October 1, 2021
By Dwight Akerman, OD, MBA, FAAO, FBCLA
There are several long-term eye health benefits of lowering a child’s ultimate level of myopia. Arguably the most important benefit is reduced risk of visual impairment. Higher levels of myopia have long been associated with increased risk of PSC cataracts, open-angle glaucoma, and retinal detachment. The most significant myopia-related cause of irreversible vision loss is myopic macular degeneration, also referred to as myopic maculopathy.
Bullimore and Brennan applied data from five extensive population-based studies of the prevalence of myopic maculopathy on 21,000 patients. They calculated that a 1.00D increase in myopia is associated with a 67% increase in the prevalence of myopic maculopathy. Said differently, slowing myopia by 1.00D may reduce the likelihood of a patient developing myopic maculopathy by 40%. Moreover, this treatment benefit accrues regardless of the level of myopia. Of course, long-term eye health benefits are challenging to demonstrate.
Beyond the long-term eye health benefits of controlling myopia, there are numerous practice and financial benefits. Many eye care professionals seek to expand their practices and break away from the stranglehold of managed vision care. Offering myopia management as a practice sub-specialty is an ideal way to grow your practice profitably. Why?
First and foremost, there is a substantial need for myopia care in children and teenagers. In the U.S., Theophanous et al. found that myopia (defined as -1.00D or greater) prevalence in 5-19 year-old American children is 42% and increasing every year! Look again if you feel your practice does not have a sufficient patient base to justify incorporating myopia management.
Another reason myopia management will grow your practice is that it is self-pay. Fortunately, management vision care and major medical plans do not cover this procedure.
Enhanced patient loyalty is another key practice benefit. Once enrolled in a myopia management program, children and their parents are engaged with the practice and unlikely to change eye care providers. They understand and appreciate the expertise you are delivering goes far beyond a routine eye exam. The annuity aspect of myopia management should not be forgotten. Most children enrolled in a myopia management program will be treated for 5-10 years.
While the eye health benefits of lowering a child’s ultimate level of myopia are profound, the practice and financial benefits of providing myopia management are also significant. I urge you to commit to the highest level of care and prescribe the most appropriate evidence-based interventions to children at risk of progressive myopia. Let’s get proactive about myopia management!
Best professional regards,
Dwight H. Akerman, OD, MBA, FAAO, FBCLA
Chief Medical Editor