Report on the Intergenerational Increase in Myopia and its Implications for Sustainable Development Goals

1.0 Introduction

A recent epidemiological study published in the British Journal of Ophthalmology reports a significant intergenerational increase in the prevalence and severity of myopia in China. The findings indicate that this public health issue is primarily driven by environmental factors rather than genetics, presenting a critical challenge and opportunity for policies aligned with the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 4 (Quality Education).

2.0 Study Overview and Methodology

The research, led by Xin Chen, MD, from Sun Yat-sen University, aimed to define intergenerational effects on myopia by comparing parents and their adult children.

• Study Design: A longitudinal cohort study of twins and their parents.
• Participants: 686 children (aged 7-15 at baseline) and their parents.
• Duration: Annual follow-ups were conducted from 2006 to 2018.
• Measurements: The study utilized cycloplegic refractions and ocular biometry for children, and non-cycloplegic methods for parents.

3.0 Key Findings on Myopia Prevalence and Severity

The study revealed a dramatic escalation in myopia across one generation, primarily due to axial elongation of the eye. The data highlights a significant public health concern that impacts well-being, a core tenet of SDG 3.

1. Overall Prevalence: Myopia prevalence nearly doubled, increasing from 42.1% in the parent generation to 78.0% in their children.
2. Severity Increase: The prevalence of moderate myopia was significantly higher in children (38.8%) compared to parents (9.9%). High myopia also increased from 5.2% in parents to 9.6% in children.
3. Refractive Distribution: The distribution of refraction in children showed a marked plateau, indicating a widespread shift towards myopia, unlike the tighter peak observed in the parental generation.
4. Stable Extremes: Prevalence rates for extremely high myopia (≤−9.0 D) and severe hyperopia (≥+2.0 D) remained largely unchanged between generations, suggesting genetic factors may still dominate at the extremes of the refractive spectrum.

4.0 Environmental Drivers and Connection to Sustainable Development Goals

The report concludes that the rapid escalation of the myopia epidemic is overwhelmingly influenced by environmental and social changes, which have significant implications for several SDGs.

• SDG 4 (Quality Education): The study directly associates the rise in myopia with increased educational pressures. This creates a conflict between achieving educational outcomes and safeguarding student health, challenging the goal of ensuring inclusive and equitable quality education that also promotes lifelong well-being.
• SDG 3 (Good Health and Well-being): The associated factor of decreased time spent outdoors is a critical public health issue. Promoting outdoor activities is a key preventative strategy that aligns with targets for reducing non-communicable diseases and promoting mental and physical health.
• SDG 11 (Sustainable Cities and Communities): The lack of outdoor time points to a need for urban planning that provides safe, accessible, and inclusive green spaces. Fulfilling this goal can directly contribute to mitigating the environmental factors driving the myopia epidemic.

5.0 Conclusion and Policy Implications

The study demonstrates that the myopia epidemic is a modern, environmentally driven phenomenon. The fact that these drivers are reversible presents a crucial opportunity for intervention. The findings suggest that genetic predisposition has been largely overwhelmed by societal shifts. A sustainable approach requires integrated policy-making that addresses public health and educational practices concurrently.

Achieving sustainable development necessitates a re-evaluation of societal structures that negatively impact health. Addressing the myopia epidemic requires a multi-sectoral approach that:

• Reforms educational systems to balance academic demands with adequate time for outdoor recreation, directly supporting both SDG 4 and SDG 3.
• Prioritizes the development of community infrastructure, such as parks and public spaces, to facilitate healthier lifestyles, in line with SDG 11.
• Launches public health campaigns to raise awareness of the reversible environmental factors contributing to myopia, empowering individuals and communities to protect their vision and well-being.

1. SDGs Addressed or Connected to the Issues Highlighted in the Article

1. SDG 3: Good Health and Well-being

   • The article’s central theme is the “epidemic of myopia” in China, a significant public health issue. It details a study on the increasing prevalence and severity of this eye condition, directly aligning with the goal of ensuring healthy lives and promoting well-being for all at all ages. The research focuses on understanding the causes and generational changes of a non-communicable disease, which is a core component of SDG 3.

2. SDG 4: Quality Education

   • The article explicitly links the rise in myopia to “increased educational pressures.” This suggests that the current educational environment and its demands are having a detrimental effect on the physical health of students. This connection brings the issue within the scope of SDG 4, which aims to ensure inclusive and equitable quality education. A quality education system should not compromise the long-term health and well-being of its learners.

2. Specific Targets Under Those SDGs Identified in the Article

1. Targets under SDG 3: Good Health and Well-being

   • Target 3.4: “By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.” Myopia is a non-communicable condition, and the article focuses on its prevention by identifying reversible environmental factors. The study’s conclusion that “environmental influences have overwhelmed any genetic influences” and that the driving factors are “reversible” directly supports the prevention aspect of this target.

2. Targets under SDG 4: Quality Education

   • Target 4.a: “Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all.” The article implies that the current learning environment in China, characterized by “increased educational pressures” and “decreased time spent outdoors,” is not entirely safe or effective from a health perspective. Addressing these environmental factors to create a healthier learning environment aligns with this target.

3. Indicators Mentioned or Implied in the Article

1. Indicators for SDG 3 (Good Health and Well-being)

   • Prevalence rate of myopia: The article provides explicit data on this indicator, stating that “The myopia prevalence in the young adult children was 78.0%, while it was 42.1% in the parents.” This serves as a direct measure of the health issue.
   • Prevalence of high and moderate myopia: The study offers more granular data, noting that the prevalence of “high myopia (9.6% vs. 5.2%) and moderate myopia (38.8% vs. 9.9%) was higher in the children.” These are specific indicators of the severity of the condition within the population.
   • Axial elongation: The article identifies this as the physical cause, stating that the myopia epidemic “is based on axial elongation, rather than changes in other biometric parameters.” Measurements of axial length, obtained through ocular biometry, are a key clinical indicator.

2. Indicators for SDG 4 (Quality Education)

   • Time spent outdoors: The article implies this as a key indicator by identifying “decreased time spent outdoors” as a major cause of increased myopia. Measuring the average time children spend outdoors would be a way to track progress in creating a healthier learning and living environment.
   • Educational pressures: The article cites “increased educational pressures” as a primary driver of the epidemic. While not quantified in the text, this implies that indicators such as daily hours of study, homework load, or school schedules could be used to measure the intensity of the educational environment and its impact on student well-being.

4. Table of SDGs, Targets, and Indicators

Source: ophthalmologytimes.com