Is there a successful formula for eye care practitioners (ECPs) to effectively integrate myopia management into practice? 

In all settings of primary eye care practice, we have at least one effective optical intervention – spectacles or contact lenses – available to provide a better myopia control option than single vision.

Kate Gifford: Let’s break this into three simple tips. 

1. Just get started. Start with a conversation about myopia – its typical childhood progression, its impact on function in the short-term and the increased lifelong risk of eye disease and vision impairment which comes with any level of myopia, and increases as myopia progresses. Provide advice on visual environment – this is good practice for all children, and especially for children at-risk and exhibiting myopia.
    
2. Consider the optical correction. We have more than enough evidence that single vision correction is not the best-practice prescribing choice for a progressing myope. In all settings of primary eye care practice, we have at least one effective optical intervention – spectacles or contact lenses – available to provide a better myopia control option than single vision. 
    
3. Take the next steps. To expand your myopia management expertise as an ECP, consider your scope and setting of practice. This could mean adding detailed binocular vision assessment and management to your treatment plan; considering co-management with ophthalmology to prescribe atropine for suitable patients and/or measure axial length; take a course to increase your clinical knowledge such as prescribing more complex contact lenses like orthokeratology. You may even consider co-management with a colleague who has equipment or expertise which could help certain myopic patients.
    

There are more than enough education and resources available to help ECPs get started – spend some time on myopiaprofile.com, as well as the other range of fantastic information outlets available. 

How do you as eye care practitioners successfully talk to and encourage parents to take myopia more seriously?

I think the ideal messaging to parents includes a focus on the short- and long-term benefits of managing myopia.

Kate Gifford: In 17 years of practice, most of my clinical work has occurred in a specialty setting, so I’ve been fortunate to have patients and their parents either referred to me or seeking my services from a very informed perspective. I recognize that this has made my job easier in ensuring parental commitment to myopia management; but that’s not to say that it works perfectly every time. 

I think the ideal messaging to parents includes a focus on the short- and long-term benefits of managing myopia. As eye care practitioners, we might hold the long term avoidable eye health risks as paramount, but this likely means less to parents, compared to the short-term benefits of less frequent prescription changes, and hence less time between eye exams that their child spends with blurry vision. Explaining these short-term impacts of progressive myopia to parents can often be the best place to start, given that more myopic children nowadays don’t have myopic parents, so first and foremost the functional impact of myopia must be explained. A myopic parent understands blur and probably also remembers the period of their life when their prescription rapidly changed, but may not have had any experience with retinal detachment or myopic maculopathy, to grasp this consequence. Both the short-term and long-term consequences of myopia and benefits of management should be explained, but as there’s a lot to explain, it can be useful to take it in steps.

The complex message on childhood myopia can be summarized through the following explanatory steps.

1. Myopia symptoms and correction – the ‘what’ of myopia
    
2. Myopia consequences and control – the ‘why’ of myopia control (both short-term reduction of time spent with blurred vision and the long-term reduction in eye disease and vision impairment risk)
    
3. Options for myopia control – the ‘how’ of myopia management. 
    

I also use my own communication tools! In the past this was the ‘Clinical Myopia Profile’ tool which started it all; and more recently it’s our infographics, parent brochures and personalized inserts. These are designed to help frame the conversation and cover key aspects of management, including visual environment advice, myopia control options and long-term consequences of myopia. I also refer parents to MyKidsVision.org, our public awareness website, which provides more information about myopia, myopia control treatments and How-To video guides on specific aspects of management. 

What’s next for Myopia Profile—in 2021 and beyond? What vision do you have for the future?

Paul Gifford: In 2020, we have added more than 150 pieces of science-based, clinically relevant content to MyopiaProfile.com, amounting to more than 300,000 words helping ECPs translate research into practice. 

In 2021, a key focus for us is to build our public awareness resources on MyKidsVision.org. We know that the My Kids Vision platforms are used by ECPs to support their in-practice clinical communication, as much as they are used by the public to learn about myopia. Hence, our plans include building more resources to help ECPs and save them time; while also working to grow awareness and encourage more parents to seek eye care for their children. We need to match increased ECP education with increased public awareness, if we’re going to be able to see real change that the world needs, to change the myopia trajectory. By providing the important blend of education and resources for ECPs and expanding parental knowledge, we are confident that we can further our mission to improve children’s vision care worldwide.