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Highlights from the 2019 International Myopia Summit on ‘controversies in myopia’
  1. Chee Wai Wong1,2,3,
  2. Li Lian Foo1,2,3,
  3. Priya Morjaria4,
  4. Ian Morgan5,
  5. Andreas Mueller6,7,
  6. Amanda Davis8,
  7. Drew Keys8,
  8. Mingguang He7,
  9. Padmaja Sankaridurg9,10,
  10. Jian Feng Zhu11,
  11. Peter Hendicott12,
  12. Donald Tan2,3,
  13. Seang-Mei Saw2,3,
  14. Ching Yu Cheng1,2,3,
  15. Ecosse Luc Lamoureux2,3,
  16. Jonathan G Crowston1,2,3,
  17. Chui Ming Gemmy Cheung1,2,3,
  18. Chelvin Sng2,13,
  19. Cordelia Chan1,
  20. Doric Wong1,2,3,
  21. Shu Yen Lee1,2,3,
  22. Rupesh Agrawal2,14,
  23. Quan V Hoang1,2,3,15,
  24. Xinyi Su13,16,17,
  25. Adrian Koh1,
  26. Cheryl Ngo13,
  27. Hao Chen18,
  28. Pei Chang Wu19,20,
  29. Audrey Chia1,2,3,
  30. Jost B Jonas21,
  31. Tien Yin Wong1,2,3,
  32. Marcus Ang1,2,3
  1. 1 Singapore National Eye Centre, Singapore
  2. 2 Singapore Eye Research Institute, Singapore
  3. 3 Duke–NUS Medical School, National University of Singapore, Singapore
  4. 4 International Centre for Eye Health, London School of Hygiene and Tropical Medicine
  5. 5 Research School of Biology, Australian National University, Australia
  6. 6 World Health Organization Regional Office for the Western Pacific
  7. 7 Centre for Eye Research Australia, Australia
  8. 8 International Agency for Prevention of Blindness, London, United Kingdom
  9. 9 Brien Holden Vision Institute, Sydney, Australia
  10. 10 School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
  11. 11 Department of Preventative Ophthalmology Shanghai Eye Diseases Prevention & Treatment Centre, Shanghai Eye Hospital, China
  12. 12 Queensland University of Technology (QUT), School of Optometry and Vision Science, Brisbane, Australia
  13. 13 Department of Ophthalmology, National University Hospital, Singapore
  14. 14 National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
  15. 15 Department of Ophthalmology, Columbia University, New York, USA
  16. 16 Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore
  17. 17 Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  18. 18 Department of Ophthalmology, Wenzhou Medical College, China
  19. 19 Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
  20. 20 Chang Gung University College of Medicine, Taiwan
  21. 21 Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Germany
  1. Correspondence to Marcus Ang, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; marcus.ang{at}


Myopia is an emerging public health issue with potentially significant economic and social impact, especially in East Asia. However, many uncertainties about myopia and its clinical management remain. The International Myopia Summit workgroup was convened by the Singapore Eye Research Institute, the WHO Regional Office for the Western Pacific and the International Agency for the Prevention of Blindness in 2019. The aim of this workgroup was to summarise available evidence, identify gaps or unmet needs and provide consensus on future directions for clinical research in myopia. In this review, among the many ‘controversies in myopia’ discussed, we highlight three main areas of consensus. First, development of interventions for the prevention of axial elongation and pathologic myopia is needed, which may require a multifaceted approach targeting the Bruch’s membrane, choroid and/or sclera. Second, clinical myopia management requires co-operation between optometrists and ophthalmologists to provide patients with holistic care and a tailored approach that balances risks and benefits of treatment by using optical and pharmacological interventions. Third, current diagnostic technologies to detect myopic complications may be improved through collaboration between clinicians, researchers and industry. There is an unmet need to develop new imaging modalities for both structural and functional analyses and to establish normative databases for myopic eyes. In conclusion, the workgroup’s call to action advocated for a paradigm shift towards a collaborative approach in the holistic clinical management of myopia.

  • Treatment medical

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  • Contributors Conception and design of the study, drafting the manuscript and approval of the version of the manuscript to be published: CWW, LLF, TYW and MA. Analysis and/or interpretation of data, revising the manuscript critically for important intellectual content and approval of the version of the manuscript to be published: PM, IM, AM, AD, DK, MH, PS, JFZ, PH, DT, SMS, CYC, ELL, JGC, GCMC, CS, CMLC, DWKW, SYL, RA, QVH, SX, AK, CN, HC, PCW, AC and JBJ.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Jost B Jonas: Advisory Board Novartis; Patent holder with Biocompatibles UK (Farnham, Surrey, UK) (Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or anti-angiogenic factor; Patent number: 20120263794), and Europäische Patentanmeldung 16 720 043.5 and Patent application US 2019 0085065 A1 Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia).

  • Provenance and peer review Not commissioned; externally peer reviewed.