May 12, 2020
By Dwight Akerman, OD, MBA, FAAO
Chief Medical Editor
Review of Myopia Management
The prevalence of myopia and high myopia is increasing in the U.S. and globally at an alarming rate, with significant increases in the risks for vision impairment from pathologic conditions associated with high myopia, including retinal detachment, myopic macular degeneration, cataract and glaucoma.
Mark Bullimore and Kathryn Richdale have written an excellent review paper that presents a comprehensive analysis of the rapidly evolving field of myopia management and addresses concerns that clinicians might reasonably have. The paper aims to do the following:
- Review the peer-reviewed literature on commonly employed myopia management modalities and expected outcomes
- Address challenges to the implementation by clinicians, including whom to manage and when to stop
- Review the safety of myopia management modalities
- Consider the potential benefits of lowering a patient’s ultimate level of myopia by one or more diopters
- Discuss possible future avenues of myopia management of which the clinician should be aware.
With many evidence-based treatments available that have demonstrated efficacy in slowing the progression of childhood myopia, eye care professionals have a responsibility to implement myopia management strategies into their clinical armamentarium proactively.
Myopia Control 2020: Where are we and where are we heading?
Mark A Bullimore and Kathryn Richdale
Purpose: This review arms practitioners with the evidence-based information they need to fully manage myopia.
Recent findings: The recent peer-reviewed literature is critically evaluated to provide a comprehensive analysis of the safety and efficacy of behavioral, optical, and pharmaceutical myopia management. Importantly, the paper addresses not only who to treat, but how to treat them, and when to stop or modify treatments. Finally, the paper discusses expectations for treatment and why slowing myopia by even 1 diopter improves long term health outcomes.
Summary: The management of an individual child should be underpinned by the evidence-based literature and clinicians must stay alert to ongoing myopia research that will undoubtedly result in an evolution of the standard of care for the myopic and pre-myopic child.
Bullimore, M. A., & Richdale, K. (2020). Myopia Control 2020: Where are we and where are we heading?. Ophthalmic and Physiological Optics, 40(3), 254-270.