Editor’s Perspective

The Current State of U.S. Myopia Management: Encouraging but Challenging

February 1, 2024

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

The prevalence of myopia and high myopia is increasing in the U.S. and globally at an alarming rate, with significant increases in the risks for vision impairment from pathologic conditions associated with myopia, including retinal detachment, myopic macular degeneration, cataract, and glaucoma.

In late 2023, Jobson Optical Research conducted a survey among U.S. eye care professionals focusing on myopia management in children and adolescents aged 18 and under. The survey collected information on the number of years in practice, the percentage of patients aged 18 and under, the percentage of myopic patients, methods of explaining the risks of ocular pathology associated with myopia, preferred methods of education on myopia management, anticipated changes in the number of myopia management patients, and the importance of managing progressive myopia in children and adolescents.

Key Findings: 

  • The survey included 461 qualified respondents who are optometrists or ophthalmologists practicing in the United States and seeing patients aged 18 and under. This is the largest ECP survey on myopia management ever conducted by Jobson Optical Research. 
  • The survey highlights a significant untapped potential market for myopia management, with an average of 23.8% of the patients of the respondents being aged 18 and under, and an estimated 50.5% of them being myopic. 
  • Only 63.6% of the respondents provide treatment therapy for myopia progression control, despite 50% of their patients aged 18 and younger being myopic. The most common reasons for not providing myopia therapy include “not enough patient demand” and “too time-consuming.”
  • It is important to note that nearly 23% of myopic patients aged 18 and under are receiving some form of myopia therapy, but a large proportion of myopic children and adolescents are not receiving myopia management treatments. 
  • The survey revealed that soft multifocal lenses (45.8%) and topical low-dose atropine (20.7%) are the most commonly prescribed interventions among the various interventions used by the respondents. 
  • The survey results highlight the need to educate eye care practitioners on myopia management. Educators should focus on clinical/scientific as well as practice management training to enable optometrists and ophthalmologists to proactively prescribe evidence-based interventions to manage progressive myopia in children and adolescents. 
  • Overwhelmingly, respondents who offer myopia management therapy said that they preferred “online CE courses,” “in-person CE meetings,” and “online journals such as Review of Myopia Management” to educate themselves about myopia management.
  • Sadly, “single-vision eyeglasses” (44.2%), “anti-fatigue/blue light blocker” (41.8%), and “progressive addition eyeglasses” (41.4%) are widely prescribed for myopia progression control. These interventions have been shown in randomized controlled clinical trials not to provide clinically significant myopia control. 
  • It is crucial to address the barriers to myopia therapy, with “treatment not covered by vision or medical insurance” being the greatest barrier to parents saying “yes” to myopia therapy for their children. Paradoxically, on another survey question, the least enabling factor to more proactively prescribe evidence-based interventions to manage progressive myopia in children and adolescents was “reimbursement by major medical or vision care plans for myopia management professional service and materials.” Reimbursement by vision care and major medical plans has always been a double-edged sword.

The survey findings provide unique insights into the current state of the U.S. myopia management market. The survey results should serve as a call to action for educators, eye care professionals, manufacturers, and parents to work together to manage progressive myopia in children and adolescents. To access a free copy of the complete myopia management survey, click here.

Myopia is the most significant threat to eye health in the 21st century. While the eye health benefits of lowering a child’s ultimate level of myopia are profound, the practice and financial benefits of providing myopia management are also significant. I urge you to commit to the highest level of care and prescribe the most appropriate evidence-based interventions to children at risk of progressive myopia. Let’s get more proactive about myopia management in 2024!

Best professional regards,

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

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