February 2, 2026
By Kevin Chan, OD, MS, FAAO, IACMM
I have recently returned from a long road trip in the wilderness amid the winter wonderland. During the trip, the scenery was nothing but magnificent. A little obstacle, though, is to reduce stress, while also keeping myself alert on the road solo. In that circumstance, I switched the gear to a “cruise control” mode and let the car run on its own at a constant pace.
Amid the solitude, it made me ponder what it means to go on “auto-pilot” mode, both qualitatively and figuratively. For some, consistency in auto-pilot mode means going at a steady pace—i.e. same speed and same velocity. Getting to a destination simply denotes little acceleration, being on a “cruise control” with little attention. In essence, the mode of navigation is passive and less cerebral. It involves little adaptation or critical thinking. As we dig into the kinematics of physics, however, speed isn’t synonymous with velocity. In fact, speed is a scalar value of magnitude alone. Velocity, however, is a vector value of the rate of change in position. It is easily understood as “60 mph north” in common terms. In other words, speed describes only how fast an object is moving, while velocity signifies ACTION based on the direction of displacement in a matter of time.
Consistency as Impediment?
You may wonder, how is the concept of kinematics related to clinical care, particularly in the realm of myopia care for children?
Well, as the notion of myopia management is gaining more traction among clinicians and in the optometric community at large, the general game plan, or more precisely a “thirst trap,” is to get started with a treatment XYZ—while in cruise control—and make it to the end as steady as possible. Nevertheless, what is commonly lacking in this model is the flexibility of the navigation mode. What if you navigate solely for the purpose of “getting there”? Do you set your navigation in the same route as you normally do?
Indeed, the notion of consistency is often described or inflated as unanimously positive or inspiring for most. However, in reality, consistency in the realm of myopia management can actually be a hindrance, or even detrimental to achieving optimal patient care.
Indeed, consistency isn’t about doing the same things at the same pace for the same results. Rather, consistency is about achieving results that warrant clear understanding of one’s position and velocity (not speed alone), regardless of frustration, detours, or more often, the “safe, autopilot” mode.
Have you ever heard about any claim that intervention ABC yields results XYZ percent better than the placebo? How about when your patients do not follow the expected trajectory via the intervention ABC, despite you consistently following or adhering to all the recommended guidelines? Do you instinctively anticipate that intervention ABC would help you get there as intuitively as cruise control? While the cruise control mentality avails steady speed and freedom, it paradoxically can also impede velocity and dampen ingenuity.
Beyond Cruise Control for Myopia Care
In preparation of offering any type of myopia interventions, I often describe to patients and families that treatment for myopia isn’t necessarily the same plan as delivering myopia care. While treatment is often intuitive, treatment itself can also be passive without adaptation or refinement. Each treatment method may not always fulfill the promise as the one-size-fits-all approach fails to meet individual trajectories and needs.
The trajectory of children’s vision is often dynamic and unpredictable. To better equip and achieve the best possible outcomes, myopia care warrants a CONTINUUM of care more than a treatment on its own in the defined period. To truly manage myopia to the fullest level, it is crucial for practitioners to get past the cruise control mentality and actively seek a personalized journey of myopia care. In other words, speed can get patients from A to B, yet with caveats or limitations. Adjusting the velocity that is specifically tailored to each child and their unique development can go farther with bigger milestones.
Here are a few key recommendations to break through the autopilot mentality:
- Myopia progression is silent and nuanced. Not every patient warrants every tool from the kitchen sink at all times. Oftentimes, what the patient needs may simply be a nuanced pivot or a step-back from the existing plan. For instance, consider amending a specific lens parameter of the existing OrthoK lens design in lieu of forgoing OrthoK for good erroneously. Actively probe into the patient’s contact lens habits or the instillation repertoire of atropine eye drops. Proactive interventions and interceptions, along with calculated risks, can pay off more than a steady autopilot journey for patients.
- Make myopia care intentional and engaged. If clinicians simply aim to follow the “blueprint” mindlessly, and patients and families aren’t aligned with your treatment plan—despite having the “best plan”—it can fail unilaterally. For every adjustment or detour, I always engage with the whole family and discuss the “why” beyond the “what. Make every move intentional with engagement. It can help develop better rapport and alignment for clinical success.
- Embrace the “slow days” in navigation. Truth be told, while the ideation of myopia management can be seemingly simple and intuitive, the journey isn’t. Expect the unexpected when “slow days” happen. It truly epitomizes the dynamic nature of myopia, owing to the unique patients’ growth and seasonal and cyclical variabilities of axial length.
Which ‘Gear’ are you on?
Being in “auto-pilot mode” in the realm of myopia management can safely get patients somewhere, but not too far ahead. Indeed, when practitioners tend to steer the journey of myopia care via a “cruise control” mentality, it can inadvertently undermine efforts to provide the highest standard of myopia treatment for children. As dynamic as myopia has become, it is vital for clinicians to stay alert, informed and cautiously skeptical, while making detours prudently at times—despite not following the norms or trends. After all, managing myopia is not a matter of speed, but a finesse of velocity and displacement in a continuum.
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