Myopia control – trick or treat?

It is estimated that half the world’s population will be myopic by 2050¹. In the UK, the prevalence of myopia in children aged between 10-16 years has more than doubled over the last 50 years and children are becoming myopic at a younger age².

There is growing interest in myopia management and interventions that may slow its progression, but is there enough evidence? And how can we explain the risks and benefits to patients?  

What do optometrists need to understand about myopia?

Our first recommendation would be to get familiar with the latest research on myopia management. The International Myopia Institute, an industry-funded not-for-profit organisation, has produced a range of white papers that provide evidence reviews, expert consensus statements, and guidance on research and clinical practice – these are a useful resource³.

So far, no treatment has been developed to completely stop myopia progressing. Success has been achieved in slowing down the rate of progression through optical and pharmaceutical intervention strategies⁴. However, there is still very little evidence about the long-term benefits and risks of the treatments available, the effect on myopia progression following the cessation of treatment, or which interventions work for which people.  This means we cannot yet recommend the widespread roll out of myopia management interventions for all patients with myopia or for those at risk of developing myopia.

With the rapidly changing landscape of “standard care” for management of myopia, there is a need for guidelines for offering myopia management interventions and tools to help eye care professionals share clear and balanced information with patients and their parents about the benefits and risks of the treatments available, including the option of no intervention. We have developed guidance on myopia management for practitioners and this week published a leaflet for patients and their parents. Our leaflet has been reviewed by members and carries the Plain English Campaign’s crystal mark.

We recognise that some optometrists in the UK are already offering myopia management interventions to patients. Our view is that it is safe and ethical to do so, provided you follow relevant guidance. This includes giving patients and parents balanced information and obtaining explicit consent. If you are not offering myopia management interventions, you do not have to do so. However, you should make sure that you can hold a discussion with patients and their parents about the evidence, the benefits and the risks and make accurate records of your discussions. 

Myopia management is an area where research and evidence is evolving and we will continually review and update our guidance accordingly. In the meantime, our leaflet is a great resource to help your patients understand what we know so far.

References

1. Holden BA et al. (2016) “Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050”. Ophthalmology 123(5): 1036-1042.
2. McCullough SJ, O’Donoghue L, Saunders KJ (2016) Six Year Refractive Change among White Children and Young Adults: Evidence for Significant Increase in Myopia among White UK Children. PLoS ONE 11(1): e0146332. https://doi.org/10.1371/journal.pone.0146332
3. International Myopia Institute White Papers
4. Kang, P. (2018), Optical and pharmacological strategies of myopia control. Clin Exp Optom, 101: 321-332. doi:10.1111/cxo.12666

Listen to our podcast episodes on myopia.