Reshaping care: New myopia management guidance released
A meteoric rise in myopia prevalence places it among the greatest eye health threats of the 21st century, precipitating calls for eye care providers to embrace promising management therapies outlined in new clinical guidance.
Released in a pair of live, virtual presentations Jan. 10-11, convened by Johnson & Johnson Vision, the Managing Myopia: A Clinical Response to the Growing Epidemic guide introduces the concepts of myopia management to doctors of optometry by summarizing the foundational knowledge and currently available scientific research into a concise and comprehensive resource. Created in collaboration with the AOA, the Singapore Optometric Association, the American Academy of Optometry, and Johnson & Johnson Vision, the managing myopia guide emphasizes the staggering global toll of uncontrolled myopia progression and supports eye care providers with the latest clinical guidance for myopia management.
Robert C. Layman, O.D., AOA president-elect, noted during the webcast that the AOA committed to supporting this guidance because it helps not only introduce relevant clinical developments in myopia management but also builds public awareness for optometry’s primary eye care role in this growing epidemic.
“Optometry is the solution—we offer easy access to eye care for 98% of the U.S. population, so we can collectively have a big impact,” Dr. Layman said.
“Because there is no safe level of myopia, and 25% of patients with an axial length of greater than 26mm will develop visual impairment by age 75, it behooves us to do our part to address this with all the best clinical tools available.”
Specifically, the 12-page myopia management guide provides eye care providers with clinical information related to:
- Deciding when and how to treat myopia.
- Evaluating pre-myopia and myopia.
- Monitoring and efficacy.
- Personalizing myopia control therapies.
Lori Grover, O.D., Ph.D., AOA trustee and optometric clinical practice guidelines expert, says the myopia management guide offers doctors helpful information for discussing myopia diagnosis and treatment options with patients, both fundamental components of shared, clinical decision-making that result in best health outcomes.
“As doctors of optometry, we understand better than anyone in the health care arena the comprehensive range of health impacts that myopia has on our patients as we have been treating myopia from a primary care perspective for decades,” Dr. Grover says. “Patients and their families continue to rely on us as the go-to eye doctors for the best available health guidance relative to eyes and vision as we are the nation’s family eye doctors.”
What is so notable about this guidance, Dr. Grover adds, is that it brings front and center clinical information and active treatment options that are emerging from clinical research that can assist doctors and their patients to make better-informed decisions about their long-term eye and vision health. Also, these data help doctors and patients understand how to reduce the negative impacts of myopia as a chronic eye condition.
“Preventive primary eye care—care that has always been provided by doctors of optometry through comprehensive eye examinations—is again shown to be high-value care relative to myopia that can minimize the amount of needed ‘cure,’” Dr. Grover says.
Myopia—the growing epidemic
Globally, it is estimated that myopia prevalence could reach as much as 52%—with cases of high myopia climbing to 10%—of the world population by 2050. This unprecedented spike in uncorrected myopia over the next several decades will exact not only a significant socio-economic toll to the tune of hundreds of billions of dollars but also a highly personal toll with the risk of sight-threatening disease increasing exponentially with severity of myopia.
Early diagnosis and treatment are crucial considering myopia progresses more quickly in younger children, and early onset implies more years of progression, the guide notes. That’s why emerging data showing myopia prevalence among children is causing urgency: by some estimates, 80% of young adults in urbanized East Asian countries are myopic.
In the U.S., myopia prevalence among young people isn’t quite as dramatic; however, studies indicate it’s still a problem. In fact, a 2018 study of children in Southern California estimated nearly 60% of 17- to 19-year-olds and nearly 50% of 11- to 13-year-olds were myopic. Combined with almost a year of pandemic lockdowns, U.S. children could be at an unprecedented crossroads when it comes to myopia.
“Due to school closures, almost 65% of households with children report the use of online learning and increased digital screen use, linked to near work,” Dr. Layman said. “Compounded by the fact that social distancing measures have limited the time children spend outdoors, we know this crisis can have far-reaching eye health and vision implications on generations to come.”
To read more about the intersection of the myopia epidemic and the COVID-19 pandemic, members can access the July/August edition of AOA Focus.
Managing Myopia: A Clinical Response to the Growing Epidemic
The 15th century polymath Leonardo da Vinci quipped, “the eyes, the window of the soul.” He couldn’t know the half of it. Only now, with 21st century technology, are researchers unlocking the secrets of the retina—and the brain. The search for retinal biomarkers of neurocognitive disorders is returning results, and optometry may hold a piece of the puzzle.
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