In today’s post you will see a controversial point which supports some of my previous posts about Nearsightedness being a risk factor for certain sight threatening eye diseases. I will be sharing a note I received from the very wise doctor Richard L. Anderson, OD, FIAO. What you will read below is a comparison of cardiovascular disease to ocular disease and you will see how the risk factor (Myopia / Nearsightedness) has a significant “Odds Ratio, OR” for contributing to eye diseases such as glaucoma, retinal detachments, and maculopathy. This is one reason, I feel treating children early and preventing or slowing down the rate of their nearsighted progression is important.
It's time to treat myopia as a disease process that is a threat to ocular health from a myriad of related disease processes. No longer can we treat myopia as an inconvenience to be compensated for with glasses or contacts. Myopia is a risk factor for other sight threatening diseases that is "far in excess of any identifiable population risk factor for cardiovascular disease." That's from a paper D.I. Flitcroft. (2012) The complex interactions of retinal, optical and environmental factors in myopia aetiology. (ABSTRACT) Progress in Retinal and Eye Research VOL 31 (2012) 622-660 doi: 10.1016/j.preteyeres.2012.06.004
What does this mean? It means that myopia as a risk factor for vision loss is worse than any risk factor known for cardiovascular disease. That's from Flitcroft, not me.
Take a look at the tables - they even appear in the abstract in the link. An "Odds Ratio" of 1.5 means that the second factor is 1.5X as likely to happen if the first factor is present.
There is no "safe" level of myopia. Forget about the idea of pathological myopia starting at -6.00. It's all pathological.
Myopia of -1.00 to -3.00 has an OR of 2.3 for glaucoma. Myopia of > -3.00 has an OR of 3.3 for glaucoma. Myopia of -.75 to -2.75 has an OR of 3.1 for retinal detachment Myopia of -6 to -8.75 has an OR of 21.5 for retinal detachment Myopia of -1.00 to -2.99 has an OR of 2.2 for myopic maculopathy
How does this compare to cardiovascular disease risk factors? Systolic BP of 150-159 has an OR of 2.2 for stroke risk. Systolic BP of >160 has an OR of 3.2 for stroke risk. Smoking >20 cigarettes a day has an OR of 2.9 for stroke risk. Systolic BP < 140 on Rx has an OR of 2.6 for myocardial infarction
What do I think?
Myopia is a disease.
The compensation of myopia by prescribing glasses is an outdated vision related service.
The treatment of myopia by the prescription of specific myopia control procedures is a medical service whose benefit is the reduction of sight threatening disease processes.
Any attempt to place myopia treatment in the realm of vision services makes no more sense than considering glaucoma treatment a standard vision exam.