Trends in myopia management attitudes and strategies in clinical practice: Survey of eye care practitioners in Africa

Nti, Augustine N; Owusu-Afriyie, Bismark; Osuagwu, Uchechukwu L.; Kyei, Samuel; Ovenseri-Ogbomo, Godwin; Ogbuehi, Kelechi C.; Ouzzani, Mhamed; Agho, Kingsley; Mashige, Khathutshelo Percy; Ekure, Edgar; Ekpenyong, Bernadine N.; Ocansey, Stephen; Ndep, Antor O.; Obinwanne, Chukwuemeka Junior; Berntsen, David A.; Wolffsohn, James S.; Naidoo, Kovin

doi:10.1016/j.clae.2022.101597

Cited by 15 publications

(20 citation statements)

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“…This was most evident in Africa (35.1%) and South America (31.1%). A recent publication exploring management attitudes and strategies to myopia management specifically in Africa found that a markedly higher percentage of African practitioners use undercorrection compared to this survey, where 52% of those surveyed at least sometimes used undercorrection in practice 28 ; this may be due to their wider coverage of practitioners, which it is hoped can be encompassed in future surveys in this series. Fortunately, the overall percentage of practitioners who undercorrect young myopic patients at least some of the time has consistently declined over recent years (27.3% in 2015, 10 20.4% in 2019, 8 and 16.9% in 2022).…”

Section: Discussionmentioning

confidence: 67%

“…Other research in Africa has found similar reasons for why practitioners may not prescribe myopia control interventions there, where cost to the patient and safety concerns were the two reasons most commonly reported. 28 Treatment availability also appears to be an issue for practitioners in Asia and South America, whereas practitioners in Australasia, Europe, and North America appear to be much less affected. This highlights the vital need for a collaborative effort across the eye care industry and clinical practice to increase accessibility, both financially and geographically.…”

Section: Discussionmentioning

confidence: 99%

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

Wolffsohn

Whayeb

Logan

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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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.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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

Wolffsohn

Whayeb

Logan

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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“…The apparent absence of current myopia control therapies such as orthokeratology, myopia control spectacles and contact lenses in most African countries poses a significant additional challenge in the remediation of the condition on the continent. 109 Ophthalmology services are also not sufficiently established in most areas to deal with even the most routine ocular health complications associated with myopia, such as cataract and glaucoma. 110 A major limitation of our investigation was that only one study 66 accounted for nearly 91% of the overall sample size.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, myopic children have an increased risk of developing severe sight‐threatening ocular disease later in life. The apparent absence of current myopia control therapies such as orthokeratology, myopia control spectacles and contact lenses in most African countries poses a significant additional challenge in the remediation of the condition on the continent 109 . Ophthalmology services are also not sufficiently established in most areas to deal with even the most routine ocular health complications associated with myopia, such as cataract and glaucoma 110 …”

Section: Discussionmentioning

confidence: 99%

Regional variations and temporal trends of childhood myopia prevalence in Africa: A systematic review and meta‐analysis

Kobia‐Acquah

Flitcroft

Akowuah

et al. 2022

Ophthalmic Physiologic Optic

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Purpose To provide contemporary and future estimates of childhood myopia prevalence in Africa. Methods A systematic online literature search was conducted for articles on childhood (≤18 years) myopia (spherical equivalent [SE] ≤ −0.50D; high myopia: SE ≤ −6.00D) in Africa. Population‐ or school‐based cross‐sectional studies published from 1 Jan 2000 to 30 May 2021 were included. Meta‐analysis using Freeman–Tukey double arcsine transformation was performed to estimate the prevalence of childhood myopia and high myopia. Myopia prevalence from subgroup analyses for age groups and settings were used as baseline for generating a prediction model using linear regression. Results Forty‐two studies from 19 (of 54) African countries were included in the meta‐analysis (N = 737,859). Overall prevalence of childhood myopia and high myopia were 4.7% (95% CI: 3.3%–6.5%) and 0.6% (95% CI: 0.2%–1.1%), respectively. Estimated prevalence across the African regions was highest in the North (6.8% [95% CI: 4.0%–10.2%]), followed by Southern (6.3% [95% CI: 3.9%–9.1%]), East (4.7% [95% CI: 3.1%–6.7%]) and West (3.5% [95% CI: 1.9%–6.3%]) Africa. Prevalence from 2011 to 2021 was approximately double that from 2000 to 2010 for all studies combined, and between 1.5 and 2.5 times higher for ages 5–11 and 12–18 years, for boys and girls and for urban and rural settings, separately. Childhood myopia prevalence is projected to increase in urban settings and older children to 11.1% and 10.8% by 2030, 14.4% and 14.1% by 2040 and 17.7% and 17.4% by 2050, respectively; marginally higher than projected in the overall population (16.4% by 2050). Conclusions Childhood myopia prevalence has approximately doubled since 2010, with a further threefold increase predicted by 2050. Given this trajectory and the specific public health challenges in Africa, it is imperative to implement basic myopia prevention programmes, enhance spectacle coverage and ophthalmic services and generate more data to understand the changing myopia epidemiology to mitigate the expanding risk of the African population.

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“…Early research exploring the increase in myopia globally was focused on the impact of near vision on the oculomotor system, 250–252 such as our research on near work–induced transient myopia 253,254 and changes in autonomic stimulation 33,255,256 . However, since the advent of treatments that can reduce the amount of myopia a child will develop (i.e., myopia control rather than management), 257–259 unlike approaches such as undercorrection, 260,261 we have charted a growing concern among practitioners across the globe and uptake of myopia control treatments 262–266 . Advances in biometers, such as the ones we have validated, 267,268 have allowed eye growth to be more sensitively tracked, and longitudinal data on untreated children 269–272 are being used in our app to allow practitioners to share a child's eye growth curve prediction to be shared with their parents along with tracking real-world data on myopic control appliances and approaches (Fig.…”

Section: Myopia Controlmentioning

confidence: 99%

2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management

Wolffsohn

2024

Optom Vis Sci

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Detailed clinical assessment is critical to allow sensitive evaluation of the eye and its management. As technology advances, these assessment techniques can be adapted and refined to improve the detection of pathological changes of ocular tissue and their impact on visual function. Enhancements in optical medical devices including spectacle, contact, and intraocular lenses have allowed for a better understanding of the mechanism and amelioration of presbyopia and myopia control. Advancements in imaging technology have enabled improved quantification of the tear film and ocular surface, informing diagnosis and treatment strategies. Miniaturized electronics, large processing power, and in-built sensors in smartphones and tablets capacitate more portable assessment tools for clinicians, facilitate self-monitoring and treatment compliance, and aid communication with patients. This article gives an overview of how technology has been used in many areas of eye care to improve assessments and treatment and provides a snapshot of some of my studies validating and using technology to inform better evidence-based patient management.

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Trends in myopia management attitudes and strategies in clinical practice: Survey of eye care practitioners in Africa

Cited by 15 publications

References 53 publications

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

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

Regional variations and temporal trends of childhood myopia prevalence in Africa: A systematic review and meta‐analysis

2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management

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