August 10, 2026
By Taylor Sprague, OD
Photo generated with AI
While conversations about myopia management have been prevalent for a while now in our OD circles, to the general population, this can still be an entirely new idea. When you recommend myopia management for a patient, this may very well be the first time the parents are learning that this concept exists.
For a highly myopic parent, this can bring shock and excitement for their child that a change in fate for their refractive error is possible, unlike when they were growing up. However, when a parent is coming into the office with the expectation that their child will just need glasses to see the board better, or an update to their prescription before the new school year, being presented with all of the options for myopia management can be overwhelming. Now, a decision that may take more thought and research is added on top of everything else a parent must think about.
Getting Specific with Patients
Our job as experts in this field is to provide evidence-based, patient-specific recommendations. While we should still present all of the available options, parents often welcome a more tailored recommendation of what we think would be best for their particular child.
In my office, I first will go over how the child’s refractive error compares to age-expected. If this is not their first prescription, I’ll also share how their progression over time compares to average. If axial length data is available, I will include this as an additional talking point in how we are monitoring progression.
From there, I will ask about any known family history of myopia. Highly myopic parents know the lifestyle impacts this brings, such as not being able to function around the house without correction in place and having thick glasses lenses. Less myopic or non-myopic parents who live with a highly myopic parent understand these implications as well. Comparing the child’s prescription to their parents’ gives perspective to where they are now and where we can expect them to land as growing years continue.
To further illustrate this point to a parent without personal myopia experience, I often demonstrate with high plus loose lenses to simulate myopia. While families more often resonate with day-to-day effects, I let them know that my bigger concern is ocular disease later in life. There’s a greater risk for glaucoma, myopic maculopathy and retinal detachment.
Talking About Treatment Options
Based on the child’s prescription, I will then go over their available treatment options and the different advantages and possible disadvantages of each. In recent months since having a myopia management spectacle lens available, I have found this option is usually the least overwhelming to parents (and children), and it can be a great introduction to the world of myopia management. The idea of glasses is familiar, the routine is simple and the risk is negligible. A disadvantage with this lens is that currently no tints are available, so for those children who are tied to their photochromatic lenses, that may be a dealbreaker. However, this can then open the conversation about contact lenses and the ability to then wear regular sunglasses.
Contact lenses seem to be the modality that overwhelms families the most. With contact lenses comes responsibility for all parties involved. They are likely a new concept to the child, require more effort and pose risk for infection if not cared for properly. On the other hand, they also provide freedom from glasses and may help a child socially.
Lifestyle Plays a Deciding Role
I often discuss a child’s activities to determine which modality might fit them best. Contact lenses are great for sports; daily disposable soft lenses might be best for a dancer or golfer, while orthokeratology lenses make sense for a swimmer or football player. Atropine drops work for any prescription, so this is a frequent starting point for patients as well, especially if they are hesitant about contact lenses or eager to begin treatment before refractive correction is indicated.
Parents often ask how long their child will need to be on treatment. My answer is ideally all throughout the growing years, but the method can change over time. Parents are comforted to know that their decision this year is not locked in for the next decade.
Make Time For a Longer Discussion
If a family seems particularly overwhelmed at the initial presentation of myopia management, I will offer to have them come back for a myopia management follow-up to discuss further. Sending them home with brochures to digest the information and giving them some time to think can help them make an informed decision.
In the best case scenario, a family embraces myopia management the first year it is presented. However, planting seeds for future years is also beneficial. For children with highly myopic parents, I bring up the idea of myopia management well before it needs to be implemented—sometimes even at their infant exam—so that parents get used to the idea and it is less overwhelming when the time comes that they actually need treatment.
My ultimate goal is to provide myopia management to every patient that needs it. Getting parents on board can take time and dedication, but it’s always worth it when you get the “yes.”
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Dr. Taylor Sprague is a 2020 graduate of The Ohio State University College of Optometry. After graduation, she completed a residency in Binocular Vision and Pediatrics at Indiana University School of Optometry and is passionate about children’s vision care. She has been an associate optometrist at Miamisburg Vision Care for the last three years, and her special clinical interests include strabismus, amblyopia, and myopia management. She enjoys both domestic and international optometric service work and has provided eye exams at free clinics around Ohio and also in Jamaica. |
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