A survey conducted by the International Myopia Institute explored global trends in attitudes and strategies for myopia management in clinical practice.
The research was conducted between March and November 2022 and updated information gathered from surveys in 2015 and 2019.
There were 74 respondents in Africa, 1,396 in Asia, 101 in Australasia, 931 in Europe, 338 in North America, 177 in South America , and 178 who did not specify their location.
Most respondents were optometrists (68%), 23% were ophthalmologists and 6% were contact lens opticians, while 79% of respondents worked in clinical practice.
Questions examined awareness of increasing myopia prevalence, perceived efficacy of treatment options, adoption of available strategies and reasons for not adopting specific strategies.
Previous surveys identified high levels of concern about myopia among eye care professionals, but also found the majority still prescribed single vision interventions to young myopes.
However, James Wolffsohn (pictured), lead author and professor of optometry at Aston University, told Optician the latest study highlighted a decline in the use of single vision spectacles.
‘Practitioners are beginning to take a more evidence-based approach to managing young, progressive myopes, fitting them with products with proven efficacy to slow myopia progression, which single vision spectacles do not.
‘The popularity of myopia control spectacle designs is rising rapidly and was the most popular option globally to manage a young, progressing myope, closely followed by myopia control soft contact lenses. However, in Asia, orthokeratology is still the more popular contact lens option.
‘The UK largely follows the pattern in the rest of the world, with more practitioners taking an evidence-based approach, although the prescribing of single vision spectacles and contact lenses to young progressing myopes is still too high.’
Global uptake
Of the 3,195 global respondents to the latest survey, practitioners in Asia were significantly more concerned about the increasing frequency of childhood myopia than other continents. In Asia, Turkey showed the lowest level of concern, followed by Israel and Vietnam, while China and India had higher levels of concern.
In Europe, Norway showed the lowest level of concern while Russia, Spain and Italy were highest. In North America, rates of concern were similar in Canada, US and Mexico, and there were no significant differences in South America.
The report identified an uptake in the number of eye care professionals globally who were practicing myopia control but noted there were significant differences within and between continents. The uptake was slow but steady, but less in African and South America compared to other continents.
Practitioners said embracing myopia management enhanced patient loyalty, increased practice revenue and improved job satisfaction.
Authors noted that with growing evidence of the negative impact of even low levels of myopia on health economics, practitioner concern and perceived activity was increasing.
This resulted in the uptake of appropriate, proven, myopia control techniques at lower levels of myopia. However, the report noted there was scope for this to be accelerated.
Additionally, authors said evidence-based education of practitioners had improved, but further advocacy from policy makers, health regulatory bodies and industry was needed to enhance accessibility and affordability of treatment options to address the growing health burden of the myopia epidemic.
Product efficacy
Globally, a combination of therapies was perceived to be the most effective method of myopia management followed by orthokeratology and pharmaceutical approaches.
Practitioners perceived single vision distance under-correction as the least effective method, followed by spectacles and contact lenses, as well as bifocal spectacles.
Single-vision spectacles were still the most prescribed option for patients with progressing myopia, but this has decreased since 2019.
It was highest in Africa then South America and lowest in Australasia, while Asia, Europe and North America all rated similarly.
Additionally, myopia control spectacles, myopia control contact lenses and combination therapy were growing in popularity.
The perceived effectiveness of under-correction was highest in Africa and lowest in Australasia, followed by Europe and North America. A similar pattern was identified in the report for single vision and bifocal lens spectacles, single vision contact lenses and rigid contact lenses.
Myopia control spectacles were deemed as most effective in Africa, followed by Australasia and Europe. Practitioners in Asia and South America perceived this option as less effective.
Orthokeratology was deemed most effective in Asia and least effective in North and South America. Pharmaceuticals were considered more effective in Asia, Europe, and Australasia than in North and South America. Time spent outdoors was rated as less effective in Australasia and North America, and most so in Asia followed by Africa and South America.
Australasia, then Europe, prescribed the most myopia control contact lenses and all other continents prescribed considerably fewer. Orthokeratology was prescribed most in Asia, followed by Europe, Australasia and North America, while South America and Africa prescribed significantly fewer.
Pharmaceuticals were prescribed significantly more in Australasia and South America, and prescribed the least in Africa and Europe.
