February 2024 Virtual event Presentation

From Theory to Practice, Part 2

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By Ricardo Pintor OD, FIACLE, Mexico
Elise Kramer OD, FAAO, FSLS, FBCLA, USA

About the presentation

The World Council of Optometry, in partnership with CooperVision, hosted its first Latin American-based multi-day virtual event, “Myopia Management: From Theory to Practice,” in February 2024. This is the 4th and final module in the series.

Module 4, From Theory to Practice (Part 2), was originally attended by over 1,400 eye care professionals, and hosted by Dr. Carlos Chacón.  

Dr. Ricardo Pintor begins by outlining his recommendations for how and when to follow-up and what to measure on a patient undergoing myopia management. Dr. Elise Kramer shares her take on how to communicate to parents and children and how to best market your myopia management services in your practice. We end with a Q&A session where more than 50 questions were submitted to our speakers!

Selected FAQ from the event

Would you consider a patient with a refraction of -0.50D a candidate for myopia management?

Dr. Pintor: It depends on the age of the patient. If it’s five year-old or a six year-old, yes, I would consider myopia management a potential avenue to take. If the patient is 12 or 14 years old, the parents are not short-sighted and and the patient engages in extensive outdoor activity, then perhaps we do not need to worry. However, if both parents are short-sighted, it’s a different story; again, it depends on their refraction, lifestyle and so on. I may recommend a follow-up in three to six months to check for any changes and if I already then see an increase, I will start a conversation around myopia management.

Can we begin myopia management treatment prior to onset (of myopia)?

Dr.Pintor: Yes, of course. If you have a child whose axial length is already at the 75th percentile (see growth curve charts in recommended resources) but is not yet myopic, however, you then add the fact that the parents are myopic and that the child does not engage in much outdoor activity. Maybe you find a high accommodation lag or high AC/A and possibly other factors that make you concerned. This is a case for myopia management in my opinion.

For how long should a patient undergo myopia management?

Dr. Pintor: This is such a great question and one that eye care professionals are often faced with in practice. It depends on the stage we are at, in other words, the severity of the case. We want a certain stability in the refraction and in the axial length for at least two years. I would not finish or stop a comprehensive myopia management treatment plan in a patient that is 10 or 12 years old, because we know that the eye is still developing and growing and genetic and environmental factors can stimulate it.

If, however, my patient is already 18 or 20 years old, whom I have closely monitored and I have confirmed stability in refraction and axial length, then we can consider stopping treatment.

What effect does time in front of digital devices have on a patient with myopia management spectacles lenses or contact lenses or who uses atropine?

Dr. Pintor: I would not make a direct link between digital devices and myopia eyes undergoing myopia management; what I would like to highlight is any time spent in front of a screen or any other ‘near work’ type of activities takes away time from being outside which we know has a positive effect on managing myopia.

The side effect of screen use on myopia is still being debated and we do not have sufficient evidence yet to say anything conclusive.

Interested in learning more?

Mitigation
Measurement
Management

Prepared by the World Council of Optometry Myopia Management Resource Committee 2023.
The World Council of Optometry Myopia Management Standard of Care initiative is a collaborative partnership between World Council of Optometry and CooperVision.

WCO CooperVision® Myopia Management Navigator

Explore the interactive and educational resource for eye care practitioners worldwide

Soft Dual Focus or Multifocal Contact Lenses

Spectacle Lenses for Myopia Control

Orthokeratology

Atropine

When to wear it

Children who are physically active
Ideal for very young wearers
Children disliking glasses and/or inclined to not wearing them full-time

Considerations

Shown to improve confidence and ability to participate in activities.

Typically more availability for astigmats.

No wearing time during waking hours.

Optical correction is still needed.

* Excluding children frequently engaged in water sports.