Treat myopia as lasting damage: the higher the degree, the more retinal detachment, macular disease, and glaucoma later

Myopia does not heal on its own, and the degree does not go back down. It is also not only a “wear glasses” matter. Versus people without myopia, the chance of myopic macular disease is over ten times higher in mild myopia and hundreds of times higher above 600 degrees. Retinal detachment is about 3 times higher in mild myopia and about 13 times higher above 600 degrees. So the deeper a child’s myopia climbs, the more risk they carry later.

Cost

No money. This item itself needs no action; what to do is in items 4 and 5 (2 hours outdoors, screen rules by age).

Benefit

A systematic review and meta-analysis pooled studies before June 2019 into three degree bands: mild (−0.5 to −3.00 D), moderate (−3.00 to −6.00 D), high (≤−6.00 D, above 600 degrees). Versus people without myopia, 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). Retinal detachment: 3.15 (1.92 to 5.17), 8.74 (7.28 to 10.50), 12.62 (6.65 to 23.94). Posterior subcapsular cataract: 1.56 (1.32 to 1.84), 2.55 (1.98 to 3.28), 4.55 (2.66 to 7.75). Open-angle glaucoma: mild 1.59 (1.33 to 1.91); moderate and high combined 2.92 (1.89 to 4.52). Odds ratios for visual impairment at age 60 and above: 1.71 (1.07 to 2.74), 5.54 (3.12 to 9.85), 87.63 (34.50 to 222.58). Ten Core Knowledge Points for Preventing and Controlling Myopia in Children and Adolescents (防控儿童青少年近视核心知识十条) says the same: above 600 degrees is high myopia; in that group, rates of cataract, open-angle glaucoma, myopic macular disease, retinal detachment, myopic optic neuropathy, and other blinding eye diseases are clearly higher than in other groups, and “myopia can be prevented and controlled but is not reversible”

Notes

Studies pooled were all observational, and the odds ratios are unusually large. For high myopia and macular degeneration, the credible range runs from 230 to 3104, so underlying studies differ a lot. Read the numbers as order of magnitude, not exact values. The visual-impairment set in the Benefit line is for people aged 60 and above. The author infers these outcomes mostly show up in middle and old age. Myopia is not finished once glasses are fitted — it is worth the effort to delay and control it. Follow-up after diagnosis is in item 12 (cycloplegic refraction). Do not buy products that claim a cure — see item 9 (cure myopia).

Sources · 2

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. 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）. gov.cn/zhengce/zhengceku/202307/content_68942…