Dr Crosby speaks at Asia Pacific Myopia Management Symposium 2025 in Hong Kong

Dr Niall Crosby was invited to speak at the 5th Asia-Pacific Myopia Management Symposium (APMMS) in Hong Kong. The APMMS 2025 attracted hundreds of attendees from around the world, both in person and virtually.

The flagship event, themed “Myopia Control in Children: Meeting the Challenge Together”, highlighted the complexities of advanced myopia management tools and relevant case studies. This regional symposium was organised by the World Society of Paediatric Ophthalmology and Strabismus (WSPOS), World Council of Optometry (WCO), The Hong Kong Association of Private Practice Optometrists (HKAPPO) and The Hong Kong Society of Professional Optometrists (HKSPO).

Dr Crosby posed the question, “Will the myopic epidemic lead to a retinal detachment epidemic?”

Dr Crosby examined anatomical and physiological mechanisms, epidemiological data linking myopia to increased rhegmatogenous retinal detachment (RRD) risk, and trends in the incidence of both myopia and RRD over time to assess whether the data supports this hypothesis.

Four anatomical mechanisms linking myopia to retinal detachment were explored: axial elongation thins the retina, particularly in the equatorial regions; lattice degeneration becomes more common with increasing myopia; myopic eyes tend to experience posterior vitreous detachment (PVD) earlier, raising tear risk; and refractive surgery may exert biomechanical stress on the eye similar to a mild concussion.

⚠️ Epidemiological evidence showing that the risk of rhegmatogenous retinal detachment increases with myopia severity—odds ratio (OR) of 3.15 for low myopia, 8.74 for moderate, and 12.62 for high myopia—with worse visual outcomes and more challenging surgical reattachments in highly myopic eyes.

⚠️ Trends: the Rotterdam Study showing that between 2009 and 2016, the prevalence of low, moderate, and high myopia increased by 15.6%, 20.3%, and 26.9% respectively in people aged 45 and over—indicating a myopic shift in the Dutch population aged 55–75. While not proving causality, this trend coincided with a rising rate of retinal detachment, leading researchers to suggest a possible link.

Dr Crosby created AI-supported calculations to build projections for the rate of RRD from 2025 to 2045, factoring in ethnicity, national myopia trends, age dynamics, and population changes. The models predict significant increases - especially in Southeast Asia - driven by younger myopic cohorts aging into the high-risk 50–70 age group.

🤔 So, will the myopic epidemic lead to a retinal detachment epidemic? Dr Crosby ultimately says no - retinal detachment won’t become an epidemic by definition due to its low prevalence (0.03%) - not having population-level effects, but the rapid increase in high myopia populations could see a tripling of RRD cases, posing a serious public health concern and demanding urgent action in prevention, surgical capacity, and education.

The symposium also featured two expert panel sessions, where leading industry professionals including Dr Crosby discussed real-world clinical scenarios and shared insights on current guidelines and standards of care in myopia management. The event underscored the need for a unified strategy among healthcare providers to address the escalating myopia epidemic in Hong Kong and across the region.