July 15, 2024
Alexandre Montague, CEO, HOYA Vision Care
At the 2024 Global Health Summit held in Geneva, May 31, 2024, HOYA Vision Care’s CEO Alexandre Montague pushed for urgent action to improve early detection and reduce the burden of myopia in children. Montague’s goal is to make myopia a global priority for governments and public health bodies, encouraging them to act collectively to ensure early detection and increase education and awareness. The urgency to prioritize myopia stems from the multifaceted impact on patients, communities, and health care systems. As the prevalence of myopia is increasing, it is also imperative for governments and public health bodies to prioritize its treatment as a public health concern to improve the quality of life for children living with this condition as well as educate on preventive solutions.
Review of Myopia Management recently caught up with Montague to learn about the importance of prioritizing myopia care, how HOYA is working to spread the message of myopia management, the potential long-term burden on health care systems if myopia is unaddressed, and more. Read the full interview here:
Review of Myopia Management: Please describe HOYA Vision Care’s commitment to tackling the burden and rising wave of myopia through your MiYOSMART spectacle lenses, providing an easy, safe, and non-invasive myopia management solution supported with clinical evidence.
Alexandre Montague, CEO, HOYA Vision Care: Globally, more than two billion people are visually impaired.1 Many need corrective solutions, but they aren’t aware or simply do not have access to such solutions. This is what we call the vision care gap. Many issues need to be addressed in this gap, but none more so than myopia and its timely management, which is a growing public health concern.
Although slowly improving, there are still huge unmet needs that we must tackle urgently. Did you know that by 2050, it is predicted that half of the population will have myopia?2 This issue is not going to go away without action. All of us, across the entire eye care ecosystem, must join forces and act now to reduce the impact of myopia.
We at HOYA Vision Care are committed to increasing awareness and education among parents and children, as well as supporting Eye Care Professionals and the health care ecosystem to improve earlier diagnosis and intervention.
If you look at the approach to myopia in the ecosystem 10 years ago, the focus was mostly on awareness of vision-friendly behaviors such as spending time outdoors and being careful with digital devices. Today, we can do more: we can deliver solutions to reduce or even stop myopia, whilst working on prevention and detecting the issues before they arise.
Over the past decade, we designed a spectacle lens that would reduce myopia progression for children. After extremely positive clinical trials, we launched this lens commercially in 2018 under the name MiYOSMART. This product is based on a technology called DIMS — Defocus Incorporated Multi-Segment — which corrects myopic refractive error and reduces its progression, lessening its impact on children.3 Keeping myopia to the lowest level possible is extremely important as highly myopic people tend to have difficult and irreversible long-term myopia-related complications associated with their condition, such as glaucoma and retinal detachment that could actually lead to blindness.4,5
Clinical trial data showed that MiYOSMART can slow myopia progression by 52% and reduce axial elongation by 62% on average, sustained over time — and in some children, the technology has even been able to completely stop myopia progression.3,6 At HOYA Vision care, we believe that every child deserves to have better treatment for their vision health. MiYOSMART is available in more than 30 countries* worldwide and over two million parents across the world have already trusted the solution for their children.
RMM: How is HOYA Vision Care supporting the global health care ecosystem to act now and work together to prioritize myopia treatment as a public health concern and support education on the condition— making people understand the impact myopia can have on children and the importance of seeking timely treatment?
Alexandre Montague: Since the pandemic, additional screen time and less outdoor activity has resulted in earlier onset of myopia and increased its progression.8,9 I will give you an example that was shared with me by a medical institution in China. The average age of myopia onset seen at this hospital in 2001 was around 10.5 years of age. After the COVID-19 pandemic, this shifted to 7.5 years. It’s incredible to think how quickly this happened. Humans have been on this planet for thousands of years, and this change happened within 20 years. It’s massive, and it shows us the level of urgency of addressing myopia as a global priority.
We can’t reach patients on our own. We create change through the Eye Care Professionals that we work with. On top of providing MiYOSMART to the markets, we support and empower Eye Care Professionals through continuous partnership and education, giving them the right tools to educate children and their parents.
We’re not the most dominant player in the field of ophthalmic optics, but we work hard to be at the forefront of generating awareness and providing the right support and innovative solutions.
We strive to incentivize governments, public health bodies, health organizations, and community engagement bodies to prioritize improving the quality of life for children living with myopia. So, we started a public health campaign, #ActNow, for policymakers to prioritize myopia awareness, education, and early detection.
In March 2022, MiYOSMART was recognized as being of public utility by the French Ministry of Health, raising government awareness, which should lead to an increase in myopia treatment reimbursement. In Switzerland, since July 1, 2024, the government has begun to reimburse myopia management solutions for children. This proves the impact we can make by raising awareness, educating, and ensuring governments understand the importance of prioritizing myopia.
RMM: What longer-term challenges are there in terms of access to treatment and meeting the goals in place?
Alexandre Montague: With resources and funding being stretched across health care systems globally, myopia is sadly deprioritized in a lot of places. That’s why we must come together to put more resources behind vision health, driving governments and key stakeholders to act now. This includes prioritizing regular eye screenings, increasing education about preventative measures and solutions available, and improving understanding and awareness of symptoms, signs, and risk factors.
Another issue is the availability of Eye Care Professionals, which has a huge impact on access. To put it simply, the number of optometrists and ophthalmologists is not growing as fast as myopia. Even in countries with sufficient eye care provisions in place, getting an appointment can take a huge amount of time.
Of course, the last point is affordability. We need to make sure that when we develop technologies, we are making them affordable over time. We also need to equip Eye Care Professionals to ensure that eye care protocols, which are based on the latest research, are properly applied. This will ensure that the best possible outcomes will be generated for patients.
RMM: How important is it to prioritize myopia in vision-forward health policies to reduce the pressure on resources and health care systems worldwide due to the impact on patients?
Alexandre Montague: So, you may ask, what is the problem of not dealing with a child’s myopia? It’s very simple. It has a fundamental impact on their learning and development. We always say in school, look for the child who always wants to sit at the front of the class. Now, think about how much myopia is increasing in prevalence; there are only so many spaces at the front of the class. And what about the shy ones, or those who have been assigned a seat at the back?
I remember around 20 years ago when I was working on refractive devices to measure eyesight. I met a 26-year-old gentleman in Japan, a very developed country with proper access to eye care, and he had high myopia in both eyes. We made him his glasses, and he was completely shocked. He said, “I have been driving all this time, and I did not even know that I was supposed to see those signs on the highway!” If you have 26-year-olds thinking this way, how can you expect a young child to know any different?
What we really need to hammer home is that once myopia has progressed, the person’s vision won’t come back. You can slow — even potentially stop — progression, but not reverse or resolve it afterwards. This is why we need to focus on prevention. The World Health Organization is working hard to prioritize this; they’ve just launched a new program, SPECS 2030, increasing eye health awareness.10 Awareness is fundamental: you won’t go to an Eye Care Professional if you don’t know there’s a problem. So being able to incentivize and educate the public to visit Eye Care Professionals is the first step.
As I mentioned before, there is a strong correlation between myopia development and time spent outdoors. Countries that are well-known for children who love sports, such as South Africa and Australia, have lower myopia prevalence — it really does make an impact. We need to make sure that parents worldwide understand the significance of this impact, so their children have a fair chance at proper vision development. We’re incentivizing this behavior with photochromic MiYOSMART spectacle lenses, protecting children’s eyes by reducing glare and hypersensitivity to the sun. Taking screen breaks and resting the eyes when focusing on digital devices is important too.
RMM: Is there anything else you would like to add?
Alexandre Montague: Our overall mission is to provide better health care solutions for people over a lifetime. We must reach out to everybody, from the youngest to the eldest person, to raise awareness about eye health and the need for vision correction. So much of the population has impaired vision that is either wrongly corrected or not corrected at all. France, Africa, Japan, the U.S. — wherever you are in the world, people are not aware enough of eye health in general. That’s where we try to influence and act with the communities around us, bringing our awareness efforts into place.
At HOYA Vision Care, we are committed to ongoing research and development into the overall issue of myopia. Myopia is a lifelong condition, but by focusing on children, we are looking now when taking action can make the biggest change.
Our research collaborators are working to define the moment when it first makes sense to act. When you look at the way a child’s eye develops, most children begin life with hyperopia — long-sightedness. Through a process called emmetropization, the focus changes as the eye grows.10 Our question is: how do you separate the standard growth of the eye from the excessive growth that generates myopia? By defining this, I envision a world where myopia is stopped before it ever becomes a problem.
*MiYOSMART has not been approved for myopia management in all countries, including the United States, and is not currently available for sale in all countries, including the United States.
References
1 World Health Organization, Blindness and vision impairment. World Health Organization, 10 August 2023. [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment. [Accessed: July 2024].
2 Holden B.A., et al., Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology, 2016. 123(5): p. 1036–42
3 Siu Yin Lam C., et al., Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial. Br J Ophthalmol, 2020. 98: p. 363–8.
4 Sun M. T., et al., Glaucoma and Myopia: Diagnostic Challenges. Biomolecules, 2023. 13(3): p. 562.
5 Recko M., Childhood Myopia: Epidemiology, Risk Factors, and Prevention. Mo Med. 2015. 112(2): p. 116–21.
6 Siu Yin Lam C., et al., Myopia control effect of defocus incorporated multiple segments (DIMS) spectacle lens in Chinese children: results of a 3-year follow-up study. Br J Ophthalmol. 2020. 98: p. 40–5.
7 Russo A., et al., Myopia: Mechanisms and Strategies to Slow Down Its Progression. J Ophthalmol. 2022. 2022: p. 1004977.
8 World Society of Paediatric Ophthalmology & Strabismus, Myopia Consensus Statement 2023. WSPOS, Dublin, 2023.
9 World Health Organization, SPECS 2030. World Health Organization, 2024. [Online]. Available: https://www.who.int/initiatives/specs-2030. [Accessed: July 2024].
10 Troilo D., et al., IMI – Report on Experimental Models of Emmetropization and Myopia. IOVS. 2019. 60: p. M31–M88.
