7 Public Health Strategies to Combat Myopia

As prevalence rates rapidly rise, myopia has become an increasingly significant global health concern, particularly affecting younger populations. To complement safe and effective management strategies, public health interventions are urgently needed to mitigate the long-term visual and economic consequences associated with progressive myopia.

Here’s a brief look at seven evidence-based strategies that have demonstrated effectiveness in combating myopia at both individual and population levels.

1. Promote increased outdoor time

To start, extensive research has established a strong inverse relationship between time spent outdoors and the onset of myopia. A comprehensive meta-analysis published in Acta Ophthalmologica in 2017 revealed that each additional hour of outdoor activity per week reduces the risk of developing myopia by approximately three percent. The protective effect is attributed to factors such as exposure to natural light and, potentially, engagement in distance-focused activities.

2. Implement school-based outdoor programs

Branching off that research, integrating outdoor activities into school routines has been analyzed and shows promising results in myopia prevention. A study published in Ophthalmology in 2013 demonstrated that encouraging children to spend recess outdoors led to a significant reduction in myopia incidence—from 17.65 percent in the control group to 8.41 percent in the intervention group over one year. Such programs are cost-effective and easily scalable within educational settings.

3. Establish comprehensive school vision screening

Also in the school setting, early detection through school-based vision screening has proven valuable. A large-scale study published in Ophthalmic Epidemiology in 2024 involving over 95,000 students found that 94.2 percent of those who failed initial screenings had refractive errors, with myopia being the most significant. 81.7 percent exhibited clinically significant refractive errors. These findings highlight the importance of routine screenings in schools to identify and address vision problems.

4. Encourage regular breaks during near work

Prolonged near work activities, such as reading or screen time, are associated with increased myopia risk. A systematic review published in PLoS ONE in 2015 indicated that each additional diopter hour of near work per week increases the odds of myopia by two percent.

5. Provide access to myopia control interventions

Access to clinically proven myopia control options—such as atropine drops, orthokeratology, multifocal soft contact lenses, and bifocal lenses—is a cornerstone of any effective public health response. However, the cost and limited availability of such interventions often pose barriers, particularly for children in low-income or underserved communities. Public health programs should prioritize making these treatments more widely accessible through subsidies, insurance coverage, school-based vision care partnerships, and public-private collaborations.

6. Integrate eye health into national health policies

Taking that one step further, the Lancet Global Health Commission emphasizes the necessity of incorporating eye health into broader public health agendas. Their 2021 report on global eye health advocates for increased investment in eye care services, workforce development, and integration of eye health into universal health coverage schemes. Such policy integration ensures sustainable and equitable eye care delivery.

7. Adopt international guidelines for myopia management

Finally, international guidelines are a way to facilitate consistent and effective myopia management across different healthcare settings. The International Myopia Institute provides evidence-based guidelines for myopia prevention and control, and their clinical myopia management guidelines report published in 2019 offers standardized protocols for risk assessment, intervention strategies, and patient education. Adhering to these guidelines helps ensure consistent, evidence-based myopia care across regions and supports coordinated public health efforts globally.

Combating the global rise in myopia requires coordinated public health strategies that prioritize prevention, early detection, and equitable access to care. By implementing evidence-based interventions such as these at the community and policy levels, we can protect the visual health of future generations and reduce the long-term burden of myopia.

References:

Burton MJ, Ramke J, Marques AP, et al. The Lancet Global Health Commission on global eye health: vision beyond 2020. Lancet Glob Health. 2021;9(4):e489-e551. doi:10.1016/S2214-109X(20)30488-5

Chamberlain P, Bradley A, Wilson D, et al. IMI–Clinical myopia management guidelines report. Invest Ophthalmol Vis Sci. 2019;60(3):M132-M160. doi:10.1167/iovs.18-25977

Huang HM, Chang DST, Wu PC. The association between near work activities and myopia in children: a systematic review and meta-analysis. PLoS One. 2015;10(10):e0140419. doi:10.1371/journal.pone.0140419

Nguyen AM, Guo X, Dai X, et al. Refractive profiles in children receiving school-based eye exams following vision screening from a large school-based vision program in 2016 to 2022. Ophthalmic Epidemiol. 2024:1-9. doi:10.1080/09286586.2024.2422351

Wu PC, Tsai CL, Wu HL, Yang YH, Kuo HK. Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology. 2013;120(5):1080-1085. doi:10.1016/j.ophtha.2012.11.009

Xiong S, Sankaridurg P, Naduvilath T, et al. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review. Acta Ophthalmol. 2017;95(6):551-566. doi:10.1111/aos.13403