The global prevalence of myopia is projected to rise dramatically, with estimates suggesting that nearly 50% of the world's population (approximately 5 billion people) will be myopic by 205012. This represents a significant increase from the 23% prevalence rate in 20003. Of particular concern is the projected increase in high myopia (≤-5.0 diopters), which is expected to affect nearly 1 billion people by 2050, a 7.5-fold increase compared to 20002.

• Asia-Pacific countries are expected to have the highest prevalence rates, with projections indicating up to 69% myopia prevalence in Asia by 20504.

• The prevalence among children and adolescents is also rising rapidly, with an estimated 740 million cases in this age group by 205054.

• Urban environments are associated with higher myopia incidence, with each 1-unit increase in urban score linked to a 9% higher risk of developing myopia over one year67.

These projections highlight the urgent need for effective myopia prevention and management strategies, as the condition is set to become a leading cause of permanent blindness worldwide18.

Regional variations in myopia prevalence are significant, reflecting the complex interplay of genetic, environmental, and cultural factors. Here's an overview of myopia prevalence across different regions:

East Asian countries consistently show the highest myopia rates, with some urban areas reaching up to 90% prevalence among young adults4. In contrast, European countries have maintained relatively stable and lower rates5. Interestingly, within regions, significant urban-rural disparities exist. Urban areas generally show higher myopia prevalence, with one study finding that each 1-unit increase in urban score was associated with a 9% higher risk of developing myopia over one year6. These variations underscore the importance of considering local environmental and cultural factors in myopia prevention strategies.

Lifestyle factors play a crucial role in myopia prevention and management. Here's a summary of key lifestyle interventions that can help reduce the risk of myopia onset and progression:

Increasing outdoor time is particularly effective, with studies suggesting that spending around two hours a day outdoors can prevent myopia3. This protective effect is attributed to exposure to natural light, which stimulates dopamine release in the retina and helps regulate eye growth1. Additionally, maintaining a balanced diet rich in antioxidants and essential nutrients can support overall eye health2.

To mitigate the impact of near work and screen time, experts recommend following the 20-20-20 rule: taking a 20-second break every 20 minutes to look at something 20 feet away5. Creating a myopia-friendly environment by adjusting lighting conditions, ensuring proper seating and screen placement, and setting screen time limits can also contribute to better eye health2. These lifestyle interventions, combined with regular eye exams and proper vision correction when necessary, form a comprehensive approach to myopia prevention and management.

Myopia presents significant public health challenges, with its increasing prevalence and associated risks of ocular diseases. Here's an overview of key public health priorities and strategies:

The economic impact of myopia is substantial, with an estimated loss in world productivity due to uncorrected myopic refractive error of 268.8 billion international dollars1. Public health approaches should be both practitioner-led and population-based, focusing on preventing myopia onset and mitigating the risk of associated ocular diseases2. Collaborative efforts between eye care professionals, educators, and policymakers are crucial for implementing effective myopia control strategies, particularly in urban areas where prevalence is highest3. As the myopia epidemic continues to grow, especially in East Asian countries, public health initiatives must adapt to address this pressing global eye health challenge4.