Engaging pediatricians, parents is critical for early myopia management
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Our understanding of myopia has advanced in recent years, with more information available and a knowledge base that’s rapidly expanding. A barrier to applying these learnings is awareness.
Children need to receive eye exams sooner, as the prevalence of myopia continues to rise. Myopia and high myopia affected 22.9% and 2.7% of the global population in 2000, respectively — those numbers are expected to reach 49.8% and 9.8% in 2050 (Holden BA, et al).
Parents need to know about the importance of eye exams for their children. Pediatricians may need a greater understanding of the increase in myopia rates, the risks for sight-threatening complications and the latest solutions to help manage the disease. When working with pediatricians and parents, it’s imperative to stress early detection and preventive measures, like increasing outdoor time and limiting near work.
Aligning pediatricians, optometrists
Pediatricians usually perform children’s first eye screenings and are positioned to refer them to an optometrist. To make this process seamless, professional organizations and industry are working together to develop educational resources to help pediatricians identify myopia early.
We’re achieving this by building relationships with pediatricians and optometrists through local educational and networking programs to share knowledge and generate more awareness of myopia — and stress the importance of optometrists in the patient’s care journey.
Here are some important statistics that optometrists can share with pediatricians:
- Myopia can progress as the eyes rapidly change during childhood. If we wait too long to intervene, it can be too late. The American Optometric Association recommends an eye exam for asymptomatic and low-risk children between the ages of 6 and 12 months, once between the ages of 3 and 5 years, before the first grade and annually thereafter.
- Children with any level of myopia face significant risks in the future, including the potential to live with visual impairment for decades. A large retrospective analysis showed that individuals with as little as 0.5 D to 3 D of myopia face 13 times increased risk for myopic macular degeneration (MMD) and three times increased risk for retinal detachment, compared with an emmetrope (Haarman AEG, et al).
- An individual with 3 D to 6 D of myopia faces a 73-fold risk for MMD, and retinal detachment is nearly nine times more common. Above 6 D, the risks for MMD, retinal detachment and visual impairment are 846 times higher, 12.6 times higher and 5.5 times higher, respectively (Haarman AEG, et al).
- Every diopter matters in terms of both vision and quality of life. If a child progresses to high myopia, the condition could make them dependent on eyeglasses and contact lenses for all tasks, with limited options for refractive surgery.
- Complications of high myopia, including structural damage to the retina, cataracts, glaucoma and macular degeneration, can permanently diminish vision and even cause blindness (Wong TY, et al).
- In addition to referring children early, pediatricians can encourage preventive behaviors like outdoor play (the risk for myopia decreases 2% with every additional hour of outdoor time per week; Wu PC, et al) and limited screen time (> 3 hours per day is associated with higher risk; Harrington SC, et al).
Tips for speaking with parents
While myopia is commonly known as nearsightedness, it can be hard to truly understand the long-term impact that myopia can have on sight and quality of life. In addition, the tools that are available now to manage myopia didn’t exist when today’s parents were children. As a result, many parents may not be aware of treatment options beyond spectacles.
Here are some tips on speaking with parents:
- Explain myopia progression sensitively. It’s difficult to hear that your child could develop high myopia, which can lead to sight-threatening impairments. It’s important to be clear, accurate and hopeful. Educational videos can help parents and children understand myopia.
- Provide an overview of treatment choices. Present parents with the options available to manage their child’s myopia that may work best for their lifestyle and needs.
- Empower parents. Recommend parents learn more about myopia and what they can do to help. Most importantly, they can ensure their child receives an annual, comprehensive eye exam.
- Individualize it. To connect with parents, address their specific values and needs. They might emphasize academics, their child’s love of sports or concerns about long-term risks, and those are all motivators for managing myopia.
With myopia’s prevalence climbing, millions of children are depending on us to succeed in working together to generate awareness so we can better identify and manage this condition. By raising awareness among pediatricians and parents, we’re empowering children to see their future.
References:
- Comprehensive eye exams. https://www.aoa.org/healthy-eyes/caring-for-your-eyes/eye-exams?sso=y. Accessed Feb. 10, 2023.
- Haarman AEG, et al. Invest Ophthalmol Vis Sci. 2020;doi:10.1167/iovs.61.4.49.
- Harrington SC, et al. Br J Ophthalmol. 2019;doi:10.1136/bjophthalmol-2018-313325.
- Holden BA, et al. Ophthalmology. 2016;doi:10.1016/j.ophtha.2016.01.006.
- Wong TY, et al. Am J Ophthalmol. 2014;doi:10.1016/j.ajo.2013.08.010.
- Wu PC, et al. Asia Pac J Ophthalmol (Phila). 2016;doi:10.1097/APO.0000000000000236.
For more information:
Chandra Mickles, OD, MS, FAAO, FSLS, is the North America professional education lead in myopia at Johnson & Johnson Vision in Jacksonville, Florida.