Setting New Goals: The International Myopia Institute

The IMI was founded in 2015 following a meeting of the World Health Organisation (WHO) and Brien Holden Vision Institute (BHVI) in Sydney that same year.

The meeting was convened to continue gathering the evidence for myopia as a public health issue, and address the issues of vision impairment and blindness due to uncorrected refractive error from myopia. Additionally it aimed to address the sight threatening complications associated with increasing levels of myopia, such as retinal detachment, glaucoma and myopic macular degeneration.

The achievements of the first stage of IMI are leading to further recognition of myopia as a major health issue, improving clinical myopia management and guiding future research directions

The IMI was established with an independent advisory board, and brought together all the experts in the multidisciplinary field of myopia research to discuss, debate and bring consensus to this area.

Its aim was to ensure that key evidence based information, from thousands of scientific articles published annually, can reach the wider audience of clinicians, health workers, educators, government and peak health bodies and ultimately advocate for improved patient care, research, and guide public health policy.

DEVELOPMENT OF THE IMI WHITE PAPERS

With this aim in mind, by 2017, the IMI had convened taskforces with chairs leading the following:

1. Definitions and classifications – Professor Ian Flitcroft,
2. Experimental models of myopia and emmetropisation – Professors Earl L. Smith III and David Troilo,
3. Interventions – Professor Christine Wildsoet,
4. Clinical trial guidelines and instrumentation – Professor James Wolffsohn,
5. Clinical management guidelines – Dr Kate Gifford,
6. Genetics of myopia – Professor Caroline Klaver, and
7. Industry guidelines and ethical considerations – Professor Lyndon Jones.

Over 86 experts participated in the committee process of developing the white papers, donating their time and knowledge to this important cause. All the seven articles underwent full review and a harmonisation process that led to the eventual publication in a special dedicated issue in the high impact scientific journal Investigative Ophthalmology and Visual Science in early February 2019. To date these papers are already exceeding the average citations for the year and will likely continue to be referenced for years to come. The importance of these white papers in informing management of myopia and classification of myopia, high myopia and myopic macular degeneration, has already led to these white papers being referenced in the WHO vision report and ICD-11.

INITIAL OUTCOMES

The IMI papers have contributed a big step towards reducing the rate of future vision impairment due to myopia. The achievements of the first stage of IMI are leading to further recognition of myopia as a major health issue, improving clinical myopia management and guiding future research directions. Providing new definitions such as ‘pre-myopia’ and standardising cut offs, for example for high myopia, establishing guidelines for clinical management of myopia and improving clinical trial methodology reporting are some of the initial outcomes.

MORE TO COME

The IMI will continue its efforts to produce further white papers to provide evidence, and to inform and provide guidance in key areas that were not previously covered, and where there is an urgent need. At this stage, new taskforces have been initiated in the proposed areas, with the following chairs leading the process:

1. The impact of myopia – Professor Padmaja Sankaridurg,
2. Paediatric high myopia – Professor Ian Flitcroft,
3. High myopia in adults and associated retinal complications – Professor Kyoko Ohno-Matsui,
4. Environmental risk factors and myopia – Professor Ian Morgan,
5. Preferred practice patterns – Professor Jost Jonas, and
6. Yearly digest – Professor Earl L. Smith III and Dr Monica Jong.

It is hoped that another special issue of the IMI papers will be published in a high impact scientific journal by late 2020. In the meantime, the hard work of disseminating the key findings of the white papers at major scientific, public health and practitioner meetings, and the advocacy of myopia as an important public health issue at the peak health body level, will continue.

All electronic copies of the IMI white papers are freely downloadable, along with the IMI Commemorative Booklet which contains the editorial and overview of the white papers, and key tables and figures originally published by IOVS. Clinical summaries of the current white papers in English and other world languages, including but not limited to Chinese, French, Vietnamese and Japanese, will be made freely available very soon in an effort to allow clinicians around the world to access the knowledge. This is all thanks to donations from the Brien Holden Vision Institute, Essilor, Coopervision, Zeiss, Alcon, and the Vision Impact Institute.

If you would like to be notified of IMI updates or be part of the IMI, membership is free at www.myopiainstitute.org. You can also contact IMI via the contact form available on the website.

Dr Monica Jong PhD, BOptom is the Executive Director of the International Myopia Institute and Secretary of the Refractive Error Working Group with the International Agency for Prevention of Blindness. She is a BHVI Consultant and a visiting fellow at the University of New South Wales School of Optometry and Vision Science.

Professor Serge Resnikoff MD, PhD is a visiting professor with the University of New South Wales School of Optometry and Vision Science. An international expert and consultant in global public health, ophthalmology, and eye health, he teaches in Paris and London and is Chair of the International Myopia Institute board, the Chair of Our Children’s Vision advisory board and the President and Chair of Organisation pour la Prévention de la Cécité (OPC), an organisation developing eye care in francophone Africa.