Changing the game

Excerpted from page 28 of the Fall 2025 edition of AOA Focus 

The prevalence and severity of myopia in U.S. children continues to increase, and it’s affecting children earlier and earlier. By 2030, nearly half of North America is projected to have myopia. 

But it doesn't have to be that way. 

The Myopia Collective—a partnership between the AOA and CooperVision that launched in April 2024 and currently has 3,500 members—is taking aim at this trend by educating the public, improving early detection rates and shifting the standard of care from basic optical correction to comprehensive treatment. 

“Myopia management has always been important, but we didn’t have the tools to implement it,” says Katherine Schuetz, O.D., a pediatric optometrist in Indianapolis. “Forever in optometry, we watched our nearsighted pediatric patients get worse and worse throughout their young adulthood, and that’s just how it was. We didn’t have a way to slow it down.” 

Doctors of optometry provide more than two-thirds of primary eye care in the U.S., positioning them as critical leaders in improving child eyesight. With increased screen time and less outdoor activity contributing to rising rates, the need for proactive care is urgent. Myopia cannot be reversed—but with proper treatment, its progression can be slowed.  

Today, doctors of optometry have new tools for managing myopia, including atropine eye drops, orthokeratology (ortho-k) and MiSight contact lenses.  

At the heart of the Myopia Collective are “change agents”—doctors of optometry from every U.S. state who serve as ambassadors for myopia awareness and progress. These clinicians receive training, tools, resources and peer support to elevate the standard of care and expand public understanding. The initiative is built on three pillars: collaboration, education and advocacy. 

Educating your community 

Change Agent Caitlyn McHugh-Glab, O.D., owner of Focused Eye Care in the Greater Chicago area, has made it her mission to spread myopia awareness to her community. She connects with teachers, parents and other clinicians, including school nurses, pediatricians, occupational therapists and physical therapists—basically anyone who works with kids.  

With a sign that reads, “Ask me about myopia management,” Dr. McHugh-Glab attends community events and health fairs to educate the public about myopia.  

“Most of my materials are geared toward parents. It allows them to ask me questions in a low-stakes environment,” she says. “Planting those seeds makes it easier to discuss when they come in for a consultation.” 

Even parents who know what myopia is often think their child simply needs glasses, she says. Many don’t realize the standard of care has changed. She takes time to explain to parents that myopia can be slowed down with a management plan that may include special contact lenses and eye drops.  

To her pediatric patients and their caregivers, Change Agent Dr. Schuetz stresses three messages: Get outdoors, read at a proper distance and take frequent screen breaks.  

“You can’t change genetics, but you can absolutely affect your risk for becoming nearsighted,” she tells families. “Spend two hours each day outside. Hold screens and books at an appropriate distance from your eyes. And every 20 minutes, take a real break—kids need two to five minutes of walking around their house or looking outside to truly relax their eyes.” 

Building a referral base 

In Indiana, Dr. Schuetz has made relationship-building a priority in her practice. When she was helping launch Little Eyes, the pediatric division of RevolutionEYES, outreach letters became part of her routine.  

In the letters, Dr. Schuetz stressed the importance of a comprehensive eye exam and asked pediatricians to refer parents to Little Eyes. In turn, Little Eyes follows up with a report about the child’s exam to their pediatrician. That collaboration built the practice’s credibility, which continues to expand and now has two locations in the Indianapolis area.  

“It helped us foster a good rapport with our local pediatricians because they saw that not every patient who was coming to us ended up in glasses,” Dr. Schuetz says. “That we’re responsible, we’re conscientious, we’re good at what we do and we’re not over-prescribing.” 

In some cases, pediatricians began referring children even in the absence of complaints, having seen how often those exams revealed undetected concerns.  

“It was a reminder to pediatricians that referring these patients for annual eye exams even when they’re little is important. It goes a long, long way to establishing our credibility, and having our pediatricians listen to us.” 

Dr. Schuetz also found it to be helpful to tell pediatricians that they weren’t competing with local ophthalmologists.  

“As optometrists, we need to respect the relationship that many M.D.s have with their fellow ophthalmology M.D. colleagues and say, ‘I’m not trying to take those patients away from the ophthalmologist. I’m trying to unburden your ophthalmology colleagues with patients they don’t necessarily need to see for annual visits.’” 

She stresses to pediatricians that if a child needs to see an ophthalmologist for a more advanced issue or concern, she will refer them directly. 

Little Eyes has also partnered with local schools to conduct free vision screenings for young students—required by Indiana law—in about 20 different schools.  

“It’s quite an undertaking, but we see probably 100 kids every single year at every school. Times 20—that’s pretty epic,” Dr. Schuetz says. About 5% to 8% of the kids fail the screening, triggering the school nurse to notify parents that their child needs a more comprehensive exam. 

As Little Eyes builds relationships with school nurses, it puts the practice top of mind when a nurse has a student who suffers an eye injury or has a red eye. “We make sure they know we’ll take care of their urgent care needs,” Dr. Schuetz says. 

Informing lawmakers 

Larger-scale advocacy aims to educate lawmakers and call for change at the state and federal level.  

Change Agent Scott Gibbons, O.D., an associate at Eyecare Associates in Nampa, Idaho, sees children and adults, including Medicaid and uninsured patients. He noticed an increase in parents bringing in one nearsighted child for an exam while not scheduling an appointment for their other children.  

“Parents would say, ‘Oh, they’re fine. They haven’t said anything about not being able to see and they passed their school vision screening.’” Dr. Gibbons would reply, “Let’s just check. It doesn’t hurt to check.”  

As soon as Dr. Gibbons began to see more and more myopia cases, he decided he wanted to be more proactive in educating the public and getting support for myopia management. Serendipitously, as he was considering how to do that, he received an email about the launch of the Myopia Collective. He joined and quickly became involved in state advocacy efforts.  

Earlier this year, Dr. Gibbons spoke at a luncheon for lawmakers hosted by the AOA-affiliated Idaho Optometric Physicians. He only had a few minutes to inform the state legislators that Idaho is one of the few states with no law or recommendation for children’s vision screening. Instead, the decision is left up to the school districts.  

“I spoke to our state legislators about how we’re at the bottom 5% of the country as far as making sure that kids get in front of a primary eye care provider to check on the health of their eyes and see where their refractive status is,” he says. “To see the shock on their faces that Idaho is one of just a handful of states that has no recommendations or no statute at all regarding children’s vision care … hopefully that made an impact.” 

Advocacy takes time and effort, but Dr. Gibbons says he believes it’s critical to share about children’s eye care with lawmakers. That means getting to know their staff, trying to set up meetings with legislators, and attending relevant committee meetings and hearings. Connecting with your state association’s legislative committee or chair is a good place to start, as well as joining the Myopia Collective.  

“You have to create the time for it, but developing relationships with those who represent your district and making them aware of your passion to help children with their vision care is important,” he says. 

Growing your practice 

For Chandler Mann II, O.D., community outreach goes hand in hand with practice growth. In 2022, he opened Stone Oak Vision Source in San Antonio, shortly after he and his wife relocated from Houston.  

“I had zero patients, and I knew zero people in the city besides my in-laws,” Dr. Mann says. Volunteering to participate in a career day at a local elementary school led to about 50 children’s appointments and helped him build a network of patients. Now, three years later, Dr. Mann’s practice has continued to grow. Today, Stone Oak Vision Source has staff, is open six days a week and books out about four weeks in advance. About 220 children are in the practice’s myopia management program.  

“Myopia management is my favorite thing to do,” he says. “I love taking care of kids. I love making an impact in their lives.”  

He enjoys being able to show kids—and their parents—that they are capable of more than they might think. If kids can tie their shoes, then they can put in contact lenses, he stresses. 

“I love teaching them that they’re able to push their brains and push their bodies further than they think they can. That really sets up a successful impact on their mentality with any new task going forward as well,” he says. “Secondarily, when you get a kid in contact lenses, especially a really myopic kid, it makes a big impact on their confidence.” 

As part of his practice, Dr. Mann recently launched the Mann Myopia Institute, with a separate website and online scheduler to make it easier for patients to book appointments. Eventually, he hopes to build a larger facility with dedicated space for the institute.  

Dr. Mann encourages doctors of optometry to make myopia management a primary focus of their exams and practice myopia control at a high level on a daily basis.