Step One: Identify High Risk Group

Consultation and Evaluation

The first step of Myopia Management System™ is to collect important information for evaluation:

• Degree of Myopia of the child

• Family history: whether the parents are myopic
  -Both parents are myopic, one of the parents are myopic or both parents are not myopic

• Daily habits
  -Amount of time spent on outdoor activities

Who are at high risk?

Risk factor: Family History ^{2, 3, 4, 5}

Compared to having no myopic parents:

• Having child with 2 myopic parents: 5.1X more likely to be myopic

• Having child with 1 myopic parent: 2.1X more likely to be myopic

Risk factor: Inadequate Outdoor Activities ⁹

• A large scale in Sydney Myopia study 2003-2005 to investigate myopia prevalence in relation to near work and outdoor activity.

• 7 year olds (n=1756) and 12 year olds (n=2367).

• Lowest risk for myopia was found in children with highest levels of outdoor activity.

• Children with low outdoor activity and high near work hours per week had 2.6x the risk of myopia than high outdoor/low near work children.

• Low outdoor/low near work groups had a higher risk for myopia than high outdoor/high near work group.

Combination of two risk factors ²

• Highest Risk: 2 myopic parents + little outdoor activities
  - 60% chance of having myopia if < 5 hrs/wk of sports or outdoor activities
  - 20% chance of having myopia if ≥ 14 hrs/wk of sports or outdoor activities

• Lowest Risk: no myopic parents + lots outdoor activities
  - Outdoor activity did not equate to less near work

Increased time outdoors decreases the chance of having myopia ²

2. Jones LA, Sinnott LT et al. Parental history of myopia, sports and outdoor activities, and future myopia. Invest Ophthalmol Vis Sci 2007 Aug;48(8):3524-32.

3. Ip JM, Huynh SC et al. Ethnic differences in the impact of parental myopia: Findings from a population-based study of 12-year-old Australian children. Invest Ophthalmolo Vis Sci 2007 Jun;48(6):2520-28.

4. Young TL, Metlapally R, Shay AE. Complex trait genetics of refractive error. Arch Ophthalmol 2007 Jan;125(1):38-48.

5. Tang WC, Yap MK, Yip SP. A review of current approaches to identifying human genes involved in myopia. Clin Exp Optom 2008 Jan;91(1):4-22.

6. Rose KA, Morgan IG et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology 2008 Aug;115(8):1279-85.