May 1, 2023
By Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE
Numerous optometry and ophthalmology organizations worldwide have developed guidance documents recommending proactive intervention to slow myopia progression in children and adolescents. Eye care practitioners and other stakeholders often look to professional organizations to provide clinical practice and public health policy recommendations.
The World Society of Paediatric Ophthalmology and Strabismus (WSPOS) recently issued a Myopia Consensus Statement 2023. This important Consensus Statement concluded, “There is sufficient evidence to warrant the adoption of myopia prevention and control measures in clinical practice in children with progressive myopia of childhood.” Globally, ophthalmology is a critical partner in managing juvenile-onset myopia. The approximately 214,00 ophthalmologists worldwide will take note of this critical Myopia Consensus Statement and utilize it as a practice resource to guide their clinical protocols.
In 2020, the American Academy of Ophthalmology (AAO) created the Task Force on Myopia in recognition of the substantial global increases in myopia prevalence and its associated complications. The Task Force is comprised of recognized experts in myopia prevention and treatment, public health experts from around the world, and organization representatives from the American Academy of Family Physicians, the American Academy of Optometry, and the American Academy of Pediatrics.
The AAO’s Board of Trustees believes that myopia is a high-priority cause of visual impairment, warranting a timely evaluation and synthesis of the scientific literature and formulation of an action plan to address the issue from different perspectives. This action plan includes the education of physicians and other health care providers, patients and their families, schools, and local and national public health agencies. It also includes defining health policies to facilitate patients’ access to appropriate therapy to promote effective public health interventions and fostering promising avenues of research.
Two leading optometric organizations with important professional guidance regarding childhood myopia have stepped forward: The World Council of Optometry and The American Optometric Association.
In 2021, the World Council of Optometry Board of Directors unanimously approved a resolution recommending that optometrists incorporate a standard of care for myopia management within their practices. The resolution states that simply correcting the refractive error is no longer sufficient, and myopia management should not be optional and instead be an obligation of optometrists. Furthermore, the resolution cites that the evidence-based standard of care should consist of three main components:
- Mitigation — optometrists educating and counseling parents and children during early and regular eye exams on lifestyle, dietary, and other factors to prevent or delay the onset of myopia.
- Measurement — optometrists evaluating the status of a patient during regular comprehensive vision and eye health exams, such as measuring refractive error and axial length whenever possible.
- Management — optometrists addressing patients’ needs of today by correcting myopia while also providing evidence-based interventions (e.g., contact lenses, spectacles, pharmaceuticals) that slow the progression of myopia for improved quality of life and better eye health today and into the future.
The clinical report, issued in 2021, builds on the American Optometric Association’s heightened focus on children’s eye health and vision care, especially during the pandemic, which has created greater leisure time and schooling online for young people, raising concerns over extended screen time and its impact on eye and vision health. Among its contents are sections on the classification of myopia, complications associated with myopia, risk factors for the development and progression of myopia, tests and equipment/instrumentation needed for myopia management, and elements of follow-up care.
Congratulations to The World Society of Paediatric Ophthalmology and Strabismus, The American Academy of Ophthalmology, The World Council of Optometry, and The American Optometric Association for their leadership and foresight to take necessary steps to promote evidence-based myopia management as the standard of care for myopic children.
Best professional regards,
Dwight H. Akerman, OD, MBA, FAAO, FBCLA, FIACLE
Chief Medical Editor