My son started using a myopia control device just before his 14th birthday three years ago, when he was at -4.00D. He was dropping about 1.00D per year. His myopia has now been stable for three years. As a direct result of this, he has a 40% less chance of eye disease in later life.
However, had he started management at first diagnosis of myopia progression, when he was nine, he would likely be stabilised around -2.00D, with even less chance of eye disease in later life.
If you want a reason to engage in myopia management, simply ask parents like me who have done it and have seen the results. Chat to older myopes who have suffered retinal detachments and ask them what message they have for parents considering this for their children.
The reason my son did not start myopia management earlier was because our eye care professional (ECP), during multiple visits over five years, did not tell us he had myopia. They repeatedly told us he had short sight, which was something we thought to be common and harmless. You can understand why we feel let down. A failure to communicate myopia at first diagnosis has increased his chances of eye disease by 40% and robbed him of -2.00D.
Along with the emerging tsunami of myopia in the UK will come growing awareness among parents that myopia is a condition linked to eye disease, as it is commonly understood that high blood pressure is linked to heart disease. This is the case in countries like Taiwan where myopia is a well-known term. In the future, a dim view will be taken of any ECP not educating parents on the condition and the control options, as would be the case now for a GP not linking high blood pressure to heart disease when diagnosing.
A rising tide
Parent education is a powerful tool. It is a rising tide that will lift all the boats. A tide strengthened by the marketing messages of the giants of Hoya and CooperVision as well as locally on social media by proactive ECPs who will take business off those not offering a full range of treatment options. Not only have we switched ECPs, but when friends and family heard our story and saw the results for themselves, we have been happily sending our new practice further business.
#MyopiaChat – one million parent conversations in 2022 is the change parents like me wish to see. It is the discussion I wanted and felt I had the right to know about. What if the optical industry educated one million parents in 2022? One million conversations in terms that parents understand. The power of change is in the test rooms, Facebook and on Mumsnet.
The reality is that it will likely take a successful legal case against an ECP for failing to use the term myopia, not linking it to eye disease and failing to outline the three control options of glasses, day lenses and night lenses to ensure 100% industry compliance. Many believe that any ECP using the term ‘short sight’ and not educating parents about myopia right now, in 2021, would struggle in any future lawsuit brought against them. I agree. If you are still casually using the term ‘short sight’ and not having the myopia conversation then be warned. #MyopiaChat is crucial for ECPs legally as well as to engage patients and parents.
The academic arguments may be at consensus, the manufacturers have the right range of products in place and the ECPs may be engaging, but if the parents do not understand the basics about myopia enough to both make an informed choice, it all counts for nothing.
As a sector, we need to address that most parents in the UK do not understand myopia in a way that enables them to engage with a discussion about it. We need to change the narrative from ECP speak to parent speak. In five years’ time we need to look back and know that we did the right thing for our children and not be in the same position wondering why we have not progressed.
Over the past nine months we have been working in collaboration with parents, ECPs and other manufacturers to figure out how to communicate the myopia message in a way that parents actually understand. We have identified there are a crucial 60 seconds at the start where the parent either understands or does not.
We recommend using the sentence: ‘I’d like to flag up that your child has progressive myopia.’ The terms ‘flag up’ and ‘myopia’ are medical enough to get parent attention without scaring them. Introduce the ‘first diagnosis’ chart available at myopiacontrolawareness.org, which was designed by parents in collaboration with ECPs for parents, to explain the basics.
ECPs should outline the three device options for myopia management: spectacles, day lenses and night lenses. Finally, discuss more time outdoors. Try to identify parents whose children use excessive screen time and emphasise the long-term health implications.
‘Retinal detachment’ is the term that seems to get parents to understand the concept of their child’s myopia being a condition linked to long term eye disease. The concept that myopia might lead to a detached retina one day is a penny dropping moment.
It is not about the big academic statements, the slick marketing campaigns and gestures. It is about 60 crucial seconds in test rooms repeated millions of times over the next five years by ECPs, working together in collaboration with manufacturers and anyone keen to be involved.
Join us and get one million myopia conversations in test rooms, with parents, by the end of 2022. Make 2022 the year we fundamentally change the UK’s mindset about myopia. •