MYOPIA PREVENTION INITIATIVES IN THE WESTERN PACIFIC REGION: MALAYSIA

Abstract

Prevalence of myopia in Malaysia is 9.8% (7 years old) to 34.4% (15 years old) with substantial proportion of unmet need for refractive error (55%).1 Myopia is expected to affect half of the world’s population by 2050, which giving them a higher risk for more serious eye conditions such as glaucoma, cataracts, macular degenerations and retina detachment. Malaysia has been involved in the Global Action Plan for prevention of blindness and vision impairment, in line with Towards Universal Eye Health: A Regional Action Plan for the Western Pacific (2014–2019). In 2018, Malaysia was also included in the joint WHO/International Agency for the Prevention of Blindness (IAPB) Meeting on Developing Myopia Control Strategies to discuss and propose policy development within the region through i) updating existing strategies and approaches to reduce the burden of uncorrected myopia ii) identifying effective activities to address the burden of myopia in countries; and iii) creating partnerships for implementation myopia control and prevention. The outcomes of the meeting were focused in addressing prevention, detection and management of myopia. China, Hong Kong, Singapore and Australia are much advanced than Malaysia as their initiatives are towards controlling progression of myopia through prescription of a breakthrough optical lens and outdoor activities integration into the school’s curriculum. In Malaysia however, despite vision screening has been in place since 1967 established under the School Health Team (SHT) program 2 inclusion of Optometrists both at public and private sector is non-structured. Challenges identified include lacking of recent data on myopia, access to cycloplegic refraction and financial barrier to spectacle. Consequently, following screening and refraction a child may not get a spectacle, thus uncorrected refractive error remains as hindrance to the effectiveness of the SHT program. In summary whilst Malaysia has incorporated vision screening program for 5 decades, there are still significant gaps in the provision of vision screening, correction of myopia and myopia control. Strategic planning and advocacy work are fundamental in the effort to improve the current program through improving role of optometrists in the refractive services and optical provision.

Prevalence of myopia in Malaysia is 9.8% (7 years old) to 34.4% (15 years old) with substantial proportion of unmet need for refractive error (55%).1 Myopia is expected to affect half of the world’s population by 2050, which giving them a higher risk for more serious eye conditions such as glaucoma, cataracts, macular degenerations and retina detachment. Malaysia has been involved in the Global Action Plan for prevention of blindness and vision impairment, in line with Towards Universal Eye Health: A Regional Action Plan for the Western Pacific (2014–2019). In 2018, Malaysia was also included in the joint WHO/International Agency for the Prevention of Blindness (IAPB) Meeting on Developing Myopia Control Strategies to discuss and propose policy development within the region through i) updating existing strategies and approaches to reduce the burden of uncorrected myopia ii) identifying effective activities to address the burden of myopia in countries; and iii) creating partnerships for implementation myopia control and prevention. The outcomes of the meeting were focused in addressing prevention, detection and management of myopia. China, Hong Kong, Singapore and Australia are much advanced than Malaysia as their initiatives are towards controlling progression of myopia through prescription of a breakthrough optical lens and outdoor activities integration into the school’s curriculum. In Malaysia however, despite vision screening has been in place since 1967 established under the School Health Team (SHT) program 2 inclusion of Optometrists both at public and private sector is non-structured. Challenges identified include lacking of recent data on myopia, access to cycloplegic refraction and financial barrier to spectacle. Consequently, following screening and refraction a child may not get a spectacle, thus uncorrected refractive error remains as hindrance to the effectiveness of the SHT program. In summary whilst Malaysia has incorporated vision screening program for 5 decades, there are still significant gaps in the provision of vision screening, correction of myopia and myopia control. Strategic planning and advocacy work are fundamental in the effort to improve the current program through improving role of optometrists in the refractive services and optical provision.