ABSTRACT
Introduction: The National Myopia Prevention and Control Workgroup was set up to review current scientific evidence, to review the National Myopia Prevention Programme (NMPP) and to recommend strategies to the Ministry of Health. Methods: A Medline search was conducted to identify relevant articles. Workgroup members met with representatives from Health Promotion Board, Ministry of Education and several world-renowned myopia researchers. Results: Near work contributes to myopia development. Greater time outdoors significantly lowers the risk of myopia. Breastfeeding may be protective. Family history of myopia and higher IQ were associated with development of new myopia (level II evidence). Other risk factors such as PAX 6 genes, higher educational level, prematurity, Chinese race, female gender and socioeconomic status were significantly associated with myopia (level III evidence). There is no evidence to support the use of commercial products for retardation of myopia progression. Topical atropine is effective in slowing myopia progression. The NMPP overpromotes use of vision breaks with little emphasis on outdoor activity. Conclusions: Further research with better quantification of near work is recommended. The role of vision breaks should be de-emphasised. There should be more emphasis on outdoor play and stricter regulation of commercial devices. Atropine is recommended only in cases of rapid myopia progression or high, progressive myopia. The frequency of vision screening can be reduced. Future research efforts should focus on specific risk factors, reassessment of selected programmes and new treatment options. Reading material summarising the workgroup’s findings can be distributed.
The prevalence rates of myopia, including high myopia (spherical equivalent at least –6.0 diopters), are rising to epidemic proportions in Asia. Singapore has one of the highest rates of myopia in the world.1-3 To address this huge public health problem, the national disease control plan for prevention and control of myopia was developed in 2000. Subsequently, the Health Promotion Board (HPB) launched the National Myopia Prevention Programme (NMPP) in 2001. The National Myopia Prevention and Control Workgroup was set up in October 2005 to review current scientific evidence, to review the NMPP and recommend strategies to the Ministry of Health (MOH). The chairman of the workgroup was Dr Yvonne Ling and the members were Dr Quah Boon Long, A/P Wong Tien Yin and Dr Leo Seo Wei. Four resource people were appointed, namely A/P Donald Tan, A/P Saw Seang Mei, Dr Rose Vaithinathan and Dr Chew Ling. Dr Derrick Heng from the Epidemiology and Disease Control Division was the representative from Ministry of Health while Dr Julia Lim provided secretariat support.
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