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Jeepers Scooby: Myopia is Getting Managed Better than Ever Before

Do you remember that catchphrase from childhood? If you can’t — or if you don’t recognize it at all — you’re truly missing out on a classic.

Scooby Doo was a childhood staple for many of us — and the mystery-solving gang, including the eponymous dopey dog, offered a plethora of catchphrases to remember. “Jinkies” was the catchphrase of the bespectacled Velma, but throughout the show she also frequently lost her glasses, to the extent that “I can’t find my glasses” became a catchphrase in its own right. Velma is one of the first cultural characters to suffer from myopia that many of us encountered in childhood.

The Many Multitudes of Myopia

Myopia, is of course, one of the most pervasive conditions in eye care and its impact on society extends far beyond cartoons. Also known as short-sightedness, myopia is a refractive error — meaning that a myopic eye cannot bend light properly.

According to the American Association of Ophthalmology, over 25% of the U.S. population suffers from myopia, with onset usually presenting in children aged 8-12 years old.1 Myopia is incredibly common in all parts of the world, and although it is a significant issue in the Americas, it is most noticeable in the Asia-Pacific region. Myopia is a pervasive and deeply ingrained disability in this part of the world.

According to The Epidemics of Myopia: Aetiology and Prevention2, one of the foremost studies into myopia, the prevalence of myopia in young adults living in East and Southeast Asia was 90% — and high myopia has a prevalence rate of up to 20% in the same group. The risk factors include a high level of education and limited time spent outdoors. Causality has been demonstrated through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia.

Make Sure Your Kids Spent Time Outdoors

The global presence of myopia is so expansive that experts view the condition as a societal problem, as much as a medical disease. While research continues into a potential cure, management and diagnosis are still the primary focus areas of most companies working in the optometry industry. Of these, perhaps the foremost is OCULUS Optikgeräte GmbH (Wetzlar, Germany).

With a history of more than 125 years in ophthalmological and optometry equipment, Oculus is one of the stalwarts of the industry. Based in Germany, the company has steadily expanded into the Asia-Pacific region over the last decade, putting myopia front-and-center as a priority. This development resulted in the creation of the Myopia Master.

Marketed as the first device to combine the important measurement parameters for making myopia management much easier, the Myopia Master promises to revolutionize patient outcomes and satisfaction. It can take risk factors into account, like ethnicity, the number of myopic parents, as well as time spent with near-vision and outdoor activities — all of which influence the growth of the eye. The tool is a way to effectively combine measurement parameters with software that allows the optometrist to make data-driven decisions and evaluation-based action recommendations.

The “Master of Myopia”

The Myopia Master’s implications for myopia and wider optometry have the potential to be remarkably significant, according to Dr. Oliver Woo. An optometrist with over 22 years of experience working in orthokeratology, Dr. Woo has been using the Myopia Master for the last five months and is highly enthusiastic about the device.

“The Myopia Master is the most systematic way for me to manage myopia from the early stage. It has its science, technology and research based on the work of the Brien Holden Vision Institute. This is big data, which you can use to present parents with projections of how their children will see at age 18,” said Dr. Woo.

“It is an entire system we can use to present an accurate picture of a myopic patient’s progression with the disease. Parents in particular are able to see their child’s condition stabilizing, it’s a really positive development to see,” he said.

Current treatments for myopia, including the application of atropine can’t be replaced by the Myopia Master, however they can be supplemented. High-dose atropine (0.5%-1%) is the most effective but it has significant side effects, such as photophobia and difficulty with near work (decreased accommodation). Low doses of atropine show a dose-dependent efficacy.3

Low Dose Cocktails and Optimism

According to Dr. Woo, doses of between 0.01% to 0.05% of atropine have been used to effectively manage myopia without incurring significant side effects. Orthokeratology has also proven to be considerably effective in treating myopia, especially when combined with low doses of atropine. Prismatic bifocal lenses and specially designed multifocal soft contact lenses have recently been tested with promising results.4

It is this multi-focused approach to myopia management that Dr. Woo believes works best, describing it as a “cocktail.” Combined with a management tool like the Myopia Master, Dr. Woo is optimistic that significant progress will be made in treating and mitigating the impact of myopia. He is also considerably positive about the role Oculus plays in its continued work in combating myopia.

“Oculus is invested in both the technology and science to develop the Myopia Master, as much as it was willing to collaborate with research centers. Looking forward, Oculus is creating educational tools for both optometry and ophthalmology on how to manage myopia in a more systematic, evidence-based and scientific way,” Dr. Woo said.

“That’s why I see the need to invest back into the industry, as well as looking forward to improving educational initiatives to train more optometrists and ophthalmologists to understand how to manage myopia,” he concluded.

References

  1. The American Association of Ophthalmology. Nearsightedness: What is Myopia? Available at https://www.aao.org/eye-health/diseases/myopia-nearsightedness. Accessed on October 9, 2020.
  2. Morgan IG, French AN, Ashby RS, et al. The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res. 2018;62:134-149.
  3. Tran HDM, Tran YH, Tran TD, et al. A Review of Myopia Control with Atropine. J Ocul Pharmacol Ther. 2018;34(5):374-379. 
  4. Spillmann L. Stopping the Rise of Myopia in Asia. Graefes Arch Clin Exp Ophthalmol. 2020; 258(5):943-959.
Oliver Woo   CV

Dr. Oliver Woo, B Optom, FIAOMC, graduated from School of Optometry, University of New South Wales, Australia in 1994 and established an independent optometrist practice in Sydney, Australia in 1997. In 2007, he became the first Australian fellow of the International Academy of Orthokeratology (FIAO) and mentor. Dr. Woo has special interest in pediatric optometry, myopia prevention and control contact lens fitting of orthokeratology and specialty contact lenses. He opened an Orthokeratology and Myopic Control Clinic in 2010. Dr. Woo uses and provides a variety methods in myopic management. Dr. Woo has been actively participating in the continuing education conference of the IAOA (International Academy of Orthokeratology Asian Branch) as an instructor and mentor for FIAO of Chinese ophthalmologists as well as in many local and international optometry and ophthalmology conferences and as lecturer and mentor. He served on the board of directors of Oceania Society of Orthokeratology (Australia and New Zealand) from 2014 to 2020. He was the FIAO Section Chairman (Oceania — Australia and New Zealand), senior member examination chair and examiner from 2014 to 2017. Dr. Woo actively participates in many local and international optometry and ophthalmology conferences as a lecturer, mentor and coach, with more than 90 international presentations.

[Email: sydneyorthok@gmail.com]

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