IMI—Global Trends in Myopia Management Attitudes and Strategies in Clinical Practice—2022 Update

Abstract

Purpose Surveys in 2015 and 2019 identified a high level of eye care practitioner concern/activity about myopia, but the majority still prescribed single vision interventions to young myopes. This research aimed to provide updated information. Methods A self-administered, internet-based questionnaire was distributed in 13 languages, through professional bodies to eye care practitioners globally. The questions examined awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies. Results Of the 3195 respondents, practitioners’ concern about the increasing frequency of pediatric myopia in their practices differed between continents ( P < 0.001), being significantly higher in Asia (9.0 ± 1.5 of 10) than other continents (range 7.7–8.2; P ≤ 0.001). Overall, combination therapy was perceived by practitioners to be the most effective method of myopia control, followed by orthokeratology and pharmaceutical approaches. The least effective perceived methods were single vision distance undercorrection, spectacles and contact lenses, as well as bifocal spectacles. Practitioners rated their activity in myopia control between (6.6 ± 2.9 in South America to 7.9 ± 1.2/2.2 in Australasia and Asia). Single-vision spectacles are still the most prescribed option for progressing young myopia (32.2%), but this has decreased since 2019, and myopia control spectacles (15.2%), myopia control contact lenses (8.7%) and combination therapy (4.0%) are growing in popularity. Conclusions More practitioners across the globe are practicing myopia control, but there are still significant differences between and within continents. Practitioners reported that embracing myopia control enhanced patient loyalty, increasing practice revenue and improving job satisfaction.

Myopia Control: Are We Ready for an Evidence Based Approach?

“…Despite its extensive use in numerous clinical trials (Supplementary Table 3 ), no systemic adverse effects have been reported [ 19 ]. However, both the effect and safety of atropine remain controversial, which likely has led to differing opinions on its use [ 66 , 121 , 126 ]. In regions where atropine is relatively widely used to control myopia progression in children, studies are being conducted to investigate its use for preventing myopia onset in premyopic children and have shown positive results [ 109 , 120 ].…”

“…Additional studies in diverse populations including clinical trials and real-world settings are necessary to confirm and validate the effectiveness of these newer optical interventions. Overall, these spectacles are gaining more and more popularity [ 66 ], because they seem safe, they do not create visual distortion, and above all their appearance is similar to SVL spectacles. Compared to SVL spectacles, however, these myopia control spectacles are significantly more expensive and not accessible to everyone.…”

“…Various questions regarding starting dose, tapering and long-term effects are still open. Myopia control spectacles, e.g., DIMS and HAL, have gained popularity owing to their safety, and they are considered effective if children are compliant [ 66 ]. The evidence, however, is still very limited and validation of the effectiveness of novel myopia control spectacles regarding their long-term effectiveness and rebound in the real world is necessary [ 19 , 58 , 66 , 201 , 209 ].…”

“…Myopia control spectacles, e.g., DIMS and HAL, have gained popularity owing to their safety, and they are considered effective if children are compliant [ 66 ]. The evidence, however, is still very limited and validation of the effectiveness of novel myopia control spectacles regarding their long-term effectiveness and rebound in the real world is necessary [ 19 , 58 , 66 , 201 , 209 ]. Myopia control multifocal SCL are also gaining popularity for active school-going children, and daily disposable modalities carry a tenfold lower risk for microbial keratitis compared to overnight OK lenses [ 242 – 245 ].…”

“…Hence, it should only be utilized in distinct cases of higher myopia and older age [ 201 ]. In particular, the combination of atropine eye drops and myopia control spectacles, such as DIMS, is increasingly applied, though research and quantification of this treatment combination is lacking [ 66 ].…”