By 2050, it is estimated that myopia will likely affect 4.8 billion people worldwide, which will equal half of the world’s population. And in some regions like Asia, up to 90% of children will be diagnosed as myopic.
A significant portion of this group will go on to develop high myopia, which can potentially lead to myopia-related ocular complications, such as myopic maculopathy and retinal detachment, all of which, if left untreated, can lead to irreversible vision impairment.
How do we challenge this status quo?
The medical field abounds with conditions that can have serious consequences, and yet, most patients continue to believe that somehow they just won’t be affected. Take dentistry, for example, how often must dentists extol the importance of flossing to patients? How often do these patients just nod and smile, and promise to brush more regularly and lay off the sugar?
When their check-up is finished they get up to leave, then they happily go back to their sugary ways. And in a year or two, they come back complaining of a toothache.
In optometry, a number of issues like this pose challenges to clinicians to an even greater degree as, unlike the example outlined above, people are less aware of the challenges posed by ocular conditions. Everyone knows that sugar rots your teeth after all, and yet we still love sweets; and people tend to visit their optometrist far less often than they do their dentist.
While there are often lifestyle changes one can make to avoid contracting an ocular condition or disease, sometimes that’s either not possible, or by the time symptoms present themselves it’s too late.
Myopia is one such condition, and much like tooth decay and obesity caused by overindulgence in sugary snacks, it’s not hyperbolic to say that this disease has reached the level of a pandemic.
Optometrists on the frontline
Optometrists are and will always be on the frontline of treating myopia — so what lessons can be learned now to better prepare their clinics for the future, and help to address the crisis we already face?
We spoke with Dr. Kevin Chan, the senior clinical director at Treehouse Eyes – Myopia Care For Kids, an eye care clinical network with facilities located across 19 different states in the US. He firmly believes that optometrists are the gatekeepers to combatting the epidemic of myopia progression and has spoken about his work in fighting the disease during TedX talks, and as a professional affairs consultant for Johnson & Johnson Vision.
“I am seeing a growing number of children and adolescents with myopia experiencing difficulties in school where they are unable to excel at their best academic potential solely because of poor vision,” shared Dr. Chan. “Socially, they are also more likely to feel withdrawn and isolated secondary to peer pressure. Some children told me that they are generally more reluctant to participate in sports activities simply because they cannot see, or they don’t want to be seen with glasses,” he continued.
Dr. Chan recommends that optometrists intervene as early as possible as the younger the patient is, the more likely they are to experience vision-related challenges and impediments in life, such as, driving, working, occupational activities, etc.
Historically, the fact that myopia was perceived or understood as merely a benign refractive error resulted in many of these younger patients falling through the cracks. Dr. Chan described how when he was a student, he was taught that conventional glasses and contact lenses were the ‘easy fixes’ for myopia. But that approach is now too narrow.
“The monolithic background and understanding of myopia have overshadowed the clinical significance and benefits of providing myopia treatment for children. While the conventional belief of myopia has been ingrained in the eye care community and the public, I think that recent research endeavors and public health advocacy has gradually driven the initiatives of myopia management. It’s good to see that the subject of myopia has gradually resurfaced,” Dr. Chan said.
Every little step is progress
So what tips can Dr. Chan provide based on his own experience? Education, education, and education — for patients and clinicians alike — is at the top of his list. Attending events and conferences to learn from the best and adopt the latest techniques are important, as is being realistic in your aims.
“Start small,” he advised. “Optometrists often presume that myopia management warrants drastic renovation of the office, advanced equipment, or taking on new hires. While these are all important, start with meaningful conversations (not the passive approach, or ‘you may want to consider it if you like’) regarding myopia with your existing patients and their families,” Dr. Chan continued.
“I find peer-to-peer education via conferences and lunch-and-learn events to be tremendously beneficial and impactful. Changing old habits toward myopia is certainly no easy task. It requires conscious and dedicated efforts towards re-building and re-branding,” he said.
“The purpose of ‘re-building’ is to provide optometrists and the public an opportunity to challenge the status quo of myopia. ‘Re-branding’ is to help the community acknowledge and affirm the lifelong impacts that myopia management can bring for children and the coming generations,” he added.
A curious village for healthy eyes
In short, Dr. Chan believes in encouraging optometrists toward revolution, an uprising of thoughtful consciousness that dispels the old myths of myopia treatment to provide better, newer treatments and education for patients. He wants clinicians to concentrate on providing a modality-based approach, one that combines a number of factors to change the mindset of eye care professionals and patients alike. Combined with the tools most optometrists have at their disposal, like orthokeratology, soft multifocal contact lenses, low-dose atropine, and myopia control spectacles, results should be sure to follow.
“The success of myopia management is largely predicated on the treatment optometrists advocate for patients and their families. The more you talk about myopia and plant the seeds early for public awareness, the more likely the family would recognize its benefits and make it a priority that they would be more eager to begin the journey of myopia management for their children,” Dr. Chan said.
“Conversation ignites curiosity. Curiosity propels action and it takes a whole village to make lasting impacts for myopia!” he concluded.
