How to Educate Parents Who Sought a Second Opinion From a Skeptical Colleague

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August 1, 2025

By Katherine Schuetz, OD

Those of us who have enthusiastically embraced myopia control in our practices have found it both rewarding and impactful for the young patients in whom we are preventing future myopia-related eye diseases. However, it isn’t uncommon for a new family to visit my office, excited to learn about the options of low-dose atropine, soft multifocal contact lenses or orthokeratology for their child, but then return to their primary eye doctor who undermines the treatment recommendation, or even questions the safety of the treatments. How does a family know which professional to trust, especially when both professionals feel strongly about their opposing approaches?

 

Guiding Reluctant Colleagues

In all new innovations, there are early adopters and there are laggards.¹ When safety and children are involved, providers are wise to be well-educated before recommending evolving treatments. While myopia management seems new to many optometrists in North America, it has been around for decades in other parts of the world that have significantly higher rates of myopia. We benefit from that previous experience and research and can use it to address doubts from both colleagues and concerned parents. Now that we understand “why each diopter matters,”² we must guide our reluctant colleagues and confused patients’ parents through the compelling data to speed up our profession’s bell curve of myopia management adoption.

Follow the Research

It is easy to feel confused as to why every OD has not yet embraced myopia management. We must remember that hundreds of well-intentioned practitioners have been correcting vision for their myopic patients via glasses and contacts for years with only the rare patient complication related to myopia. The motivation for most ODs to learn a completely different approach is low—unless you can help them grasp the realities of the complications that greater numbers of myopes will create. 

The approach of simply treating the blur of myopia cannot continue as we monitor ever-growing cases of retinal detachments, open angle glaucoma, early onset cataracts and myopic maculopathy.  The graph below,³ available for download on the Review of Myopia Management resource page, is a sobering reminder that refractive correction alone does not serve the myopic patient best long term. According to the American Optometric Association in an Evidence Based Clinical Report on Myopia Management, “The burden of blindness and visual impairment due to complications of myopia will rise significantly if no effort is made to reduce its development and progression.”

 

Guiding Parents

When a provider is second-guessing your approach, or even the concept of and need for myopia management, it is helpful to have readily available resources to help educate parents. We have seen professionals outside of optometry, such as ophthalmologists and pediatricians, on board with myopia management as well, which should be compelling to both parents and ODs.

Here are a few points to consider sending to a fellow professional or even the parent of a patient considering myopia control:

• The complications that arise from myopia progression can be severe and include myopic macular degeneration, retinal detachment, cataracts and open-angle glaucoma. This is not just about limiting dependency on glasses and contact lenses. Research shows that the prevalence of myopic macular degeneration ranges from 0.1% to 7% in low myopia, 0.3% to 10% in moderate myopia and 13% to 65% in high myopia.⁴
• Professional organizations such as the International Myopia Institute, World Council of Optometry, World Society of Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology, Canadian Association of Optometrists, Optometry Confederation of India and more have all underscored the importance of early, proactive myopia management to reduce the risks associated with myopia progression, particularly in children.
• A recent Letter from The Myopia Collective states that the American Academy of Pediatrics endorsed the American Academy of Ophthalmology white paper “Reducing the Global Burden of Myopia by Delaying the Onset of Myopia and Reducing Myopic Progression in Children” back in July 2021.⁵ Pediatricians and ophthalmologists see the long-term value of reducing future risk with early myopia control.

The Child Is the Priority

It is a fair assumption that most providers want what is best for their patients’ long-term ocular and visual health, and with respectful consistent education you may slowly change their mindset about myopia management. But when a skeptical colleague has potentially undermined your recommendation to control a child’s myopia, the biggest priority is the parent of the child you wish to treat. That requires delicacy in approach. You need to show why your colleague may not feel the same about myopia treatment, while firmly holding your ground about the importance of early myopia intervention. I will often say to parents who have never heard of myopia management treatments that this is something not all practitioners have invested the time to fully learn about and execute in their practices. Colleagues who are current naysayers either don’t think it works, think it could be unsafe or don’t think it is necessary, but we know better.

 As clinicians practicing myopia management regularly, we can give the worried parents studies and data to verify treatment efficacy, as well as dozens of anecdotal patients’ stories. You can acknowledge that myopia management requires significant study and expertise as a clinician, and your family eye doctor may be so busy in their day-to-day practice that there may not be ample opportunity for them to become experts in this new field. Luckily, the doctors in our practice have been attending conferences and successfully treating patients for many years with excellent results.

Fighting for Myopia Management

We all have different specialties within our practices, and few ODs can cover them all. It’s our responsibilities to help a confused parent see that even though all optometrists don’t practice myopia management, these treatments are necessary, important and meaningful long term. The more young myopes we keep from accelerated axial elongation, the fewer complications they will experience in adulthood. That’s worth fighting for.

 

Katherine Schuetz, OD, is a private practitioner in Carmel, Indiana, where she is a full-time clinician, splitting time between seeing pediatric patients at a primary care pediatric practice, Little Eyes, and teens through adults at RevolutionEYES. She is a Brilliant Futures panelist for CooperVision.

 

References 

1) Interaction Design Foundation – IxDF. (2016, June 2). What are Early Adopters?. Interaction Design Foundation – IxDF. https://www.interaction-design.org/literature/topics/early-adopters

2) Bullimore MA, Brennan NA. Myopia Control: Why Each Diopter Matters. Optom Vis Sci. 2019 Jun;96(6):463-465. 

3) https://reviewofmm.com/relative-risk-of-ocular-disease-secondary-to-myopia

4 Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res 2012;31(6):622–60.

5 Modjtahedi B, et al.  Reducing the Global Burden of Myopia by Delaying the Onset of Myopia and Reducing Myopic Progression in Children. Pediatrics. 2021 Jul;148(1):e2021051881. doi: 10.1542/peds.2021-051881. Epub 2021 Jun 21. PMID: 34155132.