Key strategies to reduce the global burden of myopia: consensus from the international myopia summit

In this paper, we describe key strategies to guide global collaborative efforts to further reduce the burden of myopia and myopia-related visual impairment. A modified Delphi method was applied as an iterative multistage process to collect expert and stakeholders' opinions and extract consensus strategies regarding myopia diagnosis, prevention and control. Anonymous pre-meeting preparation rounds, structured discussions for prioritisation and the development of key consensus areas were performed. Consensus was reached on three key areas to collaborate and complement existing frameworks: (1) Myopia defined not only as a refractive error but also as a disease with phenotypic features allowing for risk stratification of significant visual impairment. (2) In addition to preventive strategies, a focus is needed on preventing progression to high myopia (HM). (3) A focus on preventing and treating pathologic myopia (PM), that is, end-stage of myopia disease with irreversible visual impairment. In conclusion, the workgroup suggests a global, collaborative strategy that is needed across public health, healthcare and advocacy sectors to support efforts in reducing visual impairment from myopia. Complementary to existing preventive public health efforts, additional focus on defining myopia as a disease with risk stratification for visual impairment and an emphasis on reducing visual impairment associated with HM and PM should be considered.