Key Takeaways
- The AMA has adopted a resolution supporting classification of myopia as a disease, including recognition by CMS, as part of an effort to improve treatment access and insurance coverage
- Specialized spectacle lenses, contact lenses, orthokeratology, low-dose atropine and increased outdoor time are among approaches being studied or used to address childhood myopia onset or progression
- Growing concern about the long-term ocular risks associated with high myopia is driving calls for greater public education, childhood screening and access to early intervention
The American Medical Association (AMA) has adopted a resolution supporting the formal classification of myopia as a disease, adding momentum to efforts to improve access to myopia management for children and adolescents, according to a news release from the American Academy of Ophthalmology.
The resolution calls for myopia to be recognized as a disease, including by the Centers for Medicare and Medicaid Services, with the goal of improving access to appropriate treatment and insurance coverage. It also supports expanded public health education and improved childhood screening. The policy comes as ophthalmic organizations increasingly emphasize that myopia is more than a refractive error corrected with glasses or contact lenses. Progressive and high myopia can increase the lifetime risk of sight-threatening ocular complications.
The American Academy of Ophthalmology (AAO) has advocated for greater recognition of the condition as a public health issue. In 2021, the Academy published the white paper, Reducing the Global Burden of Myopia by Delaying the Onset of Myopia and Reducing Myopic Progression in Children, calling for international collaboration, education and strategies aimed at delaying myopia onset and slowing progression.
Myopia prevalence in the United States has increased substantially over recent decades. According to figures cited by the Academy from the National Eye Institute, approximately 41.6% of Americans are nearsighted. Globally, projections have suggested that approximately half of the world's population could have myopia by 2050 if current trends continue.
The implications extend beyond dependence on corrective lenses. High myopia is associated with increased risks of retinal detachment, glaucoma, cataract and myopic maculopathy, potentially resulting in irreversible vision loss.
A growing body of research has examined interventions intended to delay myopia onset or reduce progression during childhood. Approaches include specialized spectacle lenses, soft multifocal or dual-focus contact lenses, orthokeratology, low-dose atropine and increased time outdoors.
Specialized spectacle lenses designed for myopia management have emerged as one option for children. Soft contact lenses employing multifocal or dual-focus optical designs also can reduce myopia progression in appropriately selected pediatric patients.
Low-dose atropine has also been studied extensively for childhood myopia management. Treatment response can vary according to concentration and population, and studies have reported differences in efficacy among geographic and ethnic groups, according to the AAO.
Increasing children's time outdoors represents another important strategy, particularly for reducing the risk of myopia onset. Evidence has linked greater outdoor exposure with a lower incidence of childhood myopia.
Despite the expanding range of interventions, the Academy said awareness among parents, educators and policymakers remains limited. Insurance coverage can also present a barrier because interventions intended to slow myopia progression may not be routinely covered.
The Academy is also supporting federal legislation intended to improve children's access to vision screening and follow-up care. H.R. 2527, the Early Detection of Vision Impairments for Children Act, seeks to establish a national approach to children's vision and eye health.
