February 3, 2025
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Myopia is increasingly prevalent worldwide, posing significant risks to eye health, particularly as it progresses into high myopia. The rise in myopia, especially high myopia, is linked to an increased risk of associated ocular pathologies, including potential blindness and other vision-threatening conditions such as retinal detachment, myopic maculopathy, and glaucoma. Over one-third of myopic macular degeneration cases are observed in people with low to moderate myopia. Beyond potential vision impairment, myopia negatively impacts quality of life and contributes to significant economic costs.
Simple Rx Correction Is No Longer Sufficient
The surge in myopia cases can be attributed to lifestyle factors, such as the growing use of digital devices and reduced outdoor activity. While genetics plays a role, these environmental influences are key in determining both the development and progression of myopia.
Eye care professionals (ECPs) must recognize that myopia is not a benign condition. Correcting vision with single-vision spectacles or contact lenses is no longer sufficient, and delaying treatment to “wait and see” is not an effective strategy. Instead, strategies such as increasing outdoor time, prescribing specialized contact lenses or spectacles, and incorporating pharmaceutical treatments such as atropine therapy are essential to slow myopia progression. Furthermore, educating the public on the importance of regular eye exams is critical to addressing the growing burden of myopia-related vision impairment.
Myopia Management Is the Standard of Care
Myopia management is no longer just an option. It has evolved into the standard of care. This shift is not only backed by evidence-based practices but is also endorsed by major global health organizations, such as the World Health Organization (WHO), which has formally recognized myopia as a vision-threatening condition.
Furthermore, professional organizations such as the International Myopia Institute, World Council of Optometry, World Society of Paedatric Ophthalmology and Strabismis, American Academy of Ophthalmology, Canadian Association of Optometrists, Optometry Council of India, and others, have all underscored the importance of early, proactive myopia management to reduce the risks associated with myopia progression, particularly in children.
Consequently, ECPs must adopt a proactive, evidence-based approach to myopia management. Staying updated on the latest research and incorporating the most current clinical guidelines into practice are fundamental to providing the best possible care for patients.
Steps to Implement Myopia Management into Your Practice
The integration of myopia management into optometric and ophthalmologic practices involves a multifaceted approach. First, ECPs must build a solid knowledge base through ongoing education, utilizing credible medical sources, journals, and professional associations. Once this foundation is in place, ECPs should establish a clear vision for myopia management within their practices. This includes screening children for myopia and considering early intervention for those at risk, particularly those with myopic parents, siblings, or any refractive errors greater than age-appropriate norms.
The primary goals of myopia management are threefold: (1) to slow or halt myopia progression, (2) to provide optimal vision for daily activities, and (3) to ensure a positive quality of life during treatment. Achieving these objectives requires a comprehensive understanding of available treatment options, including optical interventions such as orthokeratology, multifocal contact lenses, and pharmaceutical treatments such as atropine. ECPs should also engage in shared decision-making with patients and their families, emphasizing the importance of patient-centered care.
Collaborating with Patients, Parents, and Other Practitioners
In addition to clinical knowledge, ECPs must be adept at the operational aspects of myopia management. This includes training practice staff to effectively communicate the value of myopia management to patients and caregivers and ensuring they can provide accurate educational resources. Clear communication about fees and services is also essential to streamline appointments and build trust with patients. Establishing standardized exam protocols, including measurements such as axial length, cycloplegic refraction, and assessments of corneal shape, will help ensure consistency in care.
Myopia management must also be framed as a collaborative effort. ECPs should be prepared to work with other health care providers, particularly when using specialized treatments. This requires a thorough understanding of the risks and benefits of various therapies, as well as a commitment to patient safety and compliance. Even as risks may exist with certain treatments, the benefits of myopia management generally outweigh them when patients follow professional guidelines.
Shifting Perspective from Reactive to Preventative
Dr. M. J. Lipson’s 2024 article Myopia Management is Now ‘Standard of Care’ emphasizes this growing recognition of myopia management as an established standard within the eye care community. The article highlights the escalating global prevalence of myopia and its associated ocular health risks, reinforcing the need for proactive care to prevent severe complications. Dr. Lipson advocates for integrating scientific research and clinical guidelines into prescribing practices and emphasizes the importance of evidence-based management. His article also stresses the importance of updating optometric curricula to ensure future practitioners are adequately trained in myopia management. Dr. Lipson calls for a shift in perspective from reactive to preventative care, empowering ECPs to offer comprehensive, well-informed treatment options to their patients.
In conclusion, myopia management has transcended its status as an emerging concept and is now firmly established as a standard of care. ECPs are encouraged to adopt a proactive, evidence-based approach to myopia, integrating available therapies into clinical practice and emphasizing patient-centered care. The successful implementation of myopia management will not only enhance individual patient outcomes but will also contribute to reducing the long-term impact of myopia-related vision impairment on a global scale.
