Editor’s Perspective

Does One Size Fit All?

July 1, 2020

By Dwight Akerman, OD, MBA, FAAO, FBCLA
Chief Medical Editor, Review of Myopia Management

Eye care professionals are often faced with choosing a myopia management strategy for children, especially those progressing greater than -0.50D per year. Do you choose regular single vision spectacles or recommend an evidence-based myopia intervention? If you recommend intervention, which one(s)?

The field of myopia management is rapidly evolving and having access to a detailed protocol outlining the best approach for various patient types and ethnicities is desirable. As more evidence-based data becomes available, researchers will be able to create this type of treatment protocol.

Soon, clinicians will be able to deploy a comprehensive myopia management strategy that involves decision-making based on age, lifestyle, familial risk, axial length, position on the axial length growth chart, progression rate, risk of high myopia, potential side effects, and individual preference.1 This personalized approach ensures optimal long-term myopia management and helps reduce the risk of visual impairment and blindness later in life.2

I often ask eye care colleagues, “How do you decide which myopia management intervention to prescribe?” Many tell me, “That’s an easy question to answer. I only prescribe OrthoK (or atropine, or multifocal soft lenses, or bifocal spectacles, etc.) for slowing the progression of myopia in children.” This approach of exclusively prescribing one intervention does not do justice to the needs of myopic children.

In medicine, we have seen the rise of personalized therapy, based on genetic and lifestyle differences, and its benefits to patients who would otherwise be subjected to a standardized ‘blanket’ therapy. Eye care professionals must consider a child’s individual needs to prescribe comprehensive and effective myopia care. The days of prescribing only one treatment for every myopic child are passé.

Best professional regards,

Dwight H. Akerman, OD, MBA, FAAO, FBCLA
Chief Medical Editor


1 CW Klaver, C., Polling, J. R., & Erasmus Myopia Research Group. (2020). Myopia management in the Netherlands. Ophthalmic and Physiological Optics, 40(2), 230-240.

2 Cho, P., & Boost, M. V. (2018). Blanket therapy, one size fits all or personal tailoring for myopia control?. Contact Lens and Anterior Eye, 41(5), 403-404.


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