I both love and hate this question. First, it gives me the floor to preach from my soapbox about the importance of myopia control — slowing down the worsening of childhood myopia — and the amazing options we presently have available. On the other hand, it casts a shadow on the real problem which is not enough providers offering what should be considered the standard of care. As myopia continues to sweep across the globe like a freight train off the rails, many eye doctors continue to prescribe spectacles in increasing strength to their patients every year. After all, we’ve been doing it that way since the 17th century. Every eye doctor on the planet gets concerned about eye health when they see highly myopic patients, yet we as a profession are reluctant to “blame” myopia for secondary eye diseases. Well that is all changing now. Experts across the globe have concluded with good evidence that myopia leads to further sight-threatening conditions. No patient or parent in this current world should ever have to utter the words “Why have I never heard of this before?” when learning about myopia control options.
Many eye doctors state their opinion that myopia control does not work. They represent the ones who have not tried it or worse, tried it without proper training and education. Myopia control does work. I see it each and every day in my practice and I try to teach other doctors about the power of myopia control.
In my typical day, when a myopic kids comes in, they and their parents learn about the ways we try to slow down their progressing myopia. We talk about OrthoK, overnight reshaping contact lenses that not only provide clear vision during the day, but very effectively protect the eyes from rapidly getting worse. We also talk about soft daily worn bifocal contact lenses that have shown excellent impact on myopia progression according to recent studies. The next category I tell them about is Atropine. Atropine is an eye drop that is used to dilate pupils and has proven to be effective in controlling myopia. I then explain that studies have shown that in a diluted strength, Atropine has shown to be effective at controlling myopia without being strong enough to have significant side effects of dilating the pupil and affecting close up focus. It is important to note that contact lenses or glasses are still required to correct blurry vision when using Atropine eye drops, and it it not as readily available across the world as contact lens or spectacle options. Then we talk about bifocal spectacles as an option especially for those that can’t wear contact lenses, though they are less effective for slowing progression. The next thing we talk about is decreasing total ‘screen time’ and getting the kids outside more often. This entire conversation will take about 5 minutes. We then will schedule another visit to begin whichever process the family choose. Sometimes, the choice gets deferred for weeks or months as they do their own research, but I have given them the gift of information and as we all know, information is power.
What our profession needs are parents and patients like you. Educated people who will ask specifically at their next eye exam, what can I do about worsening eyesight. If the answer is nothing, find a myopia control specialist. Eye doctors worldwide are starting to realize the impact myopia has globally, but it will take much time to create a new standard of care. I run a USA-based organization that teaches myopia control to doctors and we have sections all over the world doing the same important work. The future is now and statements like “Why have I never heard of this before?” will hopefully become memories of the past.