July 15, 2025
By Jonathan Chen, OD, FAAO, FSLS, IACMM
Photo Credit: Getty Images
As myopia rates rise globally, I am committed to making a difference in the lives of my patients and their families. Every day, I witness the profound impact that effective myopia management treatments can have on children and their futures.
Discovering Myopia Treatments
I first learned about myopia management at the University of Houston College of Optometry, where Dr. Earl Smith introduced me to myopia development and the peripheral defocus theory. This knowledge resonated with me, especially because I have family members who are high myopes. It was amazing to learn that there was something that we as optometrists can do to help patients with progressive myopia.
At the time, I did not have much exposure to myopia management, and it was serendipity that the Vision By Design conference happened to be in Houston that year. I volunteered what time I had after classes and got a glimpse at the knowledge shared there. That meeting sparked my interest in myopia management and led to further learning and development during my residency.
The office where I currently practice had been treating myopia management mainly with orthokeratology for the past 15 years, so I looked to grow and expand the options we could provide. I was eager to expand the options available to our patients. Recognizing the importance of a comprehensive approach to myopia management, I decided to implement consultation appointments to discuss tailored treatment plans with patients and their families. During this consultation, we detail the value of these treatment plans and provide a brochure with additional information and resources.
Optimizing Myopia Management at the Practice
Our practice initially offered two myopia management treatments: OrthoK and soft multifocal contact lenses. However, I saw an opportunity to expand as I encountered patients with refractive errors outside the FDA approved ranges. We introduced soft toric multifocal contact lenses for patients with high astigmatism who preferred alternatives to OrthoK. I also launched a myopia management program for patients not in treatment but at higher risk of progression, allowing for proactive interventions when necessary.
Creating personalized treatment plans for each myopia patient is important. Every patient presents a unique set of risk factors and circumstances, which necessitates a tailored approach. I typically lean toward OrthoK as a starting point, but I remain open to combination treatments when needed. Research shows that combining orthokeratology with low-dose atropine can yield beneficial outcomes in advanced myopia cases.1-3 This flexibility allows us to adapt our strategies based on our patients’ needs.
Finding the Right Communication Style for Each Patient
One of the biggest lessons I have learned in practice is that patients respond differently to information. Those with high myopia or knowledge of retinal detachments tend to be more receptive to start treatment. In the past, I had spent too much time explaining myopia and its treatment options, which sometimes overwhelmed patients.
With experience and guidance from my colleagues, I discovered that visuals and analogies are effective educational tools. For instance, using diagrams to illustrate how axial myopia develops can help demystify the condition for patients and their families. I feel that it’s helpful to adapt my communication style to connect with each patient, focusing on impactful discussions that address each patient’s specific concerns. This personalized approach not only enhances patient understanding but also fosters trust and rapport between the patient and the practitioner.
In addition to traditional methods, I also consider social media to be a valuable educational tool. Platforms offering short-form, engaging content can effectively disseminate information about myopia and its treatments to wide audiences. Not only does this help raise awareness but it can also attract new patients to practices around the country.
Staying Informed
Myopia management is a cornerstone of my career, and I prioritize staying as up to date as possible. I subscribe to newsletters and research papers, actively follow online content, such as Review of Myopia Management, and attend conferences around the country to hear from and collaborate with other optometrists and health care professionals.
Despite all the progress made in myopia management, I recognize the challenges I’ve faced and foresee. I frequently encounter families hesitant to start treatment, so I schedule follow-up appointments to discuss axial length and progression. While this approach isn’t foolproof, my goal is to educate patients and their families, helping them understand the importance of proactive care and make informed decisions about their eye health.
Quality Care and the Future of Myopia Management
I’m optimistic about the advancements in myopia management on the horizon. I envision a day when myopia is widely recognized and understood by the public to be a call to action. I anticipate more research and technology available to identify high-risk patients early and provide timely treatments to keep myopia levels low. My commitment to patient care and education drives me to ensure that every child’s family at the practice learns about myopia management, guiding families as new technologies develop.
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Jonathan Chen, OD, FAAO, IACMM, is an optometrist at a private practice in Atlanta, GA, with an interest in specialty contact lenses, ocular surface disease and myopia management. After receiving his OD degree from the University of Houston College of Optometry, he completed a Cornea and Contact Lens Residency at the University of Missouri St. Louis College of Optometry. He is a fellow of both the American Academy of Optometry and the Scleral Lens Education Society. He is also a member of the American Academy of Orthokeratology and Myopia Control. In his free time, Dr. Chen enjoys tennis, connecting at conferences, and exploring the world through food. |
References
1 Wang Z, Wang P, Jiang B, Meng Y, Qie S, Yan Z. The efficacy and safety of 0.01% atropine alone or combined with orthokeratology for children with myopia: A meta-analysis. PLoS One. 2023;18(7):e0282286. Published 2023 Jul 26. doi:10.1371/journal.pone.0282286
2 Tsai HR, Wang JH, Huang HK, Chen TL, Chen PW, Chiu CJ. Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis. J Formos Med Assoc. 2022;121(12):2490-2500. doi:10.1016/j.jfma.2022.05.005
3 Xu S, Li Z, Zhao W, et al. Effect of atropine, orthokeratology and combined treatments for myopia control: a 2-year stratified randomised clinical trial. Br J Ophthalmol. 2023;107(12):1812-1817. Published 2023 Nov 22. doi:10.1136/bjo-2022-321272
