February 18, 2025
By Shelby Johnson, OD, MPH, FAAO, Associate Clinical Professor and Chief of Pediatrics SUNY College of Optometry
Photo Credit: Getty Images
In 2024, the Myopia Management Special Interest Group (SIG) within the American Academy of Optometry (AAO) was founded. This initiative emerged from a belief within the AAO membership that, although myopia care encompasses several critical areas — primary care optometry, pediatrics, binocular vision, and contact lenses — there was a need for it be a distinct area of focus within the organization. Equally significant are the larger issues of accessibility, equity, and research, which must be addressed to promote a more comprehensive approach to myopia management. The SIG aims to encourage collaboration, facilitate knowledge exchange, and drive innovation across these diverse and interconnected aspects of the myopia care landscape. I am honored to be named the inaugural Chair of the Myopia Management Special Interest Group.
Considering Public Health Factors
My personal interest in the public health aspects of myopia deepened during my Master of Public Health studies, which were completed in August 2024. As part of the MPH program internship, I reviewed patient data from an academic clinic in New York City. One of the most striking findings from this research (currently unpublished) was the significant difference in myopia prevalence between patients from various socioeconomic backgrounds. Patients from the lowest socioeconomic status (SES) zip codes, located in the Bronx and who largely self-identified as Black and Hispanic, were 1.7 times more likely to be myopic than those from highest SES zip codes, located in Manhattan and encompassed a larger proportion of self-reported Asian and white patients.
At first glance, one might consider the straightforward explanation of a higher prevalence of myopia in Black and Hispanic children; however, given the consensus in the literature, this explanation is likely inaccurate, and alternative factors must be examined. When viewing myopia through a public health lens, it is reasonable to consider factors such as access to care via insurance and other social determinants of health as potential contributors, particularly in an urban environment like New York City. This research underscores the necessity of focusing on equitable care delivery and reinforced the necessity to establish the SIG with an emphasis on improving access for underserved individuals and populations.
Disparities in Myopia Management Care
Another key catalyst in forming the SIG was the National Academies of Sciences, Engineering, and Medicine (NASEM) report on myopia, particularly a contributory review that highlighted disparities in access to myopia care within the U.S. The authors were struck by the limited research on access to myopia management in the U.S., especially when compared to regions such as Asia. The NASEM report also emphasized that evidence-based treatments are not as widely available in lower-income areas, reinforcing findings from New York City research and underscoring the urgent need for improved access to care across the country.
The SIG offers a platform for collaboration across various sectors — optometry, public health, research, and policy. By uniting experts, we can advance both the clinical and systemic aspects of myopia management. There is immense potential to enhance care in the U.S. by tackling gaps in access, raising awareness, and advocating for policy changes. The SIG will investigate advancements in treatment options, but effective treatment alone is insufficient. We must also focus on public health initiatives to raise awareness about myopia, educate parents on the significance of early detection, and advocate for policies that guarantee all children have access to effective treatments. Ideally, this initiative will complement other programs such as The Myopia Collective, a partnership between the American Optometric Association and CooperVision, to elevate the standard of myopia care. Myopia management must be a collaborative effort, with optometrists, pediatricians, and other health care providers working together to ensure children receive timely interventions.
Carrying out Myopia Research
Furthermore, there is a pressing need for more research that reflects the diverse demographic landscape of the U.S. We need more studies that address the specific challenges faced by underserved populations, where myopia often goes undiagnosed or untreated due to access barriers. The SIG offers an opportunity to address this research gap by promoting collaboration among clinicians and researchers who are dedicated to improving myopia care for all.
As the SIG expands, I am thrilled about the opportunities for collaboration and innovation. By bringing together optometrists, public health professionals, researchers, and policymakers, we can create actionable strategies to tackle both clinical and systemic challenges in myopia care. The SIG can play a vital role in developing new methods for myopia management that are not only effective but also equitable. The future of myopia care is promising, and I’m eager to see how this group can help shape it.
 |
Dr. Shelby Johnson is an Associate Clinical Professor and Section Chief of Pediatrics at SUNY College of Optometry, where she oversees students in the Pediatrics, Special Needs, and Myopia Management Clinics. She also serves as the faculty supervisor for the Pediatrics Micro-Credential program. Originally from Calgary, Canada, Dr. Johnson earned her OD degree and completed a Pediatrics/Primary Care Residency at UC Berkeley School of Optometry in 2018. In 2024, she earned an MPH from UAlbany, which she now applies to her research on the public health aspects of myopia. Additionally, Dr. Johnson is a Change Agent with the Myopia Collective, a collaborative initiative by the AOA and CooperVision. In 2023, she was honored with the inaugural “40 Under 40” Award from UC Berkeley Optometry. |
