May 20, 2019
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Single vision spectacles for progressing myopes is not best practice

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Options for controlling progressive myopia in children include the use of atropine, orthokeratology, multifocal soft contact lenses, and progressive-addition or bifocal spectacle lenses, but single vision spectacle lenses are not effective for this purpose, according to a white paper from the International Myopia Institute.

“Although the efficacy over more than 5 years of myopia control treatment, plateau and rebound effects has not been established, current evidence still suggests that initiating some form of myopia control treatment is better than single vision correction,” the researchers said in one of the papers recently published in Investigative Ophthalmology & Visual Science.

The clinical management guidelines from the International Myopia Institute outline how clinicians can:

  • identify an appropriate patient for myopia control by evaluating risk factors;
  • discuss myopia control and risks with parents and patients;
  • discuss risks, benefits and expectations of treatments (including informed consent/off-label discussion);
  • perform a baseline exam;
  • select a treatment strategy; and
  • provide clinical care.

The report also details future treatment directions.

Author Kate Gifford, PhD, BAppSc(Optom)Hons, GCOT, FBCLA, FIACLE, FCCLSA, FAAO, told Primary Care Optometry News that a dramatic increase in clinician awareness and product innovations by industry has recently matched findings that predict 50% of the world’s population will be myopic by 2050.

Gifford is a private practitioner, researcher and chair of the International Myopia Institute’s (IMI’s) Clinical Management Guidelines Committee.

For this particular report, “The clear message for eye care providers is that it’s no longer best practice to simply prescribe single vision spectacles for progressing myopes when better options to control myopia are available,” she said in an interview. “Myopia management, at minimum, starts with a discussion on the consequences of myopia, risk factors and treatments – allowing parents and patients to make informed decisions that could influence lifelong eye health outcomes.

“The IMI white papers, and particularly these Clinical Management Guidelines, are designed to support ECPs through this imperative evolution of clinical practice,” she added. – by Nancy Hemphill, ELS, FAAO

Disclosures: Gifford reports financial relationships with Alcon, CooperVision, Essilor, Menicon, Myopia Profile Pty Ltd. and Visioneering Technologies. Please see the full study for other authors’ financial disclosures.