MYOPIA: A PUBLIC HEALTH CHALLENGE DELIVERED DURING TREVEC 10.0 WEBINAR SERIES

Added: 2026-05-31

[00:11:56]All right. So, good afternoon, good morning, good afternoon, good evening, wherever you are.

[00:12:05]Can you hear me? I just want to get a live chat if anyone can hear me.

[00:12:16]All right.

[00:12:34]Okay. I think um Bye. Thank you very much for the chats.

[00:12:44]Uh I have to um move with you to be sure that um we are together.

[00:12:52]All right. Thank you very much. So I want to welcome you to the 10th edition of our webinar series organized by treattop vision eye center trebeek. Uh we are actively involved in public health education. We are ensuring that every Nigerian, every African and everyone in the world is equipped as far as health knowledge is concerned. Uh we um we we we have the understanding of public health.

[00:13:27]Um I hold my second degree in public health and I uh one of the things we always stress is that we if we prevent um eye diseases if we prevent um if we prevent any disease or any ill health or any condition if we prevent it is actually cheaper it's much more you know economical to manage u manage prevention that curing than than the curing part.

[00:13:58]So this is what um pushed us to ensure that the public is constantly enlightened about um healthcare um I care in particular and um we have never failed in that and this is our 10th edition or 10th um presentation as it concerns this particular matter and so I want to welcome us to this wonderful presentation today. I'm sure you can see my screen and hear me very clearly. I will in a few minutes share the slide. Uh we're going to be looking at a very very interesting topic today.

[00:14:39]So just to mention, I'm sure my face is not um strange. My name is Dr. Osaz Ab.

[00:14:46]I am an optometrist and also a public health educator. And so we're going to be looking at a very very interesting um topic today which cuts across board which is actually the in as far as u global health is concerned it's actually looking at um it's actually taking the center stage as far as um eye health is concerned right now and so it is very very important we look at this very condition and that condition is simply called myopia. Uh over the years we have looked at this aspect of eye care to be uh something different from what it is now. And so today we're going to be ensuring that we all get a good grasp of what myopia is about. So I'll just share my slide very quickly.

[00:15:55]And so um just to also mention we um would really love that you subscribe like this channel. If you've not subscribed to this channel before uh please do so you could get notifications as to when we are having any of our webinar series. And of course, you also have access to the previous um recordings of the past um webinar series. Um can you see my screen?

[00:16:27]Just to be sure that you can see my screen.

[00:16:35]Um can I get a chat that you could see my screen?

[00:16:47]All right.

[00:16:50]So, we're going to be looking at myopia, which just like I mentioned before is a public health challenge and not just as it is now. It's it's um would I say the danger it poses to us right now is enormous but it's not compared to what is coming. And so we must um be aware just like we say in this part of the world that um prevention is always better than cure.

[00:17:32]And so it would be very very very wise for us to know what this condition is about and how to mitigate its challenges. So that's the topic for today. We're going to be looking at myopia a public health challenge for the next generation. And coincidentally this week is actually world myopia awareness week. So it is um we are using this presentation to also commemorate this week to ensure that the public is enlightened about myopia and its health challenge not just for this current generation but also for the next generation. And so we're going to be having a few outlines here as you could see. So um this meeting is going it's going to be a very short meeting.

[00:18:22]It's going to be about an hour. And so in that short time, we're going to try to see how we explain what myopia is.

[00:18:31]We're also going to try to look at the scale of this problem itself. And also we're going to be looking at why is myopia increasing um and also why it matters, why it is a public health health. We're also going to look at the concept of pathological myopia. Is there anything like pathological myopia? Um I know this audience is a mix of both professionals and um and the lay men and so I'll try as much as I can to break certain big terms down to your understanding because it's for the public. And so um how can we slow myopia is also another thing we're going to look at very briefly.

[00:19:12]then what would be the public health you know strategies on how to uh actually make sure that we control myopia uh and also what are the uh posing challenges ahead we also we're also going to be looking at that and then what can you do what can I do I'm doing um what I can right now one of the reasons why we are doing this presentation is to ensure that we know and when you have knowledge knowledge gives you power. Okay. And then lastly, we're going to be looking at the future outlook um call to action to actually protect the sites of children and young adults and also building a brighter future. So very quickly, what is myopia?

[00:20:01]I'm sure this is a term that you have heard severally and you may have heard it in um in the TV or so many places.

[00:20:10]But what is myopia? I'll just break it down very quickly. If you look at what myopia is, simply we also call it shortsightedness.

[00:20:18]Okay, shortsightedness meaning that this patient or whoever is having myopia can only see at short distances. They can't see things a far. And so if you have the challenge of seeing things only at near and things at distance looks blurry, that means you may be suffering from myopia. And so it's one of the most common vision challenges, one of the most common vision conditions affecting people of all ages. So it doesn't it's not an age related disease or age related condition. It is it cuts across all ages from children even to adults.

[00:21:02]And so just like I mentioned that it is when optically or technically it's when if you look at this diagram in front of you here you would see that this is a normal eye and so when rays go into the eye I hope you see my post here when the ray go into the eye it should focus on an area we call the retina. The retina is the area at the back of the eye that allows us to see images clearly. All right. Now, if paradventure due to the length of the eyeball, the eyeball is too long or perhaps the uh power in the eye. We call it the refractive power. If it is too much, then the ray will focus in front of the eye like you see in this second image.

[00:21:55]And that will cause that patient not to see that object clearly and that is what we call myopia. So myopia simply means the eyeball is too long or perhaps the cona which is the anterior part of the eye is too correct or have too much power and then the light doesn't focus where it should focus. So symptoms of myopia could of myopia could be that just like I mentioned the classical sign is that distant vision will be blurred.

[00:22:28]Sometimes you could have some form of strain and sometimes you could have headaches if it is associated with other visual conditions. Okay. Uh it could have it could stem from different types based on the degree. If it is low um it could be low rather it could also be moderate and it could also be high. So myopia is a refractive error and most people especially young children that you see wear glasses it's possible that the glasses you're wearing is to correct for myopia. And so that's a brief of what myopia is. Um so in summary myopia just means shortsightedness. you can't see things that are are far off. You only have um you only see things that are close by. Now let's look at the scale of this problem. The scale of myopia, the scale of this problem. Just like I said earlier um going I would say some few years back we never saw this coming but today what we are seeing now is that currently we have about 2.6 6 billion people affected with um this um condition called myopia and that is um 33% of the world's population. Okay. But there's a projection that by the year 2050 half of the world almost half of the world that's about 4.9 billion people will be affected.

[00:24:04]All right. So this is a scary scary statistics and we need to one of the reasons why we must we're going to be much more proactive here in Africa though we don't have so much data here because there's poor research in this part of the world however we must see that one of the things that have happened over the short period is that the prevalence in Africa is is low yet yes due to a lot of factors one of them is poor researching but the rise in the prevalence is is alarming. So you you will find out that Africa is also affected with this. Don't think it's it's um just a western um statistics it is also affecting us also here as far as um um Africa is concerned. Yes, you have more prevalence in the Asian um Asian continent where you have it's almost about 90% you know prevalence meaning that it's quite quite high in that part of the world. Okay. However, it doesn't mean that we here in Africa are not at risk. But if the entire world become or half of the entire world become myopic at a projected year of 2050 that is quite a shocking news. It means that every amongst every 10 persons you see, five of them will be myopic, you know, or battling with myopia. And that is really really scary. And so it is really really needed that this information is put out there for people to understand what we what myopia is and how to mitigate myopia.

[00:25:49]So one of the things you should also note is that there's an age of onset.

[00:25:54]Okay? Though the age of content may not be known um you cannot say it starts at age 2 or age three or age 4. That is why the need for regular eye checks the need for um frequent and prompt eye exam is necessary. As young as that child is, you could bring that child for ocular exam if per adventure there's need for um or there's the presence of myopia but there are also other risk factors that have been shown to be associated with the development of myopia there I'll look at that later but let me just mention so you have that understanding if there's a reason why uh you should send your child for an eye exam um look deeply in your family. What is there anyone that has myopia or that wears glasses before? That's a great sign or a great risk posed to that child. So if there's a family history of spectacle wear then it means that that child may need to or may be suffering or will be suffering from myopia. And so we need to be very very uh proactive as far as this is concerned. So this is really really a global epidemic if it is not properly addressed. And so the third thing we're going to be looking at is um why is myopia increasing? Okay. So, I'll just quickly say this. Um, if you have any questions, please don't wait till the end of the to the end of the presentation before you ask your questions, I would really um appreciate if you send in your questions right away. Uh, put it on the chat box um and we'll look at that at the end of the session. Okay? So, please start putting in your questions if you have any.

[00:27:53]Um, so why is myopia increasing? There are a lot of reasons why myia is increasing. Uh back in the day when we were younger, we usually have um out more of outdoor activities. But today, children are you know locked within their homes for a lot of reasons which are generine which are genuine. Uh security situation in the world today it's um it's not as good as it used to be. Okay. So, um, parents would most likely want their children to be indoors compared to them being outdoors. And so, that in itself, it's a driver to the rise of myopia, to the high prevalence or high incidence of myopia. And so, it's very very important we have that at the back of our mind.

[00:28:45]Okay. So environmental factors meaning less time outdoors um increased network increased screen time homework reading and all of that is actually one of the reasons why myopia is increasing. You may think that you you are helping that child. Yes, of course. Telling the child to go take their books um to go use their iPad to learn to do a lot of um academic work. Yes, it's good. However, there must be a balance between that and outdoor activities. And when they go outdoor, they shouldn't go outside with their gadgets because that's also um that's contra, you know, um it's it's really not working. Okay? It's counterproductive.

[00:29:31]If they're going outdoors, they should do activities that help them look at distances. Okay? So don't say go outdoors and read your book or go outdoors and play your game on their iPad or on their tablets. That's counterproductive. If they're going outdoors, they should go outdoors and um you know just have the distant view, relax accommodation, play around, play football, just run around, ride their bicycles and all of that. If that is not there, then it means that um myopia would increase. One of the reasons why myopia increases. Another reason is lifestyle.

[00:30:09]Okay. Yes, technology is advancing especially in this part of the world. Uh but that that comes with its own rules.

[00:30:19]It comes with its own um demeritics which we must pay attention to. I just mentioned now that your um the use of digital devices you know constantly has taken up other forms of games or leisure activities that helps you know relax the eyes more and so you see more children are on their phones on their um laptops um playing games video games and all of that. So lifestyle has changed and this has affected the way myopia is increasing. Another reason why myopia would always increase would be genetics.

[00:30:59]I mentioned earlier that when there's um when a parent or when both parents are having myopia then there's a 60% chance that one of the children will be myopic. But if a patient if a parent one parent is myopic then there's a 30% chance that um the child will be myopic. So genetics, you can't run away from that. And so if that is there, it's something you can't adjust because it's already part of your gym. But there are things you could do to ensure that it doesn't worsen or you are proactive to ensure that it doesn't become uh so much of an economic so much of a burden both economically, financially, and otherwise.

[00:31:44]All right. And another thing another thing that would drive myopia to increase would be education pressure.

[00:31:52]um our our in those days um particularly in this part of the world I mean Nigeria precisely I heard my parents used to say that before you start school you must do an activity put your hand over your head if your hand doesn't touch your ear you can't start you can begin you know preschool and um but today that's not the case um a child that has given birth to today can start off you can start off schooling because of the times we are in. Dad has to go to work, mom has to go to work and as soon as um the child comes out, you know, maybe one month, two months max, three months max, the child is already in daycare and that would, you know, put some form of pressure in that child. You know, at that point, the child's already exposed to screens. At that point, the child is exposed to reading, writing materials and all of that. So that in itself can also cause myopia to increase and there are quite a number of other factors but because of our time we'll just limit it to these ones. Okay. So one once again u environmental factors lifestyle genetics educational pressure and all of that could is what is causing the myopia to increase.

[00:33:14]Why does it really matter? Okay. Why is the why is this a health a health burden? Um just like I mentioned before, myopia is now is currently beyond just blurry vision at distance. Okay. Studies have actually shown that aside the blurry vision, aside the fact that vision is not clear at distance, there are also some concerns that we should not um rule out and that is why it is at the center stage of um global eye health today. So there's a high chance that if you have myopia um there's a high chance that you will have retinal detachment.

[00:33:56]If you have myopia, especially high myopia, myopia greater than uh six diotes. Okay. Uh so what that means is that for a person that doesn't have myopia and you that have myopia, you are at you are three times more at risk to develop retina detachment compared to those that don't have myopia. And that's alarming. Okay. Now also myopic macopathies most high myop my that we say in clinics usually have some form of maculopathy that's a a a a lesion or a problem around the macula that's also very very very fundamental you know um also studies have shown that children or adults young adults with myopia are also at higher risk of developing glaucoma which is one of the fact it is the leading cause of blindness, irreversible blindness today. Glaucoma is the leading cause of irreversible blindness. Okay, it is the second um cause of blindness globally, but it tops the list when talk when we're talking about irreversible blindness.

[00:35:12]Cataract actually is a worldleading cause of blindness, you know, today. But um studies is also shifting that narrative saying that refractive errors right it's now topping that list okay so if you look at that is why we need to pay attention to myopia because myopia is a refractive error and you'll see now that um it's becoming it's shifting from the fact that catact you know yes catact still tops that list but right now it seems as if refractive error is beginning to contend for that uh um top uh top position in that list. And so we must be very very very cautious and careful and much and pay more attention to myopia. Aside the blurry vision, the economic burden for myopia is massive.

[00:36:04]Studies have shown that annually you have about $244 billion that is lost due to lack of productivity due to refractive errors or due to myopia. What does that tell us?

[00:36:18]It means that the uh individual productivity is reduced and it is costing the world this amount of money $244 billion.

[00:36:31]You know, imagine that was added to the world's um global income. That would also help. But because of the burden, the economic burden of myopia, we are losing that amount of money globally.

[00:36:45]And that is really really really not um not not nice at all. And of course, most importantly, the quality of life of those patients are not optimal. Okay? It impacts their education. It impacts employment. For example, if a person if if an individual uh that wants a job goes for an interview and is wearing maybe a very thick glasses to help correct their visual for them to see um for them to move around that may be though we don't we don't say stigmatization but sadly that's what it is. All right. So people are preferred.

[00:37:29]People that have better vision are preferred when it comes to employment.

[00:37:34]Okay. So most times people have to find and find a way to hide that high refractive error by either wearing contact lenses or some form of um therapies to hide that condition. So it affects employment, it also affects daily function and of course well-being.

[00:37:55]So it's something that we must pay attention to. It affects the quality of life of these individuals.

[00:38:03]All right. So pathological myopia, I want to say something about this.

[00:38:09]Although um we don't um right now because of the massive um attention myopia is getting from the global space we take every myopia case or we don't take any myopia case with kids gloes to ensure that um every myopia we meet in clinic we give it utmost attention all right but for it to get to this stage called pathological myopia. Pathological myopia means that the myopia has gotten so worse that it's affecting you know um the eye itself. It's now a state of disease. All right or disease like we call it. Okay. So um pathological myopia is what makes myopia that is where we don't want to get to.

[00:39:06]All right. That's where we don't want to get to it because every myopia as small as 0.5 or as small as 1.0 zero, whichever one you call it, can progress to a point where it becomes pathologic. And so the myopia case that comes to you, whether you are the mmologist or an optometrist or anybody, okay, even if you are not an eye care provider, you see someone that has myopia, you there's something you could actually do. All right. Giving the right information, telling the person to go for the right checkup can help that patient or can prevent what we call pathological myopia. And so pathological myopia is when myopia becomes blinding.

[00:39:56]It puts that patient in, you know, at risk of being blind or or or being visually impaired. Okay. So we don't want it to get to that point. I mentioned to you in previous slides that myopia compared to a regular person, okay, could cause has the person that has myopia is at risk of retinal detachment at risk of and retinal detachment could lead to blindness if not addressed on time. Macallopathies also usually are permanent permanent visual impairment conditions. Theoma like I said earlier is um uh the second leading cause of blindness generally but the first leading cause of irreversible blindness. So you see that um my has so many connection with becoming visual uh to becoming viscoming visually impaired and we don't want that. So this is where we don't want to get to and just like I gave you the statistics that the year 2050 half of the world will become blind and we are saying that about 10 to 15% of that population will have high myopia which is usually pathologic. So you see that we are in a very very very serious serious serious um emergency I'll call it a state of emergency right now uh as far as myopia is concerned and so high myopia like I said can cause structural changes making the retina to stretch out and koid to stretch out. It leads to irreversible loss of vision especially in people under 50 and also once the damage occurs it cannot be reversed.

[00:41:43]Okay. So, pathological myopia like I said is a progressive degenerative condition that is seen in myopia typically with myopia equal to you know 6.0 greater than or equal to 6.0.

[00:42:00]All right. That's about 6.0 diopters.

[00:42:03]That's what we call high myopia.

[00:42:07]Okay. So, it's not just getting higher glasses or increasing the patient's prescription. It's more about life long threats to patient. And I'm sure that this should sound scary to some of us that are not that may not understand what myopia is about. And so, we should not joke with this condition.

[00:42:30]Now the question is can this myopia that that is that we are faced with can it be controlled? The answer is yes. The answer is yes and this is where we must pay attention to.

[00:42:46]So if myopia could lead to severe vision loss what can we do? What can we do to control that? What can we do to ensure that we don't get to the point where it becomes pathologic and of course lead to blindness or lead to vision loss.

[00:43:08]Just like I mentioned before, one of the reasons why myopia would increase is because of environmental factors. So we must consistently preach that children should have more outdoor time at least 2 hours every day. This reduces myopia by about 50%.

[00:43:33]Okay. So these are things that have been proven. Okay. So it is evidence based.

[00:43:39]Um they are not just speculations. These are things that have been tested and we have seen it work. And so it is being advised that whichever um um um position or condition you find yourself, please ensure that you allow these children to have a minimum of 2 hour outdoor time.

[00:44:04]And when they go outdoor, what they do matters also. They don't just go there and still play their video games or they should run around just as said in this photo here. Let them run around, let them play, let them do hide and seek, let them play football, let them uh you know ride their bicycles and all of that. If you do that, then you are actually helping to slow down slow down the progression of myopia so it doesn't get pathologic.

[00:44:34]Uh we have several optical interventions. Uh we have several of them out there today. Uh the use of the focus um um contact lenses, we call them multif focal contact lenses. We also have myopia control spectacle lenses. Uh we have also keratology k lenses which they are rigid lenses that helps to remove the eye you know at night and these children wake up um have good daytime vision. Okay. So these are um these are some factors that helps to just a moment. I hope you can still hear me and see me.

[00:45:27]Um please if you can still hear me just um say yes. I've been talking for a while now.

[00:45:37]You can if you can hear me still.

[00:45:40]Can I just see a chat on the chat box?

[00:45:45]All right. Thank you very much. Okay.

[00:45:47]So, we are still following.

[00:45:49]Okay. So, so there are several optical um optical interventions that have been proven to help myopia work. One of these days hopefully uh we'll be looking into that.

[00:46:00]Um but you just know that we could actually control myopia with some form of interventions out there. Okay. Um also um there are some medications that can help to control myopia. We have what we call low dose atropene about 0.05 concentration that can help to slow that slow down myopia progression. Because this is an audience, this is the public, I don't want to go into the mechanism of action of these medications, but if anyone is interested, you could put it in the chat box and then I'll explain that later. And another thing is behavioral patterns. Okay, behavioral.

[00:46:40]You must also learn to relax the eye.

[00:46:43]Okay. When you are indoors, uh probably reading uh or doing your work, um have it as a habit to um look at distance, you know, for every 20 minutes of near work, look at a distance 20 ft for 20 seconds. That helps to relax the eye, you know, so that this myopia doesn't progress. So, let's train our children in that. In fact, in the some Asia countries like Singapore, Taiwan, they having policies right now to ensure that um children are forced to go outdoors. In fact, uh they they they now have some of some of these Asian countries make the classrooms of these kids to be glass glass walls. Okay? so that these children could actually look at distances to relax their eyes, not putting them in that confined space.

[00:47:43]That confined space usually reduces um um the chance for the eye to relax and that will cause myopia to progress. So these and many more have been shown to um control myopia. And so if you if you want to treat my opinion because um just also I need to mention this that your regular spectacles because some of you especially those of my students and some of my clients that are here you make if you have if your child is having myopia I must have mentioned at some point that the regular spectacles you wear will not help you okay rather it will even make the myopia to grow worse okay um there's something we called peripheral hyperopic defocus that happens when you wear your regular spectacles and that will cause the myopia to progress instead of helping. So yes, the child may see clearly but just like we said it's not just all about having clear vision. It's about having um um it's not just about having clear vision but clear and comfortable vision and also controlled vision you know in to a point or to a state where we don't see progression of that particular myopia. Okay. So these are the things that work. Now what are the public health health strategies? We cannot overemphasize. We cannot overemphasize this aspect and this is one area that I am really really very passionate about. Okay. Talking about this talking about eye health concerns is something that I would always do. We are mandated anyways to ensure that the public is properly informed because when you have an enlightened society then things work well you know in that particular um community.

[00:49:38]And so one of the ways we could actually achieve um reducing this scary scary uh statistics is by prompt and regular school screening exams. Very recently we wrote to some schools because of course in a few days from now we'll be celebrating um May May Day that's children's day and um we'll be written to a few schools for some form of enlightenment. Let's come and talk to them. let's come and give them you know some education some educative presentation as far as eye health is concerned because sometimes they don't even know the things but when experts public health experts go and speak on these matters it it it reinforces the you know the need to um be c be cautious and also be conscious of um you know these concerns and so regular school screening programs because detecting these conditions early would help. Early detection helps massively. Okay. So, whatever we need to do, if you're here and probably you are you have um you're working in a school, please let us know.

[00:50:52]We can come around and help uh screen these children and also educate the entire school. Also, educate the parents um um parents association PTA meetings.

[00:51:04]you could invite us, we could come and give a talk just to ensure that um people and public in general is aware and also on the corridor of power. Those that are making our policies should also ensure that policies that favor um the need to reduce this pending danger is enacted. We need policies like just like I mentioned to you in countries like Taiwan, Singapore because those areas have almost 90% prevalence of myopia and more than half of that is high myopia.

[00:51:41]Okay. So they are mandating students or mandating schools to ensure that children have you know good enough time outdoors. Uh so we need to have such policies policies that would help you know this um condition to be cailed.

[00:51:57]public education just like what we are doing now. Okay, I've already mentioned that uh parents, teachers, um even students themselves needs to be aware and so campaigns on public ed education is really really really myopia also access to uh myopia.

[00:52:29]control options. And to be very honest, most of the maria control options are quite expensive and and that's that's um that's a big deal because people that may not be able to afford it will not be able to and so they prefer I would say they prefer they have no choice than to manage or to be in that condition without any form of help and this is also another area that um whoever that's listening out there can also help to see how we reduce you know uh the cost of some of these things government could come in um manitarian organizations could come in and see what they could do to help in this regard okay so giving single vision spectacles will not really help anymore have shown that uh but we need to see how more education is put out there and then if the education is there the control measures should also be affordable especially in low resource settings.

[00:53:35]All right. What are the challenges ahead? We are closing now. I know the time is fast spent. The challenges ahead or the barriers to progress. Um number one, lack of awareness in a general population. This is where we come in as public health experts to ensure that we constantly educate people about this. Um knowledge is power and power will help you to give you the ability to do work as it is defined in um physics you know back in those days.

[00:54:09]um also cost and access to marriage control in low income areas. We also say that that's another challenge and whoever government humanitarian organizations could see how they could help you know in this or even you know private individuals could also I have a patient that um each time she travels out she always remember to get medication not just for herself but for others and um she's she's really really been a blessing to a lot of people. So when she comes with these medications, you know, those that couldn't that can't afford them, you know, are giving they are given, you know, uh freely and some people just it's quite it's quite she's doing a lot okay in her own capacity.

[00:54:57]And so if more persons do that then you will help others you will help people that um can really afford these medications. Okay. Uh another thing is that there's no global consensus as far as standard screening age is concerned.

[00:55:13]So we need much more uh research much more um data that would help us know when screening when we need to start screening these children. But we don't need to wait for that. Okay? As long as that's a challenge that shouldn't stop you know us from doing the screenings that we need to do. Okay? We must ensure that um at regular interval go to preschools as long as the child could read and write or perhaps could identify objects. That's a good state of a good time to screen them. Another challenge that we are facing especially in this part of the world in Africa we still see um glasses as you know a taboo. She see glasses as oh no my child can't wear glasses. Oh, glasses will scroll the children's eye or it makes the eye worse. That's the notion that we still have till date and these misconceptions have to be addressed otherwise we'll still remain in this uh menace. Okay. So we need to fight these challenges and whoever is listening to me right now you could contribute in ensuring that these challenges doesn't stop us from um from achieving the goal. What can you do?

[00:56:30]What can I do? I am doing my bit and I and I will continue to do this. For those of us that are parents, encourage your children to have 2 hours minimum of outdoor time. And also try to limit their near work. Some children they read by bringing the print so close to their eyes. That is really really not nice.

[00:56:52]When you see that please correct that habit. Okay. But sometimes it's not really their fault because that's the way they could see it. And so what you could do to help them is to bring them or take them to um the experts so that that um habit can be cailed. And of course as parents also ensure that you take your children and even yourself for annual checks. Once a year is not too bad. It's not too much to ask for. Uh for those of us that are in schools, let's also ensure that we build outdoor breaks into our school day. Um the children need to go out and play and when it is break time, let no child remain in the class and force them. Let them go outdoors. Don't uh let them go outdoors. Okay? because that would help them to um be free from this um this increased risk of myopia development or even myopia progression. Okay. So um let them go outdoors. Ensure that they go outdoors and also promote active healthy routines for all students. Um um sometimes let them still the outdoor thing. Just let them go outdoors and not living that sedentary lifestyle. Okay?

[00:58:04]Let them be active as they go outdoors.

[00:58:07]Let them play. Let them run around.

[00:58:09]Okay. But another point is for children that may not be able to that are not that have some form of impaired vision.

[00:58:17]They will be able to enjoy outdoor. Why?

[00:58:20]Because they are not even seeing clearly. Okay. You're saying the child will play football, go outdoor and play football and the ball is he or she is not seeing it clearly or go and play catch up. They can't catch whatever they is being thrown at them. These are these are concerns that um we also need to look at and so they need to see an expert that would help them. So if you observe that a child is always wanting to be indoors uh don't want to go around a child is bu to play. If a child is not playing something is wrong you must be able to find solution to that. It could be that that child is not seeing the way he or she should.

[00:58:59]Um so for those that are in uh that are in um in authority to make our policies please they should include myopia in the the health plans national health plans or perhaps international health plans so that um some of these things some of these medications some of these control measures are affordable by everybody um so that um we can also contribute our quota in reducing this burden. uh we should also invest in screening education and mopia control programs.

[00:59:32]Okay. Funds can also be um invested you know in this regard so that um um this menace can be cailed. Why for everybody?

[00:59:44]Everyone just make it as make it a rule make it mandatory make it a routine that you go check your eyes. Okay, just have that at the back of your mind that once every can be once a year, it could be twice a year as you can as you you know based on your your schedules please just have time to check your eyes. Okay, because any detection will always always protect the future uh the vision the future vision.

[01:00:16]So what do we look out for a preventable epidemic? Can we actually prevent this very very large scale problem? Is it possible to prevent it?

[01:00:28]Well, if we don't do anything, that whole statistic is showing that if we don't do anything by the year 2050, which is just about 24 years from now, some of you that are listening now may I'm sure you will still be alive then.

[01:00:42]Okay? But some of you also will have children that may be in that or may be at risk of this. So uh give or take we all are part of these things and it is it is really really really important that we contribute our quarter to seeing how this can be stopped. So yes it is preventable if we do something but if you don't if we don't do anything if we leave it for only set a set of people a few set of persons to do and you don't do yours then sadly we miss Sorry, I don't know if you can still hear me.

[01:02:08]Um, I had an interruption of network.

[01:02:10]Can you still hear me please?

[01:02:23]Can someone mention in the chat box if you can hear me? Okay.

[01:02:28]All right. So, we can hear you can hear me. Thank you very much.

[01:02:35]Okay. So, we're looking at the uh future outlook and the and a preventable epidemic. Yes. Like I said, we can actually prevent this epidemic from becoming from becoming live, you know, staring us in the face. So, let us shift goal from correction to prevention. And that's actually the goal of every um every um health care professional, especially those of us in public health.

[01:03:06]will ensure that um our focus because of course in the we have three levels of three levels of um health care. Okay, we have the primary, we have the secondary and we have the tertiary. But in public health, we have four actually. There's something that precedes the primary which is usually preventive. Okay. So the preventive part is what we focus on as public health experts to ensure that the disease or the condition doesn't even come at all.

[01:03:45]Okay. We are much more um it's cheaper that way. And so more focus should be shifted from doing the intervention to prevention. Okay. And also if perhaps we couldn't prevent it and it happens then we can actually control it.

[01:04:04]All right. So, um, so in wrapping up tonight's presentation, what are the takeaways? What do you, what are we saying you should go home with?

[01:04:18]The first is know that myopia is rising and it is rising very very fast.

[01:04:29]Okay, Maropia is rising very very fast and is driven largely by the environment we find ourselves which is usually indoors and also our lifestyle lifestyle of always on the gadgets looking at screens um and all of that. So that's one fact we must go home with tonight. Another one would be that high myopia is dangerous. If that myopia progresses progresses to a point where it becomes high myopia then that can lead to an irreversible loss of vision.

[01:05:14]It leads to a point where vision cannot be restored.

[01:05:21]So that's what you need to go home with.

[01:05:23]And of course the third will be outdoor time early detection and the myopia control that have been proven to work could actually modify this condition. It could actually reduce the um the trivial and most importantly the uh this scary statistics we may end up not getting there. Okay. And that is why there's a call to action from every one of us listening today. Uh we need to ensure that every of our um every um attention and not just only attention every of your um resources both human material finance you know knowledge whatever it is you must invest it. So let us act today so that we can protect our tomorrow. Small steps now and we'll get to that point where vision is clear and of course that will impact largely on the quality of life of not just you but the whole world. So I want to thank you for listening to this presentation.

[01:06:42]Um this is uh this is our uh our social media handles. Do well to follow us on Facebook, Instagram, Tik Tok and um YouTube and of course our website and also just to also mention please try subscribe to our YouTube channel if you have not done that. Uh subscribe so you could get more information about um the next webinar and what topic it's going to be. Uh I'm sure uh you this tonight's meeting was enlightening and so in the next few minutes before we wrap up I'll just um take the questions that uh are there on the chat box um Okay. So, okay. So thank you very much everyone for joining this um webinar. So I'll just quickly look at the questions on the chat box and answer them um very quickly before we close.

[01:08:15]Sorry we are taking so much time but we're wrapping up shortly. So the question is coming from this question is coming from Enoch and he said sir with increase in screen time among students do you think modern lifestyle is becoming a bigger cause of myopia than genetics? Well well that is what we're talking about. We we we have not been able to define uh which of them causes more or causes more increased risk of myopia. Uh but if we're not careful, it may overtake genetic genetics. Um the only the only difference between the risk pro gateway or the risk that is associated with genetics and lifestyle is that genetics you cannot control it. It's not modifiable. But that of the lifestyle is and so that in itself should also give us the um the the uh the ability to be able to control you know lifestyle.

[01:09:23]Genetics you can't run from it because it's inbuilt. It's how you are. All right. And so that is that can be modified that can be controlled. Okay.

[01:09:33]But even with that there there are still some things you can do because the presence of genetics as well as the presence of other conditions can also the problem.

[01:09:43]So it's not it's better we look at um the areas we can modify and then modify that. So lifestyle yes can get to a point where it becomes um a much higher risk than genetics itself but as it is now that is what we are not there yet.

[01:10:02]But if care is not taken, we will get there. And that is why there's a call for action from every one of us. I hope I was able to answer that question, sir.

[01:10:12]Okay. So the next question is from Cami.

[01:10:14]She says, "Good evening, sir. My question for you today is why does aial elongation continue even after refractive correction in myopia?" Okay.

[01:10:27]So this is uh you want me to go very technical. This is one of my students.

[01:10:31]Uh okay. So for you just remember this word or this phrase PHD peripheral hyperopic defocus. Now when you correct myopia with your regular single vision lenses. Okay. What you do is that you are correcting vision. You are not treating the problem. you're not controlling the problem because the back of the eye remember it's not a flat surface. Okay? So when you use that single vision lens to correct the eye, you just correct the center part of the eye. All right? You correct the center part of the eye and the periphery remember it's a curve. The back of the eye is correct. So the periphery is not corrected. The rays will meet at the back because the periphery of the eye is inwards. if you understand what I mean.

[01:11:23]So the central part yes is corrected but the periphery is not and because of that the image will be focused behind and remember in hyperopia what happens is that images are actually behind the retina and so because the brain understands that there's a peripheral hyperopic defocus the brain in itself will want to correct that defocus and when in a bit of doing that it causes a signal Now for exial elongation.

[01:11:57]Okay. And when the exial length elongates to correct the peripheral defocus hyperoptic defocus what happens at the center the center becomes myopic again. And that's what explains why a myop that is wearing single vision of minus2 today. In the next 6 months that glasses is not as clear as it was 6 months ago. They go and they change it to something higher to maybe minus um - 250 and you see it keeps going high and high and high like that become until it becomes minus 6 or minus 8 because you'll be using spectacles that are not right to address it. So that's exactly why ex length will elongate even if you use um refractive corrections spectacle corrections like single vision spectacles.

[01:12:48]All right. So I hope um I was able to address that question but if you if you don't mind we could still see you could ask me that again when we meet in school. Um the next question is from um Master George. She says with the increase in the prevalence of myopia, how can the professional ensure the government is duly informed and help in reducing these challenges?

[01:13:16]Well, uh well, we will keep doing our bits. We don't have as some of us don't have I can't just I can't just walk into the national assembly for example and say I want to go and tell the president or the lawmakers to do something concerning this. what we keep doing is to engage the media like what we are doing right now. Okay. Um some some few weeks ago I was invited for a talk on one of the um um media media houses okay and I was able to explain certain things about eye health and all of that. So the opportunities we have to engage you know the media we all need to do that as professionals we keep we need to okay social media now is another very important tool uh I don't know if these policy makers go on social media but I'm sure they have it that goes there that should tell them the right things so we'll keep doing this keep engaging the the u u the media states putting the right information out there so that people will be much more informed and hopefully it gets to the right um source and then actions could be taken by these policy makers.

[01:14:29]Um okay, another question is uh he said if someone already has myopia can spending more time outdoors help reduce the chances of the myopia increasing or progressing I think that is yes exactly so that's one of the things we are we are saying here that myopia control one of the proven myopia control methods is increased outdoor time so two um hours minimum per can help to control myopia progression.

[01:15:01]I think that's very clear. Okay. So, um the another question here which will be the last question because of our time is can myopia progression ever stop completely?

[01:15:15]Uh okay. So, what studies have shown to us is that yes, you could have some um um some point where it stops. So uh what studies have shown to us is that um at age 24 uh yes you still see some form of progression. Okay but at between age 24 and 825 or around that area you'll find that 94% or 96% of um 96% of the that population must have stopped progressing 96 at age 24.

[01:15:51]So let's flip it back. So it means that four if it's 96% okay if 96% of that age group stops progressing at age 24 it means that there's still 4% that will progress you see that so what I do is that until uh we have seen clearly that myopia is not progressing because you don't know the patient that comes to you even if that patient is 24 25 years and is myopic you don't know if that particular patient will all amongst that 4% that will progress or the 96 that will not progress. So what I do I'm not a spirit that would know that I'm not um I don't I don't see the future except God gives me grace to see that I don't know so I won't be able to tell that this patient will progress except like I said we have found out that over time this patient has remained consistent there's no there's no evidence of progression at that particular age then we can um we can we may not be we may not we may not necessarily give any form of myopia control however At that age, you could still find some level of progression. But when you have crossed that age, that's what studies have shown. We have not looked at older adults from um say 30 and above. We don't expect myopia to progress at that age. But uh you could still find one or two case where uh you have aset myopia.

[01:17:19]Okay, it's there. It's already researched. It's already studied. Okay.

[01:17:23]So, but summary to say to end that question is even at age 24 you still have some people progress but it is worse when you are younger. Younger than that you have much more people progressing. So, but at age 24 you have 96% stopping and 4% not. Okay. So, I don't know if that answers that question.

[01:18:19]Thank you.

[01:18:26]>> Okay. So, if you could still hear me.

[01:18:28]Sorry for that break. I think um we have been able to u conclude this webinar series today. I want to especially thank everyone for joining this um webinar.

[01:18:42]Thank you so so much and please ensure that you um if you've not subscribed try to subscribe so you could get more of our previous videos and even this current video uh of video recording so you could be more informed and enlightened and please share the video so that others could learn and benefit from um what's going on as far as um myopia is concerned. So thank you everyone. I I'm sure um sorry for that break earlier that was due to a hitch in the network and thank you very much everyone for joining and I hope to see you next month for another exciting um webinar presentation. Thank you everyone and do have a wonderful evening or morning or afternoon whichever way whichever place you are in the world.

[01:19:32]Have a wonderful day. Bye.