November 10, 2025
By Dr. Keshav Bhat
Photo Credit: Getty Images
The conventional wisdom in myopia management has been to avoid overwhelming parents during routine eye examinations. The standard recommendation suggests briefly mentioning myopia progression, then scheduling a separate consultation to discuss treatment options in detail. While this approach seems logical on paper, it ignores a fundamental reality of modern family life.
As both an optometrist and a parent, I’ve experienced firsthand how difficult it is to carve out time for return medical visits. When my child’s pediatrician asks me to come back for repeat bloodwork or a follow-up discussion, I understand the clinical reasoning, but I also feel the weight of coordinating schedules, arranging time off from school, taking time off from my work and managing the inevitable disruption to our family routine. This perspective fundamentally changed how I approach myopia management discussions in my practice.
Rather than adding another appointment to already overloaded family calendars, I developed a streamlined communication strategy that respects parents’ time while ensuring they receive comprehensive information about their options. The key was refining my language and creating a simple visual framework that could be delivered effectively during the initial examination.
The Power of Objective Data
Our pretest routine for all myopic patients includes axial length measurement. This single addition to our workflow has transformed how parents understand myopia progression. When I share these findings during the examination, the visual representation of their child’s eye growth adds more value to the conversation than practically anything else I can say. Numbers and graphs make the abstract concept of myopia progression tangible and real.
While I’m reviewing these findings with the family in the exam lane, my team member is simultaneously emailing a PDF version of the report to the parent. This means that by the time we transition to discussing management options, they already have objective data about their child’s eye health in their inbox, ready to share with their partner or review later.
The Two-Column Approach
Armed with this objective information about their child’s axial length, parents are much more receptive when I draw two columns on a piece of paper. The left column is labeled “Correction” and represents the traditional approach: standard glasses or contact lenses that simply correct the current refractive error. The right column is labeled “Correction + Control” and represents what progressive, forward-thinking practices now offer to address myopia progression.
This visual distinction, combined with the axial length data they’ve just seen, immediately clarifies that we’re not just talking about seeing clearly today, but about protecting vision for the future. The measurements provide the “why” and the two columns provide the “what we can do about it.” Under the “Correction + Control” column, I list the available myopia management options, then circle the approach I believe best suits this particular child’s age, gender, lifestyle and personality. This personalized recommendation demonstrates that I’ve thoughtfully considered their unique situation.
I hand this paper to the parent, typically the mother who has accompanied the child to the appointment, and explain that this gives them something tangible to discuss with their partner at home. Combined with the axial length report already in their email, they now have both objective clinical data and a clear roadmap of options. This simple piece of paper becomes a conversation starter and decision-making tool for the family.
Empowering the Team
My front desk staff and our dedicated myopia management team member then take over, walking the family through the relevant details based on my recommendation. They provide comprehensive paperwork that outlines the treatment process, appointment frequency and pricing transparency. Crucially, this paperwork includes a QR code that links directly to our telehealth scheduling system.
The Power of Availability
Here’s where I make an offer that surprises many parents: I tell them I’m available for a joint telehealth video call with the entire family to answer any questions, even after hours or on weekends. I emphasize that I understand both parents want to be involved in health care decisions, and I’m willing to accommodate their schedules.
The remarkable thing is that despite making this offer to dozens of families, I’ve only been called upon once to conduct an after-hours consultation. The point isn’t whether they take me up on the offer; the point is what the offer itself communicates. It demonstrates that I’m a caring physician who genuinely wants to support their family’s decision-making process, that I respect their time constraints and that I’m confident enough in my recommendations to discuss them anytime, anywhere.
Results That Speak
This approach has transformed our myopia management program enrollment. While we understand achieving 100% sign-up (same-day or later) is not practical, instead of losing families in the gap between identification and consultation, we’re achieving a significantly higher volume of same-day sign-ups for our treatment programs. Parents leave the office not just with a prescription, but with objective data about their child’s eye health, a clear understanding of their options, a personalized recommendation and the confidence that comes from working with a practice that truly understands their needs.
The conventional approach of deferring detailed discussions might seem professionally appropriate, but it often creates barriers that prevent children from receiving the proactive care they need. By respecting parents’ time, communicating clearly and efficiently, providing objective clinical data and demonstrating genuine availability, we can provide better education and achieve better outcomes for our young myopia patients.
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Dr. Keshav Bhat is the founder and visionary behind Union Family Eye Associates. His education journey began at the Elite School of Optometry in India (1990) and includes a Master of Science from the University of Auckland in New Zealand (1994), followed by a Doctor of Optometry degree from the New England College of Optometry in Boston (2001). Dr. Bhat’s practice specializes in myopia management and challenging contact lens cases. In all, Dr. Bhat brings over 20 years of experience in optometry and is committed to delivering professional, accessible eye care tailored to each individual’s needs. |
