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MANAGING MYOPIA

A Clinical Response to the Growing Epidemic

WHAT IS MYOPIA?

Myopia is a chronic, progressive disease characterized by excessive eye elongation, risk of associated sight-threatening complications, and a negative-powered refractive error.1-4

GROWING GLOBAL EPIDEMIC

  • Reports of increased myopia prevalence in children first emerged in Asia in the 1980s.5,6
  • The number of people with myopia has nearly doubled within the past 20 years in both Eastern and Western Societies7
  • Prevalence among young adults is reported to be above 80% in many Asian regions,8 and 50% in the U.S. and parts of Europe9,10
  • Children in the first wave of high myopia prevalence (those born after 1970) are now on the cusp of experiencing sight-threatening complications as adults11-14

NO SAFE LEVEL OF MYOPIA2

  • The elongated eye is susceptible to pathological complications with significant risks to eye health and vision13,14
  • Any degree of myopia increases the risk of sight-threatening complications, with some complications leading to blindness in adulthood2,15
  • Each diopter increase in myopia results in 67% increased risk of myopic macular degeneration (MMD)16

Any degree of myopia increases the risk of sight-threatening complications.

CONTROLLING MYOPIA PROGRESSION image

Arrow pointing upwards over chart.

MANAGING MYOPIA PROGRESSION

  • Eye-care practitioners now have the opportunity to slow myopia progression rather than just correct the visual symptoms17
  • Increased time outdoors can delay myopia onset18 and may slow its progression19
  • Several myopia-control therapies have shown efficacy of over 0.3 mm (around 0.75 D) over two to three years of treatment20-23

IN PRACTICE

BENEFITS OF A NEW APPROACH

SHORT-TERM BENEFITS

  • Address myopia today: Provide your patients with latest treatment options proven to slow progression of myopia and correct vision, versus traditional vision correction that will not slow down myopic progression
  • Lifestyle benefits: For patients wearing Ortho-K or soft multifocal contact lenses for myopia management, there are immediate benefits of going glasses-free during the day, including performance in sports and increased confidence.24,25 Several studies have shown that kids are very capable of wearing contacts26 and they greatly prefer them to glasses once getting the hang of insertion and removal.27

LONG-TERM BENEFITS

  • Reduced Risk of Sight-threatening complications (most important): decreasing patients’ axial elongation and slowing refractive error growth may result in reduced risk for vision impairment later in life13,14 from diseases such as myopic macular degeneration28, staphyloma29 retinal detachment30 glaucoma31 and cataracts32
  • Better Surgical Outcomes: reducing myopia progression results in refractive and surgical outcomes later in life; as an example, patients with lower amounts of myopia will be better candidates for refractive or cataract surgeries33
  • Better Visual Outcomes: reducing myopia progress helps patients see better without correction due to a lower prescription.33

Benfits of a new approach image

Black girl on swing smiling, representing benefits of treating myopia early.

Benfits of a new approach image

Black girl on swing smiling, representing benefits of treating myopia early.
BENEFITS OF A NEW APPROACH

BENEFITS OF A NEW APPROACH

SHORT-TERM BENEFITS

  • Address myopia today: Provide your patients with latest treatment options proven to slow progression of myopia and correct vision, versus traditional vision correction that will not slow down myopic progression
  • Lifestyle benefits: For patients wearing Ortho-K or soft multifocal contact lenses for myopia management, there are immediate benefits of going glasses-free during the day, including performance in sports and increased confidence.24,25 Several studies have shown that kids are very capable of wearing contacts26 and they greatly prefer them to glasses once getting the hang of insertion and removal.27

LONG-TERM BENEFITS

  • Reduced Risk of Sight-threatening complications (most important): decreasing patients’ axial elongation and slowing refractive error growth may result in reduced risk for vision impairment later in life13,14 from diseases such as myopic macular degeneration28, staphyloma29 retinal detachment30 glaucoma31 and cataracts32
  • Better Surgical Outcomes: reducing myopia progression results in refractive and surgical outcomes later in life; as an example, patients with lower amounts of myopia will be better candidates for refractive or cataract surgeries33
  • Better Visual Outcomes: reducing myopia progress helps patients see better without correction due to a lower prescription.33

Benfits of a new approach image

Black girl on swing smiling, representing benefits of treating myopia early.

Benfits of a new approach image

Black girl on swing smiling, representing benefits of treating myopia early.

MYOPIA MANAGEMENT IN YOUR PRACTICE image

Asian boy wearing glasses, who may have myopia, carrying a backpack, as if he’s headed off to school.

MYOPIA MANAGEMENT IN YOUR PRACTICE

Incorporating myopia management into your practice requires a slight shift in your approach and how you communicate with your patients.
  • Prepare Your Practice. To integrate myopia management into your practice, there are many steps you may need to take. See this article for some great ideas on where to start, including assessing and purchasing the equipment needed, understanding the chair time required and enrolling your staff.
  • Consider All Patients. Offer myopia management options to ALL pediatric patients that could benefit. Don’t wait until you see further progression to broach the subject.2 See a helpful article here.
  • Educate in advance. In advance of their next appointment, send information to parents of patients that could be candidates within your database educating them on myopia as a disease, and the potential to slow its progression. This will ensure parents are mildly familiar with the options available.
  • Encourage Parents To Ask. Optimize your communication to help your patients understand the benefits of myopia management.
  • Address cost concerns directly. Myopia control therapy can seem expensive at first, which is why it’s important to clearly state its benefits and value to parents. See a great article here on suggested in-office tips.

MYOPIA MANAGEMENT IN YOUR PRACTICE image

Asian boy wearing glasses, who may have myopia, carrying a backpack, as if he’s headed off to school.
MYOPIA MANAGEMENT IN YOUR PRACTICE

MYOPIA MANAGEMENT IN YOUR PRACTICE image

Asian boy wearing glasses, who may have myopia, carrying a backpack, as if he’s headed off to school.

MYOPIA MANAGEMENT IN YOUR PRACTICE

Incorporating myopia management into your practice requires a slight shift in your approach and how you communicate with your patients.
  • Prepare Your Practice. To integrate myopia management into your practice, there are many steps you may need to take. See this article for some great ideas on where to start, including assessing and purchasing the equipment needed, understanding the chair time required and enrolling your staff.
  • Consider All Patients. Offer myopia management options to ALL pediatric patients that could benefit. Don’t wait until you see further progression to broach the subject.2 See a helpful article here.
  • Educate in advance. In advance of their next appointment, send information to parents of patients that could be candidates within your database educating them on myopia as a disease, and the potential to slow its progression. This will ensure parents are mildly familiar with the options available.
  • Encourage Parents To Ask. Optimize your communication to help your patients understand the benefits of myopia management.
  • Address cost concerns directly. Myopia control therapy can seem expensive at first, which is why it’s important to clearly state its benefits and value to parents. See a great article here on suggested in-office tips.

MYOPIA MANAGEMENT IN YOUR PRACTICE image

Asian boy wearing glasses, who may have myopia, carrying a backpack, as if he’s headed off to school.

MARKETING MYOPIA MANAGEMENT

Here’s how to get started with an effective myopia-management marketing campaign:
  • Get your staff on board: Agree on a simple message that your whole staff can reinforce.
  • Get help and support: Your vendors can provide with you with marketing materials, educational aids, best practices, and more.
  • Talk to every parent: While we are now aware of risk factors which are involved in myopia development, it is not possible to definitively predict whether children will or will not develop myopia. That’s why it’s important to make parents aware of the risks of untreated myopia, and the treatments that are available.
  • Focus on the emotional benefits. Resist the urge to get bogged down in the details of specific product designs.

MARKETING MYOPIA MANAGEMENT image

Two Asian girls who may have myopia running on the beach, enjoying an active lifestyle without glasses because of treatment.

MARKETING MYOPIA MANAGEMENT image

Two Asian girls who may have myopia running on the beach, enjoying an active lifestyle without glasses because of treatment.
MARKETING MYOPIA MANAGEMENT

MARKETING MYOPIA MANAGEMENT

Here’s how to get started with an effective myopia-management marketing campaign:
  • Get your staff on board: Agree on a simple message that your whole staff can reinforce.
  • Get help and support: Your vendors can provide with you with marketing materials, educational aids, best practices, and more.
  • Talk to every parent: While we are now aware of risk factors which are involved in myopia development, it is not possible to definitively predict whether children will or will not develop myopia. That’s why it’s important to make parents aware of the risks of untreated myopia, and the treatments that are available.
  • Focus on the emotional benefits. Resist the urge to get bogged down in the details of specific product designs.

MARKETING MYOPIA MANAGEMENT image

Two Asian girls who may have myopia running on the beach, enjoying an active lifestyle without glasses because of treatment.

MARKETING MYOPIA MANAGEMENT image

Two Asian girls who may have myopia running on the beach, enjoying an active lifestyle without glasses because of treatment.

REFERENCES

This website addresses primary myopia rather than the secondary myopias, such as syndromic or cataract-related myopia, as defined in the IMI report.
1. Flitcroft DI et al. IMI–Defining and classifying myopia: a proposed set of standards for clinical and epidemiologic studies. Investigative ophthalmology & visual science. 2019;60:M20-30.
2. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31(6):622-660.
3. Donovan L, Sankaridurg P, Ho A et al Myopia progression rates in urban children wearing single-vision spectacles. OVS 2012;89(1):27-32.
4. Pärssinen O, Kauppinen M. Risk factors for high myopia: a 22-year follow-up study from childhood to adulthood. Acta Ophthalmologica. 2019;97(5):510-518.
5. Lin LL et al. Nationwide survey of myopia among schoolchildren in Taiwan, 1986. Acta Ophthalmologica. 1988;66(S185):29-33.
6. Au Eong KG, Tay TH, Lim MK. Race, culture and Myopia in 110,236 young Singaporean males. Singapore Med J. 1993 34(1) 29-32.
7. Holden BA, Fricke TR, Wilson DA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology 2016;123:1036-42.
8. Ding, Bo-Yuan, et al. "Myopia among schoolchildren in East Asia and Singapore." Survey of ophthalmology 62.5 (2017): 677-697.
9. Vitale S et al. Prevalence of refractive error in the United States, 1999-2004. Arch Ophthalmol. 2008;126:1111-9.
10. Williams K et al. Increasing prevalence of myopia in Europe and the impact of education. Ophthalmology. 2015 Jul 1;122(7):1489-97.
11. Morgan IG, French AN, Ashby RS, et al. The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res. 2018 Jan;62:134-149.
12. Sensaki S, Sabanayagam C, Verkicharla PK, Awodele A, et al An Ecologic Study of Trends in the Prevalence of Myopia in Chinese Adults in Singapore Born from the 1920s to 1980s. Ann Acad Med Singap. 2017 Jun;46(6):229-236.
13. Tideman JW, Snabel MC, Tedja MS et al. Association of Axial Length With Risk of Uncorrectable Visual Impairment for Europeans With Myopia. JAMA. Ophthalmol. 2016 Dec 1;134(12):1355-1363.
14. Haarman AEG, Enthoven CA, Tideman JWL, et al. The Complications of Myopia: A Review and Meta-Analysis. Invest Ophthalmol Vis Sci. 2020 Apr 9;61(4):49.
15. Perkins ES. Morbidity from Myopia. Sight Sav Rev 1979;49:11-9.
16. Bullimore MA, Brennan NA. Myopia-control: Why Each Diopter Matters. Optom Vis Sci 2019;96:463-5.
17. Kate L. Gifford, Kathryn Richdale, Pauline Kang, et al IMI – Clinical Management Guidelines Report. Invest. Ophthalmol. Vis. Sci. 2019;60(3):M184-M203.
18. He M et al. Effect of time spent outdoors at school on the development of myopia among children in China: a randomized clinical trial. JAMA. 2015;314:1142-8.
19. Wu PC et al. Myopia prevention and outdoor light intensity in a school-based cluster randomized trial. Ophthalmol. 2018;125:1239-50.
20. Chamberlain, Paul, et al. "A 3-year randomized clinical trial of MiSight lenses for myopia control." Optometry and Vision Science 96.8 (2019): 556-567.
21. Lam, Carly Siu Yin, et al. "Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial." British Journal of Ophthalmology 104.3 (2020): 363-368.
22. Chua, Wei-Han, et al. "Atropine for the treatment of childhood myopia." Ophthalmology 113.12 (2006): 2285-2291.
23. Chen, Connie, Sin Wan Cheung, and Pauline Cho. "Myopia control using toric orthokeratology (TO-SEE study)." Investigative ophthalmology & visual science 54.10 (2013): 6510-6517.
24. Santodomingo-Rubido, Jacinto, et al. Myopia control with orthokeratology contact lenses in Spain: a comparison of vision-related quality-of-life measures between orthokeratology contact lenses and single-vision spectacles. Eye & Contact Lens 39.2 (2013): 153-157.
25. Pomeda, Alicia Ruiz, et al. “MiSight Assessment Study Spain: a comparison of vision-related quality of life measures between MiSight contact lenses and single-vision spectacles.” Eye & contact lens 44 (2018): S99-S104.
26. Walline, Jeffrey J et al. Contact Lenses in Pediatrics (CLIP) Study: chair time and ocular health. Optometry and Vision Science 84.9 (2007): 896-902.
27. Walline JJ, Gaume A, Jones LA, Rah MJ, Manny RE, Berntsen DA, Chitkara M, Kim A, Quinn N. Benefits of contact lens wear for children and teens. Eye Contact Lens 2007;33:317–21.
28. Ohno-Matsui K et al. Updates of Pathologic Myopia. Prog Retin Eye Res 2016;52:156-87.
29. Ohno-Matsui K, Jonas JB. Posterior staphyloma in pathologic myopia. Prog Retin Eye Res 2019;70:99-109.
30. Mitry D et al. The Epidemiology of Rhegmatogenous Retinal Detachment: Geographical Variation and Clinical Associations. Br J Ophthalmol 2010;94:678-84.
31. Marcus MW et al. Myopia as a Risk Factor for Open-Angle Glaucoma: A Systematic Review and Meta-Analysis. Ophthalmol 2011;118:1989-94.
32. Pan CW et al. Myopia and Age-Related Cataract: A Systematic Review and Meta-Analysis. American Journal of Ophthalmology 156.5 (2013): 1021-1033.
33. Bullimore, Mark A., and Noel A. Brennan. "Myopia control: why each diopter matters." Optometry and Vision Science 96.6 (2019): 463-465.

PP2021OTH6123
REFERENCES

REFERENCES

This website addresses primary myopia rather than the secondary myopias, such as syndromic or cataract-related myopia, as defined in the IMI report.
1. Flitcroft DI et al. IMI–Defining and classifying myopia: a proposed set of standards for clinical and epidemiologic studies. Investigative ophthalmology & visual science. 2019;60:M20-30.
2. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31(6):622-660.
3. Donovan L, Sankaridurg P, Ho A et al Myopia progression rates in urban children wearing single-vision spectacles. OVS 2012;89(1):27-32.
4. Pärssinen O, Kauppinen M. Risk factors for high myopia: a 22-year follow-up study from childhood to adulthood. Acta Ophthalmologica. 2019;97(5):510-518.
5. Lin LL et al. Nationwide survey of myopia among schoolchildren in Taiwan, 1986. Acta Ophthalmologica. 1988;66(S185):29-33.
6. Au Eong KG, Tay TH, Lim MK. Race, culture and Myopia in 110,236 young Singaporean males. Singapore Med J. 1993 34(1) 29-32.
7. Holden BA, Fricke TR, Wilson DA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology 2016;123:1036-42.
8. Ding, Bo-Yuan, et al. "Myopia among schoolchildren in East Asia and Singapore." Survey of ophthalmology 62.5 (2017): 677-697.
9. Vitale S et al. Prevalence of refractive error in the United States, 1999-2004. Arch Ophthalmol. 2008;126:1111-9.
10. Williams K et al. Increasing prevalence of myopia in Europe and the impact of education. Ophthalmology. 2015 Jul 1;122(7):1489-97.
11. Morgan IG, French AN, Ashby RS, et al. The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res. 2018 Jan;62:134-149.
12. Sensaki S, Sabanayagam C, Verkicharla PK, Awodele A, et al An Ecologic Study of Trends in the Prevalence of Myopia in Chinese Adults in Singapore Born from the 1920s to 1980s. Ann Acad Med Singap. 2017 Jun;46(6):229-236.
13. Tideman JW, Snabel MC, Tedja MS et al. Association of Axial Length With Risk of Uncorrectable Visual Impairment for Europeans With Myopia. JAMA. Ophthalmol. 2016 Dec 1;134(12):1355-1363.
14. Haarman AEG, Enthoven CA, Tideman JWL, et al. The Complications of Myopia: A Review and Meta-Analysis. Invest Ophthalmol Vis Sci. 2020 Apr 9;61(4):49.
15. Perkins ES. Morbidity from Myopia. Sight Sav Rev 1979;49:11-9.
16. Bullimore MA, Brennan NA. Myopia-control: Why Each Diopter Matters. Optom Vis Sci 2019;96:463-5.
17. Kate L. Gifford, Kathryn Richdale, Pauline Kang, et al IMI – Clinical Management Guidelines Report. Invest. Ophthalmol. Vis. Sci. 2019;60(3):M184-M203.
18. He M et al. Effect of time spent outdoors at school on the development of myopia among children in China: a randomized clinical trial. JAMA. 2015;314:1142-8.
19. Wu PC et al. Myopia prevention and outdoor light intensity in a school-based cluster randomized trial. Ophthalmol. 2018;125:1239-50.
20. Chamberlain, Paul, et al. "A 3-year randomized clinical trial of MiSight lenses for myopia control." Optometry and Vision Science 96.8 (2019): 556-567.
21. Lam, Carly Siu Yin, et al. "Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial." British Journal of Ophthalmology 104.3 (2020): 363-368.
22. Chua, Wei-Han, et al. "Atropine for the treatment of childhood myopia." Ophthalmology 113.12 (2006): 2285-2291.
23. Chen, Connie, Sin Wan Cheung, and Pauline Cho. "Myopia control using toric orthokeratology (TO-SEE study)." Investigative ophthalmology & visual science 54.10 (2013): 6510-6517.
24. Santodomingo-Rubido, Jacinto, et al. Myopia control with orthokeratology contact lenses in Spain: a comparison of vision-related quality-of-life measures between orthokeratology contact lenses and single-vision spectacles. Eye & Contact Lens 39.2 (2013): 153-157.
25. Pomeda, Alicia Ruiz, et al. “MiSight Assessment Study Spain: a comparison of vision-related quality of life measures between MiSight contact lenses and single-vision spectacles.” Eye & contact lens 44 (2018): S99-S104.
26. Walline, Jeffrey J et al. Contact Lenses in Pediatrics (CLIP) Study: chair time and ocular health. Optometry and Vision Science 84.9 (2007): 896-902.
27. Walline JJ, Gaume A, Jones LA, Rah MJ, Manny RE, Berntsen DA, Chitkara M, Kim A, Quinn N. Benefits of contact lens wear for children and teens. Eye Contact Lens 2007;33:317–21.
28. Ohno-Matsui K et al. Updates of Pathologic Myopia. Prog Retin Eye Res 2016;52:156-87.
29. Ohno-Matsui K, Jonas JB. Posterior staphyloma in pathologic myopia. Prog Retin Eye Res 2019;70:99-109.
30. Mitry D et al. The Epidemiology of Rhegmatogenous Retinal Detachment: Geographical Variation and Clinical Associations. Br J Ophthalmol 2010;94:678-84.
31. Marcus MW et al. Myopia as a Risk Factor for Open-Angle Glaucoma: A Systematic Review and Meta-Analysis. Ophthalmol 2011;118:1989-94.
32. Pan CW et al. Myopia and Age-Related Cataract: A Systematic Review and Meta-Analysis. American Journal of Ophthalmology 156.5 (2013): 1021-1033.
33. Bullimore, Mark A., and Noel A. Brennan. "Myopia control: why each diopter matters." Optometry and Vision Science 96.6 (2019): 463-465.

PP2021OTH6123