The position of the Swiss Society of Ophthalmology on myopia

Hi.

I guessed it would be interesting to share the official position of this Swiss order of ophthalmology, to see how it contrasts with some other maybe.

Their position on myopia:

In french; https://www.sog-sso.ch/fileadmin/user_upload/Datenablage/Fuer_Patienten/IMSOAD_Myopie_18_5_20__002__FR_relu.pdf

In german: https://www.sog-sso.ch/fileadmin/user_upload/Datenablage/Fuer_Patienten/IMSOAD_Myopie_18.5.20__002_.pdf

Unfortunately, there is no Italien, no romansh and no English version of this 3 page pdf so I’ve put the french version through DeepL. (Edit: change to google translation because of the issue of Deepl’s translation)

Position statement of the Swiss Ophthalmological Society (SSO) concerning the prevention and treatment of myopia in adolescence

In the majority of cases, myopia occurs due to longitudinal growth excessive eyeball. This usually begins at school age and lasts ends in early adulthood. Unlike body length, the eye can continue to grow in adults. Myopia is not in itself pathological, but constitutes a risk factor for a series of eye diseases. Detachment of the retina, degenerative retinal diseases and glaucoma are among the complications the most common of myopia. The risk of significant eye disease increases with the length of the eye, it is particularly high in myopia pathological. The risk situation persists even after intervention by refractive surgery, that is, laser correction.

Various risk factors for the onset of myopia are known. Predisposition hereditary comes into play, which means that children of nearsighted parents have an increased risk of becoming myopic themselves. In most people myopic, environmental factors seem to play a more important than a genetic predisposition. The lack of daylight represents the predominant and best studied risk factor. Children staying exclusively or very often in confined spaces have a high risk of becoming myopic. Nearly extensive activity may also play a role. Given than people who spend a lot of time reading and doing other tasks more closely also stay in confined spaces, it is nevertheless difficult to determine statistically whether close work actually has a affect the occurrence of myopia. Up close activities include reading, but also the use of electronic media such as smartphones, computers and television. It has so far not been possible to demonstrate that the consumption of electronic media had a negative impact on the development of myopia. Moderate use seems wise, however.

Current therapeutic concepts follow three objectives: to prevent the occurrence of myopia, delay its onset and slow its progression in order to reduce in particular the part of pathological myopia. To prevent myopia and slow the progression of existing myopia, we recommend: - spend two hours a day in the open air - observe a brief break every 30 minutes during up-close activities extended periods such as reading, working on a computer, tablet or smartphone. This may consist of looking into the distance out the window. In addition, it is appropriate avoid too short a working distance (optimal reading distance about 40 cm). During up-close activities in confined spaces, the brightness is essential and as much natural light as possible is desirable. These recommendations are valid for children and adolescents aged 0 to 20 years, most of the data from children between 6 and 12 years old.

In the event of pre-existing myopia, there has been the possibility of slow down progress. Large randomized and blinded studies have shown that atropine as eye drops in very low concentrations could slow the progression of myopia statistically and clinically significant. The use of these drops is therefore a relevant option to slow down the progression of myopia. The question of whether these drops allow possibly prevention of myopia is currently being investigated. Likewise, nighttime contact lenses (Ortho-K) are probably effective against the progression of myopia. The durability of the effect is however much less studied only for atropine. Research concerning the association of the port of Ortho-K lenses and atropine are insufficient and this currently cannot be generally recommended. In addition to these two possibilities, a whole series of other therapeutic measures against myopia are available on the market (variants of contact lenses, glasses special eye drops based on other substances). However the efficiency of all these new treatments are not sufficiently proven and therefore cannot be generally recommended. An under-correction of myopia, that is to say a weak correction that does not lead to to optimal visual acuity from a distance, currently also cannot be recommended as a general guideline. Eye training and exercises are not effective against myopia and its progression. Those interested will find further recommendations from the Swiss Society of Ophthalmology on the link “Myopia”.

Here it is. They admitting it’s more an environnement factor than genetic factor however, they don’t recommend lowering correction glasses because they probably don’t have enough “evidences” or aren’t really interested in investigating that way but that’s my two cents.

6 Likes

It’s not too terrible, but they don’t even entertain the idea that myopia is reversible (even in special cases.)

It’s amusing to me how that’s a taboo subject.

6 Likes

Thats good.

Yeh its slowly getting in there.
I did a crap load of journal reading when I started EM and from what I can see the Swiss Society is just reflecting what is available in the literature out there.

To my knowledge there are no studies looking at using reduced lenses for “myopia reversal” in humans. There are short term studies in humans. But no reserchers are game enough to claim that myopia can be reversed yet. They researchers then usually suggest the great potential for reduced lense use. But I haven’t found any long term studies in humans.

5 Likes

They’re going to fix balding before myopia, that’s my wager. :joy:

5 Likes

They had me right up till that last paragraph… And the 40cm reading distance since we 50 is better. And the fact that they didn’t recommend to remove correction for close up.
But otherwise nice to see that environmental factor bit. Now if only they would broadcast that…

3 Likes

Does anyone have that link to the Singaporean Opto Society?
was that you @nycmao ? Talking about retaining children’s original script before starting with higher diopter glasses…

I think the link is on this site:

He specifically recommends under-correcting by 0.25 to 0.5 diopters, and in fact recommends using a different pair of glasses for close-up and distance. It’s about as close to a mainstream advocate for EndMyopia as exists (I think).


8 Likes

yeh thats great.
I would love to know if he knows about EM.

There is also that American Optometrist that practices myopia reversal that Jake interviewed years ago.
I remember in that interview she mentions that she thinks there are probably a few hundred practitioners in the USA that are practicing myopia reversal or myopia control. But she says that no-body is outspoken about it…for some reason…

3 Likes

Just e-mailed him. Let’s see what’s up. Maybe he’ll do a podcast episode.

4 Likes