It’s hardly breaking news that myopia is exceedingly common. After all, a condition that affects such a wide swathe of the population doesn’t exactly escape notice. Myopia is also optometry’s oldest adversary. Measuring refractive error was literally built into the earliest definition of the profession, and correcting it sustained practitioners for decades before the rise of medical optometry.

It’s tempting to think of refractive errors as simple traits dictated by genetic factors, like hair or eye color. Just a fact of life. And we sometimes bring that same passive acceptance to the modern-day environmental factors that are accelerating its prevalence, like increased near-vision tasks in a digital device–centric world and reduced time spent outdoors in developed, industrialized societies.

So, why is myopia suddenly being discussed with an urgency and alarm usually reserved for a disease epidemic—think Spanish flu or AIDS—that comes out of nowhere and strikes without warning? At the risk of oversimplifying, I think we can thank one man: the late Brien Holden, who passed away in the summer of 2015. 

Professor Holden is of course renown for a career’s worth of breakthroughs and insights. Soft contact lenses as we know them today wouldn’t exist without him, for one.

But his parting gift, to optometry and the world, was calling out myopia for what it is: a disease, one that can and should be influenced by doctors for the good of the populace, or else we should expect dire consequences. 

“I don’t want to be an alarmist,” Brien told the Australia Broadcasting Corporation mere weeks before his death, “but the fact of the matter is if we ignore our children becoming short-sighted, and increasing rapidly, they are at risk for future life.” In that interview, he was getting the word out about his then-forthcoming study of myopia prevalence that predicted over half the global population becoming myopic by the year 2050, including one billion high myopes. “That of course makes it very difficult for children to see, to learn, people to work, older people to survive,” he told the news service at the time.

This landmark study—Brien’s last major work—was a wake-up call to the eye care community and other stakeholders in health care: insurers, politicians, industry and mom and dad. Hopefully, we’re entering the next phase of myopia, where all the aforementioned are working to implement new ideas and policies aimed at stemming the tide. 

Changes in thinking and behavior are never easy. But everyone can, and should, play a part. Manufacturers are developing targeted products. The researchers at the Brien Holden Vision Institute are working hard to continue the legacy of their founder. We at Review have devoted this issue to myopia management to help give you a roadmap forward. And as the parent—a myopic one, at that—of a two-year-old, I’ll be sure to take my son outside to play more often (knowing the protective effect it confers) and will keep my iPhone out of his hands as much as possible. As is often the case, it takes a village.