Managing myopia

While most myopia control talks focus on the theory of the condition, a look at myopia management strategies and how practitioners can start implementing them was welcomed when CooperVision's European professional affairs manager, Elizabeth Lumb, took to the main stage at 100% Optical (ExCeL Exhibition Centre, 4–6 February).

Optometrist Ms Lumb highlighted that when it comes to myopia management, “it’s time to stop talking and start doing.”

Myopia stats

Ms Lumb explained that myopia is a big deal at the moment and affects all regions of the world. She shared with delegates how myopia was first noticed in the Far East, where prevalence has now reached such an extent that an emmetropic teenager in China is an outlier.

Ms Lumb drew on figures close to home, reporting that today not only has myopia reached the UK, its prevalence has more than doubled since the 1960s.

“Not only has myopia doubled in the UK, but more than that, children are becoming myopic at a much younger age,” she stressed, adding that: “Starting myopia younger means that you finish myopia at a much higher level.”

Ms Lumb used research to emphasise the growing concern of myopia. She shared statistics that showed how, if current trends continue, 50% of the global population will be affected by myopia within a few decades. “For those in the audience who are keen on numbers,” she said, “50% of the global population looks like five billion people.”

Management plans

Ms Lumb offered practitioners a three-step action plan to managing the condition among their patients, two thirds of which, she said, practitioners can already do with ease if they are not already.

Ms Lumb’s first step involved assessing the patient’s risk of myopia, something that she stressed “all practitioners are well placed to do.”

She referred to myopia’s genetic link, advising practitioners to: “Look at refraction at a young age, consider family history, but don’t let it be the only reason you discuss myopia with a child and their parents, and establish a management plan when appropriate.”

Step two focused on behavioural management, during which Ms Lumb urged practitioners to look at the lifestyle of their young patients. “I believe that we can encourage people to spend more time outside, and if you are not doing this already, you should be,” she said.  

The third step is optical management. While summarising the management options available to practitioners, Ms Lumb explained the benefits and risks associated with spectacles, bifocal and multifocal contact lenses, and Ortho-K. She stressed that when selecting a management option, practitioners must assess and determine if the benefits of a method outweigh the risks involved.

However, Ms Lumb said that research shows that practitioners need to be able demonstrate that a management technique can reduce myopia progression by at least 50% for parents to get onboard.

Drawing on her own experiences as a practitioner, Ms Lumb warned practitioners to be mindful of under-correcting. “Undercorrection is being used in various parts of the world to try to stop myopia progression,” she said, explaining that: “The theory is that myopia defocus stops elongation, meaning that the eyeball stops growing and myopia is halted. However, two studies have now shown that undercorrection can lead to progression at a quicker rate.”

“Therefore, undercorrection is not advisable,” she concluded.