When it comes to myopia management treatments, there often isn’t a one-size-fits-all approach. Each child is unique. It’s important to consider factors such as what sports they play, their maturity and their social lives when thinking about the long-term success of their myopia management outcomes. Ultimately, treatment compliance will lead to the greatest outcomes. The best option is the one that yields the greatest compliance.
In addition to the child’s personality and lifestyle, practitioners will also want to think about the latest scientific data, the patient’s prescription and current and upcoming FDA approvals. While this may seem like a daunting task with many influencing factors, it can be done successfully. Let’s break it all down.
CREATING A MYOPIA MANAGEMENT TREATMENT PLAN
With the different options available, how do you know which ones are right for which patients? It’s important to remember that each child is different. Not every treatment is right for every patient.
From a clinical standpoint, ECPs should strive to create a comprehensive myopia management strategy. That plan involves decision-making based on age, lifestyle, familial risk, axial length, position on the axial length growth chart, progression rate, risk of high myopia, potential side effects and individual preferences. A personalized approach ensures optimal long-term myopia management.
Here’s a look at how some practitioners approach the myopia management treatment plan:
Alyssa Pack, OD, of La Jolla, California: “Several factors influence the choice of treatment, such as financial constraints, a child’s comfort with contacts, corneal shape or other specific needs such as rapid growth or swimming. It’s essential to listen to the patient and their family. If needed, schedule a follow-up consultation.”
Sami Khaldieh, OD, of Herndon, Virginia: “I have to get to know my patients very well: their hobbies, how much they sleep, if they’re a serial eye-rubber, among other things. One factor that plays a big role for me is what the patient actually wants. I’ve learned over the years that the best treatment is the one that is used consistently.”
Marie Homa-Palladino, OD, FIAOMC, IACMM, of Newtown Square, Pennsylvania: “I create myopia management treatment programs based on my individual patient, considering risk factors such as the age of onset, axial length and degree of myopia. I also look at the family dynamics and highlight the pros and cons of each treatment option.”
Glenda Aleman, OD, of Miami, Florida: Practitioners should feel comfortable prescribing and using myopia management treatments off-label, as the benefits outweigh the risks. “As clinicians, we shouldn’t let pending FDA approvals stop us from doing everything we can to help our patients,” she says.
WHEN TO COMBINE TREATMENTS
Getting patients and their parents on board with myopia management is a feat in itself. But what happens when you’ve started a patient on a treatment and their myopia is still progressing?
For many practitioners, this is the time to introduce a second treatment method to target the progressing myopia from two different angles. This is most often used for patients who are at the highest risk of high myopia. Taking a more aggressive approach may be necessary for certain patients.
Tina Douroudian, OD, leads myopia management at Arlington Loudoun Pediatric Ophthalmology. Her experience there has led her to create a protocol for combination treatments. Dr. Douroudian shares her checklist.
A study published in Ophthalmology Times in May 2024 concluded that, “Clinical trials indicate short- to medium-term efficacy in reducing myopia progression for various interventions, but none have demonstrated long-term effectiveness in preventing high myopia and potential complications in adulthood. There is an unmet need for a unified consensus for strategies that balance risk and effectiveness for these methods for personalized myopia management.”
| Stay updated: Review of Myopia Management presents an analysis of research on an ongoing basis. Find the latest under the Research Review section. |
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Read more articles in the Getting Started with Myopia Management series. Be sure to check back as the series will be updated regularly with more content.
