I have spoken with hundreds of eyecare practitioners about myopia and met many myopia rock stars who are blazing a trail for future generations of practitioners to follow. I’ve also spoken with many respected colleagues who are not proactively managing myopia. If I had to sum up the general sentiment toward myopia among this group, the best word would be apathy: “A lack of interest, enthusiasm, or concern.” That’s not to say that these colleagues don’t want the best for their patients. I think that in many cases, they simply aren’t aware of the current knowledge base surrounding myopia.

What Myopia Apathy Sounds Like

Following are some common statements demonstrating myopia apathy and why it may be time to reconsider these notions.

“It’s only myopia.” Viewing myopia solely as an optical inconvenience ignores the well-established association between myopia and ocular diseases such as retinal detachment and myopic maculopathy (Flitcroft, 2012). While higher myopes possess a higher absolute risk for comorbidities, the much larger pool of patients exhibiting low-to-moderate myopia also possesses increased risk for disease. For this reason, it is prudent to regard any childhood myopia as a risk factor for future ocular disease.

“We’ve been doing it this way forever.” It might be tempting for some practitioners to believe that continuing to manage myopia reactively using traditional means of correction will at least preserve a status quo of sorts—that while it may not reduce the number of people who experience high myopia and comorbidities, things won’t get any worse. Unfortunately, this is not the case. Myopia prevalence is increasing to the point that if we continue to manage myopia only reactively, rates of high myopia and complications from myopia progression will actually increase (Holden et al, 2016; Vitale et al, 2009).

“I don’t know enough about it.” It is certainly acceptable to not be an expert in a field that is, in essence, still relatively new to vision care. However, with the wide array of venues available to learn about myopia management, we are approaching a point at which all practitioners who see children should have had an opportunity to become educated on these treatment options. Continuing education events, trade journals, educational websites, and knowledgeable colleagues are all great resources to learn the basics about myopia control. There is even an entire conference specifically for myopia!

“I’m not interested in orthokeratology.” Orthokeratology (ortho-k) is a wonderful option for many young progressing myopes. With that said, not every eyecare practitioner has the training, interest, and access to the tools to fit ortho-k lenses. However, myopia management has come to incorporate so much more than corneal reshaping—soft contact lenses, pharmacologic therapy, and spectacle lens designs have all shown promise at slowing myopic axial elongation (Huang et al, 2016).

“Won’t myopia control hurt my practice?” There seems to be a fundamental misunderstanding among some who are not familiar with myopia management that it may reduce the number of patients seeking our services or may somehow reduce a practice’s bottom line. This is the opposite of the truth. Myopia management does not cure myopia, it proactively reduces the rate at which it progresses in individuals who are myopic. As when adding any subspecialty to your clinic, incorporating myopia management offers the opportunity to serve your patients while building your practice.

“My patients wouldn’t be interested.” Most of us don’t currently have a steady stream of patients requesting myopia management services. However, the same could be said when trying to establish a successful glaucoma subclinic. First, you must acquire the tools and the training to be successful. Then, you need to educate your patients on your exam findings and the best treatment options. It is your responsibility with any new technology to help establish the demand—after all, patients come to you because you are the expert on their eyes. CLS

For references, please visit www.clspectrum.com/references and click on document #316.