeneration). Each additional diopter is associated with an increase in risk of +58 percent for myopic macular degeneration, +20 percent for open-angle glaucoma, +21 percent for posterior subcapsular cataract and +30 percent for retinal detachment.11 These statistics underscore the importance of starting myopia management early to mitigate or reduce the risk of developing serious complications.

  • +58%

    Myopic macular degeneration

  • +30%

    Retinal detachment

  • +20%

    Open-angle glaucoma

  • +21%

    Cataracts

Academic performance and myopia

For obvious reasons, uncorrected myopia or poor vision in general may affect the academic performance of children with possible consequences into their future, including their career. Scholastic performance was found to play a role with evidence suggesting a connection between educational achievements and the health in later adult life.5

Uncorrected visual deficits may affect attention, perseverance, and academic performance. When corrected with spectacles, an improvement in academic performance and psychosocial wellbeing of students was seen.6 Interestingly, although spectacles are a common and widespread means of vision correction, in some situations, there can be persistent negative stereotypes associated with wearing spectacles resulting in poor compliance. There are additional barriers that influence whether a child receives and consistently wears spectacles, such as access to vision care, costs, as well as parental education.7 These factors need to be considered in optometric and ophthalmic practice and any resentment towards vision correction resolved with sensitive measures.

Economic impact of myopia

Individual level

The economic impact of myopia on the individual includes direct costs for diagnosis, treatment, and transport (to and from treatment places) as well as productivity loss related to time spent on eye examinations, traveling to clinics, loss of time from workplace etc. These costs may vary depending on country of residence, severity of myopia and age of the individual. Costs are found to increase with age especially in older individuals and attributed, in part, to the complications arising from myopia.8 Expenditure also increases with the severity of myopia as there may be increased costs for regular check-ups, different management solutions, or more frequent replacements due to changes in the prescription.

Societal level

The economic burden of myopia on society includes healthcare expenses related to eye examinations and vision correction as well as expenses for medical treatments, medication, surgeries, or medical procedures due to complications. In countries with high prevalence of myopia such as Singapore, the direct health expenditures associated with myopia were found to be higher than costs associated with some chronic diseases such as Parkinson’s disease.2 However, with rising prevalence, the costs of managing myopia related conditions is expected to rise worldwide in the future.9 In addition to health expenditure, myopia results in the loss of productivity that impacts the society. It was estimated that productivity loss, due to severe visual impairment and blindness from myopia, amounted to 94.5 billion US dollars in 2019 and could rise to 229.3 billion US dollars in 2050.9
 

What this means in practice: myopia management

It is expected that the burden of myopia and high myopia will rise due to the growing prevalence of myopia.2 At the societal level, managing myopia has a positive impact on productivity. Importantly the costs associated with correcting and controlling myopia progression are lower than the overall gains in productivity.10

Thus, when it comes to practicing myopia management, prevention where possible and if not early detection and approaches to slow progression are the key to reducing the impact of myopia. Lower levels of myopia reduce the risk of costs associated with managing the condition (for example, less need for frequent follow-ups, device costs etc) and reduce the risk of eye complications.

Education on the positive effects of minimizing excessive near work and spending more time outdoors is a key element in myopia management. For those that are already myopic, guidelines can be followed for appropriate management. Single vision devices correct vision but do now slow progression of myopia and therefore, providing one or more strategies that slow progression is useful. It is also important to have an open discussion to dispel reservations related to certain treatments, solutions, costs, future health implications etc.
 

  • 1

    Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036–1042.

  • 2

    Sankaridurg P, Tahhan N, Kandel H, et al. IMI Impact of myopia. Invest Ophthalmol Vis Sci. 2021;62(5):2.

  • 3

    Rose K, Harper R, Tromans C, et al. Quality of life in myopia. Br J Ophthalmol. 2000;84:1031–1034.

  • 4

    However, correction can’t raise quality of life to the level of a person with normal vision.

  • 5

    Case A, Fertig A, Paxson C. The lasting impact of childhood health and circumstance. J Health Econ. 005;24(2):365– 389.

  • 6

    Dudovitz RN, Izadpanah N, Chung PJ, Slusser W. Parent, teacher, and student perspectives on how corrective lenses improve child wellbeing and school function. Matern Child Health J. 2016;20(5):974–983

  • 7

    Morjaria P, McCormick I, Gilbert C. Compliance and predictors of spectacle wear in schoolchildren and reasons for non-wear: a review of the literature. Ophthalmic Epidemiol. 2019;26(6):367–377.

  • 8

    Zheng YF, Pan CW, Chay J, Wong TY, Finkelstein E, Saw SM. The economic cost of myopia in adults aged over 40 years in Singapore. Investig Ophthalmol Vis Sci. 2013;54(12):7532–7537.

  • 9

    Holy C, Kulkarni K, Brennan NA. Predicting costs and disability from the myopia epidemic–a worldwide economic and social model. Invest Ophthalmol Vis Sci. 2019;60(9):5466.

  • 10

    Fricke T, Holden B, Wilson D, et al. Global cost of correcting vision impairment from uncorrected refractive error. Bull World Health Organ. 2012;90(10):728–738.

  • 11

    Bullimore MA, Ritchey ER, Shah S, Leveziel N, Bourne RRA, Flitcroft DI. The Risks and Benefits of Myopia Control. Ophthalmology. 2021 Nov;128(11):1561-1579.