In the past decade, there has been a great deal of research published discussing the many issues surrounding myopia development, detection and treatment. However, most of the information isn’t easily accessible to the practising clinician – and even if it is, often the results conveyed are not presented in a format that the clinician can apply to clinical practice. With this in mind, the World Council of Optometry and CooperVision have formed a partnership that aims to provide information in a context that can be integrated into everyday practise, by every practitioner, in every country of the world.
Earlier this year (2021) the World Council of Optometry (WCO) and CooperVision announced a collaboration to address how optometry manages myopia in response to the release of substantial new evidence relating to prevention, diagnosis and treatment of this disease. As part of the collaboration, representatives from both organisations came together to address the call to action. The group of experts included optometrists from both WCO and CooperVision, as well as digital learning experts.
The evidence of these studies has proven that optometry needs to change its mindset regarding myopia – from simply correcting refractive error to addressing myopia as a disease entity
Why the need?
It is well-known that myopia is one of the most common vision and eye health disorders worldwide, and the leading cause of correctable visual impairment in children. A study released in 2016 demonstrated that the prevalence of myopia was increasing at an alarming rate. With an increase in the magnitude of myopia, studies also found an increase in associated eye health problems that can lead to further visual impairment; specifically cataracts, retinal detachment, myopic maculopathy, glaucoma, and optic neuropathy. The myopia epidemic is leading to an increasing burden on a patient’s quality of life and will lead to a rise in healthcare expenditures for both individuals and healthcare systems.
The profession of optometry has historically addressed uncorrected refractive errors, and specifically myopia, by using optical corrections including spectacles or contact lenses. However, significant evidence has emerged, gained from well-designed research, that has contributed to a better understanding of the progression of the disease, its risk factors, subsequent consequences, and possible interventions to successfully slow its progression. The evidence of these studies has proven that optometry needs to change its mindset regarding myopia – from simply correcting refractive error to addressing myopia as a disease entity.
Active management of myopia is critical to minimising the risk of irreversible visual impairment from myopia-related ocular pathologies. Even more important is for optometrists to identify who is at the greatest risk of becoming myopic, and to implement strategies to help mitigate these risks.
To ensure optometrists around the world have access to the tools they need to address myopia, WCO committed to collaborating with CooperVision to develop different resources. A number of these resources now reside in a section on the WCO website. Keeping in mind the global focus of this partnership, all the downloadable resources are available in multiple languages: English, Spanish, Chinese (simplified), Chinese (traditional), French, Russian, and Arabic.
DEFINING THE STANDARD
The first step of this partnership was to develop an accepted standard of care that was entirely based on current science. This resulted in the creation of the first ever World Council of Optometry Resolution for the Standard of Care for Myopia Management by Optometrists (myopia. worldcouncilofoptometry.info/standardof- care). The resolution was written collaboratively and approved by the entire WCO Board of Directors, who represent all six regions of the world.
The myopia resolution highlighted the need to shift the approach of optometry to address myopia as more than a simple refractive error. Additionally, it defined the evidence-based standard of myopia care as focusing on three main components: mitigation, measurement, and management.
The next step was to develop resources that would support optometry’s response to myopia. Our approach was different from many myopia management resources available, in that the focus was to change behaviour rather than just inform the eye care practitioner.
To do this, the objective was to distil complex information into easy-to-read, action-oriented tools. As a result, the tools developed are globally applicable with resources reflecting the fact that not all interventions are available to all, thus guiding the eye care practitioner to come to a myopia management plan that works for their practice.
This led to the development of Myopia Moments – six single-page documents to assist clinicians in understanding the risk factors for myopia, what they can do to help delay the development of myopia, and when to intervene. Additionally, Myopia Moments present and explain various options for intervention and make appropriate recommendations for patients. More clinical interventions are in development and the goal is to maintain tools that represent current research outcomes.
The hope is that any eye care practitioner, regardless of their skillset, available equipment, and patient profile, is able to gain something of value from this initiative, and adapt myopia management as a standard of care.
Our team is currently working on a new series of Myopia Moments, touching on a number of hot topics in the myopia management space, such as how to identify pre-myopic children and appropriate care for the many untreated myopes we see in our clinics now, and those who will continue to visit in the coming years. We are also looking at a number of engaging patient and parent tools that the eye care practitioner can use to introduce myopia as a condition, communicate strategies to delay onset, and introduce treatments.
A FAR REACHING PLAN
Our hope is that this work results in optometrists, and other eye care professionals, becoming aware of the importance of myopia management and shifting how they approach myopia in their practice, with the goal of working together to slow this epidemic. The days of just correcting the refractive error are in the past. Both WCO and CooperVision plan to continue to collaborate and work together in this area far into the future, as more evidence emerges and treatment regimens evolve.
Dr Sandra S. Block, M.Ed., MPH, FAAO, FCOVD, is Professor Emeritus, Illinois College of Optometry; President-Elect, World Council of Optometry; and Global Clinical Advisor for the Special Olympics Opening Eyes program.
Dr Susan Cooper FAAO, is the World Council of Optometry Managing Director, WCO Past President, and Chair of Optometry Giving Sight in Canada.