Is There a Role for Corneal Refractive Therapy

O.A.M., Ph.D., D.Sc.Myopia is the leading cause of vision loss worldwide, effecting atleast 1.6 million people—and these numbers will continue to grow.It is estimated that by 2020, myopia will effect 2.5 billion people,making the global impact of visual impairment enormous. Morethan half of ethnic Chinese children 11–12 years old in Singapore,Hong Kong, and Taiwan are myopic, and by the time thesechildren reach 17 to 18 years of age, the rate of myopia will beclose to 90% (Fig. 1).Myopia is a serious health problem because it is irreversible,often bilateral, and affects individuals in their most productiveyears. High myopia ( 6.00 D) can lead to a decrease in quality oflife and an increased risk of complications, including cataract,glaucoma, and retinal detachment. In addition, the duration ofblindness caused by complications associated with myopia can lastfor many years, with blindness caused by myopic retinopathylasting for up to 17 years, diabetes and age-related maculopathylasting up to 5 years, and glaucoma lasting 10 years.In children, the statistics are particularly worrying. Not only isthere a high percentage of blindness caused by refractive error, butdata from the Refractive Error Studies in Children show that thereis a very high degree of uncorrected refractive error in childrenfrom Chile, Nepal, India, and China (Table 1). The burden ofuncorrected refractive error is also high in adults from developedcountries, with uncorrected refractive error being responsible for25% of functional blindness ( 6/60) and 56% of visual impair-ment in a population of Australian adults.