Abstract

Climate change is increasingly discussed as a challenge to public health, yet its effects on the eye are still easy to overlook. The ocular surface is directly exposed to air, temperature, humidity, wind, ultraviolet radiation and pollutants. These conditions can influence tear-film stability and ocular comfort, particularly in people already vulnerable to dry eye disease. At the same time, childhood myopia continues to require a stronger preventive and clinical response, while adults with refractive errors increasingly seek freedom from glasses and contact lenses.
These developments should be considered together, but not confused. Environmental stress on the ocular surface, childhood myopia and adult refractive surgery are related through the broader responsibility of eye care; they are not interchangeable conditions, nor does current evidence establish that climate change causes myopia. This article argues for an approach that begins with the patient’s ocular surface, visual needs and long-term eye health. Where corneal laser surgery is appropriate, the choice between techniques should be individualised. Surface ablation, including transepithelial photorefractive keratectomy, may be a relevant option for selected patients, but it is not universally superior and requires careful counselling. The goal of refractive care should be more than unaided vision: it should preserve comfort, function and the patient’s freedom to feel well.