Menu
Myopia Management PERSPECTIVES
Evidence-Based Practice in Myopia Management
Paper authors: James Wolffsohn, Elizabeth Lumb, and Anna Sulley
Evidence-based practice, which arose from Evidence-based medicine, emphasizes the integration of the strongest available research evidence from peer-reviewed journals and clinical experience into clinical decision making and care. A hierarchical evidence model categorizes research evidence based on its strength, from systematic reviews and randomized controlled clinical trials to case reports and expert opinions; the strength of this evidence can be used to decide if it should (or should not) affect methods of clinical care. Overall, evidence-based practice empowers eye care professionals (ECPs) to make well-informed decisions, ensuring the best possible outcomes for their patients.
In this second Perspective, we examine an article by Wolffsohn et al. titled ”Evidence-based practice in myopia management” (Optometry in Practice, 2021). The paper explores evidence-based strategies for preventing the development and slowing the progression of myopia. However, its insights extend beyond myopia management, and also highlight the broader significance of evidence-based practice in the field of optometry and healthcare more generally.
Combine Evidence & Experience
The authors emphasize that evidence-based practice in myopia management involves making healthcare decisions based on the strongest available research evidence from peer-reviewed journals. Well-rounded patient care is achieved by ECPs by combining this evidence with their own clinical experience and input from the patient.
Staying Updated
The paper underscores the importance of staying updated with the latest research developments. It encourages ECPs to be proactive in seeking new evidence and incorporating it into their practice, not only for myopia but also for various eye conditions.
Several Critical Strategies Available
This article also explores critical strategies for preventing myopia development and slowing its progression – for example, environmental modification (including increased time outdoors), and optical treatments (such as soft dual-focus contact lenses, orthokeratology, and soft multifocal contact lenses) have all shown promise in controlling myopia progression. Additionally, pharmaceutical treatment with atropine and combination therapy approaches have been explored to enhance the efficacy of myopia control.
Awareness Still Needed
The authors note that ECPs continue to fit standard single-vision correction to progressing myopic patients, so there is an ongoing need for greater awareness and adoption of evidence-based myopia management.
In addition to clinical recommendations, the paper highlights key design recommendations for clinical studies from the International Myopia Institute’s 2019 report:
These features significantly enhance the credibility and reliability of myopia management research, providing a robust foundation for the advancement of our understanding of myopia control strategies.
ECPs play a crucial role in managing myopia and its potential complications. The research underscores the importance of timely interventions to slow axial elongation and reduce the risk of myopia-related ocular complications. Factors such as patient age, refractive error, and parental myopia history can help predict the likelihood of myopia development, aiding early management decisions. Various clinical management options with good supporting evidence are now available, and we will discuss them in upcoming Reports. Keeping up-to-date with the ever-expanding academic literature and efficacy findings is essential to offer the best care to paediatric patients.
Stay Informed: Check in each month to our Myopia Management Reports series and other resources here on the Standard of Care for Myopia Management website. Regularly review the latest research, systematic reviews, and professional guidelines to stay abreast of the latest myopia management strategies.
Proactive Intervention: Recognize high-risk children prone to myopia development and proactively address the situation using a “mitigate, measure, and manage” approach as per the WCO resolution:
Personalized Care: Tailor myopia management approaches to individual patient needs, considering factors like age, refractive error, and parental myopia history.
As we embark on this series, our goal is to equip you, our dedicated ECPs, with evidence-based insights to navigate the dynamic field of myopia management effectively. Together, we can make a significant impact in reducing the prevalence and progression of myopia, safeguarding the eye health and vision of generations to come.
For the full-length article, please visit here.
Presented by Sara McCullough, Nicola Logan & Carmen Abesamis-Dichoso
Learn how to recognize risks of developing myopia in children based on presenting refractive status, axial length, and family history and to implement a clinical management protocol.
Presented by Philip Cheng, Wen Juan Chui & Ariolfo Vazquez
Hear how current leading practitioners in the field of myopia management choose a myopia management strategy for their patients.
Presented by Thomas Aller
Learn about tools and strategies for monitoring the myopia progression of your patients, assessing the effectiveness of their treatments and modifying their treatments to maximize their effectiveness.
Learn how to recognize risks of developing myopia in children based on presenting refractive status, axial length, and family history and to implement a clinical management protocol.
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.
When to wear it
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.