Editor’s Perspective

Tailoring the Myopia Management Conversation

August 1, 2023

By Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE

Because most parents of myopic children have never heard of myopia management or the eye health dangers of myopia, excellent communication is essential to get the parents to say “YES” to your recommended treatment plan. Great eye care professionals communicate with their patients in a way that is clear, concise, and easy to understand. They take the time to listen to patient and parental concerns and answer any questions they may have…all while staying on schedule. 

Having observed many leading eye care professionals specializing in myopia management, I have formed my top three (everything happens in threes!) lists of communication do’s and don’ts. 

Communication “Do’s” 

  1. DO focus on emotional, lifestyle, and eye health benefits of slowing the progression of myopia that matter most to parents and children:
    • Lower risk of sight-threatening comorbidities than those with higher degrees of myopia
    • Better vision when not wearing corrective lenses due to lower degrees of myopia
    • Better candidates if they choose to have refractive surgery later in life to correct their vision
    • Better vision-related quality of life
    • More options available to correct their myopia
  2. DO keep your language simple and easy to understand for patients. Clinical terms are used regularly in conversations between eye care professionals. However, patients most likely do not understand these terms. Great eye care professionals use simple language that patients can understand. 
    • “High myopia may cause rhegmatogenous retinal detachment 30 years from now.” Not!
    • Axial elongation → Excessive eye growth 
    • Slow myopia progression → Keep prescription low
  3. DO involve children in discussions about their eye care. Skilled eye care professionals take the time to talk to their patients, not just the parents, and get to know them personally. They ask about their hobbies, interests, and school. This helps children feel more comfortable and involved in their own care, which usually results in better adherence to the recommended treatment plan.

Communication “Don’ts”

  1. DON’T inflate the chances of success — under-promise and over-achieve. Manufacturer-quoted percentage reductions of myopia Rx or axial length progression are based on averages from tightly controlled clinical trials where subjects were highly compliant, which may not apply to your myopic child. Expect variability in response to treatment from patient to patient.
  2. DON’T forget to stress the importance of the long-term nature of myopia care. If a child begins myopia care at age 8, that child will likely be under your care for at least eight to 10 years. 
  3. DON’T forget to practice your progressive myopia “elevator speech” to improve efficiency. Practice on your staff, your spouse, and your children. Initial myopia consultations or follow-up visits can go off the rails if you are not prepared to answer questions clearly, succinctly, and confidently. You never want a parent or child to feel rushed, but on the other hand, in fairness to your staff and other patients, you cannot allow an examination scheduled for 20 minutes to draw out to an hour.

Parents and children must understand that myopia may continue progressing while undergoing myopia therapy. Ensure that the parent and child understand that the myopia treatment may not stop axial length or Rx from changing until the late teenage years, but it is designed to keep them from significantly progressing. 

Always ask parents about their communication preferences. Successful myopia practitioners understand that every patient is different and has unique communication preferences. Some prefer text, e-mail, print, QR codes, etc. Ask patients how they prefer to communicate and adjust their communication style accordingly.

You can have the most remarkable clinical skills in the world, but your influence and impact will significantly diminish if you cannot persuade patients and parents to follow your recommendations. That’s why communication is no longer considered a “soft skill” among the world’s top business or medical leaders. Leaders who reach the top do not simply pay lip service to the importance of effective communication. Instead, they study the art in all its forms — writing, speaking, presenting — and constantly strive to improve those skills.

Best professional regards,

Dwight H. Akerman, OD, MBA, FAAO, FBCLA, FIACLE
Chief Medical Editor

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