On Thursday, Jan. 16, at the 2025 Global Specialty Lens Symposium (GSLS), Kevin Chan, OD, MS, led a continuing education session titled "Finding the Elephant in the Room: Refine the Knowns and Unknowns of Myopia Management,” that explored the complexities of myopia progression and the evolving landscape of treatment strategies.

“There are still as many unknowns as the already-known ideas or theories in the realm of myopia management,” said Dr. Chan. “While we may not yet fully understand the exact mechanisms or nuances of myopia management, it is key, as practitioners, to stay open-minded and astute when it comes to collecting and interpreting clinical data based on each context and other associated factors.”

Dr. Chan's presentation tackled critical questions about the effectiveness and variability of orthokeratology (ortho-k) in controlling axial elongation in young patients. He emphasized that while ortho-k is proven to slow axial length progression, the response can vary widely among individuals, prompting the need for personalized approaches.

A key component of the session explored the interplay between axial length and corneal curvature, highlighting the axial length-to-corneal radius ratio as a more robust predictor of myopia progression than axial length alone. Dr. Chan shared findings from studies demonstrating the dynamic nature of axial elongation and its dependence on age, ethnicity, and other factors.

The course also delved into emerging treatment combinations, such as the concurrent use of low-dose atropine and ortho-k, which have shown promise in enhancing efficacy for patients with rapid myopia progression. Additionally, Dr. Chan addressed the challenges of interpreting corneal biomechanical changes, the significance of washout periods in ortho-k, and the nuances of managing patients who may be classified as “nonresponders” to certain treatments.

Dr. Chan shares he is curious about how the same lens designs and approaches to myopia management can yield various outcomes. “As I've been actively involved in direct patient care and clinical research in myopia management in the past decade, I attest to the firsthand cases of both success and failure. For that, I have become increasingly more passionate in sharing ideas and helping practitioners to get started with myopia management and keep challenging the status quo of correcting versus treating myopia therapeutically,” he said. “Myopia management is indeed a multifaceted subject that incorporates core clinical analysis along with behavioral or lifestyle recommendations for patients. Individualized patient care has become more crucial than ever, and I expect it to become the next tidal wave in the contact lens industry.”