Lately, it seems as though you can’t attend a continuing education event or trade show, read an article, or have a discussion with a colleague without talking about myopia. Of course, myopia isn’t new. Practitioners have been “correcting it” for years quite successfully. Correcting the vision of a newly diagnosed myopic kid with eyeglasses is one of the most straightforward things that eyecare practitioners have done since eyeglasses were invented. The usual patient journey is simple and expeditious. For years, it’s been a simple sequence of:

1. A school or pediatrician screening picks up blurry distance vision.
2. A healthy kid who has healthy eyes comes in for an examination.
3. We easily and confidently diagnose myopia and prescribe glasses.
4. A few hours or days later, the glasses are dispensed.
5. The child marvels at how well he or she can see.
6. The parents and patient are happy.
7. The check clears.
8. The school nurse receives the signed form.
9. We’re done for about a year.

The next year and for the years thereafter, it’s as easy as lather, rinse, repeat. As the child’s axial length marches on, he or she continues to see 20/20, and everyone is happy.

With this sequence happening thousands of times a day for hundreds of years, it’s no wonder that this industry-wide, fully ingrained habit has been so difficult to break. But, as the science readily shows, break it we must, or these myopic kids may be at significant risk as myopic adults (Saw et al, 2005).

Form a New Habit

To address the “So what, it’s only myopia” syndrome (SWIOMS—you read it here first!), three fundamental things need to change. Saying “myopia matters” is unequivocally true. But saying it and doing something about it are two different things. For it to matter to you—and to address your personal SWIOMS—consider these three fundamentally different viewpoints of myopia.

1. Nearsightedness is NOT the same thing as myopia. Rather, think of nearsightedness as the symptom (blurry distance vision) that results from a disease called myopia.
   If “disease” doesn’t sit well and you’re stuck on refractive error, that’s fine. Just note that this particular “refractive error” comes with a lot of potential pathology baggage. Whether practitioners call it a disease, refractive error, condition, or syndrome, the name is secondary to what they do about it and how they commit to helping their patients.
2. You’re not treating kids; you’re treating very small adults. Significant myopia-related consequences do not happen in kids who are younger than 7 years old and have less than –1.00D of myopia. But, those kids have a very high likelihood of progressing and typically will not stay at –1.00D. So, practitioners need to think of it as treating kids’ anticipated higher degree of myopia as adults. Our commitment to treating low degrees of childhood myopia is akin to vaccinating kids to ward off adult diseases later in life.
3. If you don’t want to treat it yourself, refer to someone who does. Just like with vision therapy, specialty lenses for keratoconus, or dry eye treatments, practitioners always have the option to refer patients to others who specialize in something that they don’t. You owe it to these patients to ensure that they receive the best possible care.

Address your SWIOMS. Your patients’ vision depends on it. CLS

For references, please visit www.clspectrum.com/references and click on document #291.