July 1, 2021
By Dwight Akerman, OD, MBA, FAAO, FBCLA
When I speak with colleagues about myopia care for children, it becomes evident that almost every eye care professional has a different definition of myopia management. The term myopia management is often used synonymously with myopia control and myopia care. So, what exactly does myopia management mean?
Myopia management refers to proactively implementing a strategy to delay the incidence of myopia or slow the progression of myopia in children. From a treatment perspective, myopia management is defined as slowing axial elongation, which also reduces the rate at which the dioptric value of the refractive error increases. Various treatments such as topical low-dose atropine, novel spectacle designs, center-distance multifocal/dual-focus soft lenses, and orthokeratology have been proven in randomized controlled trials (RCTs) to slow axial elongation in myopic children.
From a holistic standpoint, I believe eye care professionals should adopt the following framework to define myopia management:
- Be proactive: have an informed discussion with every pre-myopic or myopic child and their parents.
- Identify risk factors for pre-myopia, myopia, and high myopia.
- Educate children and their parents about the long-term eye health risks associated with axial elongation and the advantages of a lower dioptric prescription.
- Provide specific lifestyle and visual hygiene recommendations to reduce the incidence and/or progression of myopia.
- Prescribe evidence-based interventions to slow axial elongation and reduce the risk of developing high myopia.
For a more detailed discussion about this topic, I recommend reading an excellent article written by Prof. Debbie Jones, “What Myopia Management Is and What It Is Not.”
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 proactive about myopia management in 2021!
Best professional regards,
Dwight H. Akerman, OD, MBA, FAAO, FBCLA
Chief Medical Editor