Myopia and Optometry: It’s Ours to Own

I’m honoured to be speaking to you along with my colleagues, friends and people within our optometric community whom I respect and admire for the impact they have on our profession. I will start us off in my capacity with the World Council of Optometry (WCO) to give you a global perspective of myopia and the impact that its upcoming epidemic will have on our patients, our practices, but even more so its impact the world over. I hope to illustrate to you the etiology, some new findings and current realities, and the risks to adult vision.

I think it is important, first, for everyone to have a brief history, specifically of WCO’s role and its relationship with myopia and myopia control and how central it is to this talk in a broader sense.

The reason WCO is important to us in Canada is because even though we are the beneficiaries of all those who have created our position and our role in the Canadian healthcare system, there currently is no official national strategy on vision care in Canada. One of the reasons that Canada is not mandated to have one is because the vision care sector has virtually no presence at the World Health Organization. There is no secretariat or office dedicated to vision. As a matter of fact, we are under Non-Communicable Diseases and currently in Disabilities and Rehabilitation. It’s actually very difficult to find us there!

Because there is no such directive from the WHO to its member countries, including Canada, there is no formal national mandate. This is a bigger issue globally where optometry is often not recognized as a healthcare player, including in much of Africa, Asia and Latin America. And you will be shocked to hear that even France does not recognize our profession and, as a matter of fact, it’s illegal to be an optometrist in France.

The World Health Organization estimates that 285 million people suffer from moderate to severe vision loss with 39 million considered blind. Of these, 123 million or 43% have uncorrected distance refractive errors. Uncorrected refractive error is the leading cause of visual impairment globally which places a financial burden on the economy, is a significant contributing factor to poverty, and is avoidable.

Our WCO Councils and Presidents have done a tremendous job of advocacy with our federal governments in recent years. In the last 15 years, Canada has signed on to the only two WHO-recognized vision care sector programs: VISION 2020: The Right To Sight, and the Global Action Plan for the Prevention of Avoidable Blindness and Visual Impairment 2014 to 2019, where the goal is to reduce avoidable blindness by 25% by 2019.

So why is WCO and its relationship with the WHO important to us as Canadian optometrists? The next wave of WHO Sustainable Development Goals will be passed at the General Assembly for the WHO in 2020 and one item under the mandate of the new Director General is Universal Health Coverage. It is our aim, along with our partners in the International Agency for the Prevention of Blindness, to have the vision care sector recognized globally by the WHO within the broader public health arena. That has never happened before, and if we don’t get in this time it will be 10 years before we have another chance at this.

This directive runs until 2030. We have the attention of WHO and this directive is not being led by ophthalmology, and that is a first. Having such a WHO directive given to the federal government officially opens the door for formal dialogue for a National Vision Care strategy that is good for the public and our profession.

Remember, we own myopia and this impending crisis is ours to lead. But if we don’t take the lead, others are already lining up to own it. Along with the Brien Holden Vision Institute, the WCO recently announced Myopia Awareness Week for 2019. There are details to follow.

I felt it imperative to lay the groundwork for this talk by giving everyone an update on how optometry is recognized globally and what role we need to play in the management of myopia both here in Canada and globally.