In 2015 the World Health Organisation (WHO) held an international scientific meeting looking at the growing problem of Myopia.[1]
In addition to recommendations on areas such as myopic macular degeneration and an identified need for further research into myopia, the WHO meeting concluded that: “Measures for the detection and management of myopia should be an integral part of plans for the provision of eye-care services.”
That report was followed by a WHO meeting in May 2021 at which all countries committed to a 40% increase in effective coverage of refractive error by 2030.[2] So why is the WHO so concerned with the problem of Myopia? Well, apart from the fact that it has been estimated that without action half of the global population will have Myopia by 2050, uncorrected distance refractive error is the largest cause of preventable blindness worldwide. Moreover, one 2012 estimate [3] put the annual productivity loss due to uncorrected refractive error alone at $202 billion.
These are high numbers but what does myopia management cost in practice? In an era in which prices for basics such as food and fuel are rising significantly, how much might UK parents have to pay out to ensure adequate myopia identification and control?
It’s a bit of a good news/bad news scenario. On the plus side, NHS sight tests are free for those who are under sixteen, or under the age of nineteen if in full-time education. In this article, we are mainly concentrating on the cost for children but some adults, including the over 60s, can also qualify for a free sight test. [4]
However, anecdotally some opticians are no longer offering NHS sight tests due to the time cost of undertaking a robust eye examination. And we do have to remember that a standard examination is unlikely to allow for an in-depth myopia management consultation. The key to myopia management is the regular measurement of the length of the eye from front to back, also known as axial length. Most practices don’t yet have access to the ‘optical biometers’ necessary for these measurements and they are expensive to purchase.
These consultations might need to cover areas such as identification of potential Myopia trigger points, the likely progress of the condition, and options for ongoing Myopia management. This latter might include a discussion on the relative merits of specialist Myopia management glasses or contact lenses. For those who may have to pay for a specialist Myopia management private eye check, the cost could range from £35 up to £100 or even more, just for the initial consultation
Of course, the eye examination is only the first step. The next consideration is the cost of corrective glasses or contact lenses. Here again, children are entitled to receive an NHS voucher which may go some way towards the cost of lenses. At the time of writing these vouchers start at £39.10 for single vision lenses with a mild prescription and then range incrementally upwards to £215.50 depending on the power of the lens required and whether a single or mutli-focal lens is needed.
In most cases, the problem is that the NHS voucher may well not be sufficient to cover the cost of glasses or contact lenses; particularly those specifically for Myopia management. A quick trawl through some opticians’ websites reveals that the cost of Myopia management contact lenses could easily be in the region of £50 per month; whilst specialist glasses lenses could easily top the three hundred pound mark.
Another treatment option, orthokeratology, which involves the wearing of specialist contact lenses at night to temporarily reshape the eyeball, will also require a monthly contact lens cost of some £50 alongside a consultation fee which could be in excess of £200.
It’s important to remember that these fees are actually comparatively low and are a fair reflection of the cost of professional time and the equipment needed in practice.
Any one of these options therefore is significantly more than will be covered by an NHS voucher, leaving parents or carers to pick up the shortfall. And whilst some specialist clinics will offer a monthly direct debit option to spread the cost of the consultation plus Myopia management treatment, that still means that over the course of a year Myopia management for one child could easily be in the region of £500 to £1000.
With no special provision currently for those on low incomes, that could result in numbers of parents having to make the choice to forego specialist Myopia management treatment and instead opt for a basic corrective glasses option. Whilst that should correct the short sightedness, enabling the child to see more clearly, it won’t help to reduce the progress of the Myopia. As a result, some children may finish up with a greater degree of Myopia than otherwise might have been the case.
With the Government being a signatory to the WHO May 2021 agreement we may well see developments in the provision of Myopia management vouchers for children in due course. In the meantime, parents who are unable to afford corrective lenses can still take steps to manage their children’s Myopia by restricting the time spent on close work and encouraging children to spend at least two hours out of doors each day.
If you're a parent whose child has been diagnosed with myopia, or if they are struggling with their distance vision, we hope you found MyopiaFocus helpful. Please join our community or sign our petition to get the government and NHS to recognise myopia as an ocular disease/serious ocular condition and fund myopia management for children.