Standards Set for Myopia Care

Released by The Australia and New Zealand Child Myopia Working Group, the report follows the inaugural 2018 Child Myopia Report and highlights the shift in trends, awareness and understanding of myopia since 2018. Additionally, it presents the Working Group’s recommended standard of care for myopia management, to slow its progression, which is an important step in reducing its prevalence and impact.

We call on the profession to adopt the recommended standard of care to ensure myopia management is universally practised and available to every child

The report:

• Presents the recommended best practice standard of care for myopia management, outlining what needs to be done to continue to manage and reduce its impact both locally, in Australia, New Zealand, and globally.
• Provides the evidence as to why it is time to change how myopia is managed with intervention starting as soon as possible.
• Implores parents and carers to get their children’s eyes tested and, if diagnosed, talk about its management. A coordinated approach to public health initiatives to motivate parents or carers is key.

Dr Loren Rose, paediatric ophthalmologist and founding member of the Child Myopia Working Group said, “There is an urgent need for a greater focus on managing myopia and increasing awareness of the importance of children having regular eye examinations. By doing so, this will enable every child diagnosed with myopia to be managed with the recommended standard of care. A myopia management standard of care is critical, given that each year of delay in developing myopia substantially reduces the chance of a child developing high myopia in adulthood.”¹

New Zealand optometrist and fellow founding member Jagrut Lallu added, “For Australia and New Zealand, the forecast rate of myopia by 2050 is estimated to be 55% and we currently have an estimated 36% of the population affected.² Furthermore, Australia is expected to have 4.1 million high myopes and New Zealand over 600,000 high myopes by 2050, unless myopia management is implemented by everyone. These forecasts highlight the scale of the problem that is facing the profession given Australia in 2020 had an estimated 1.1 million, and New Zealand over 200,000, high myopes.”³ 

RECOMMENDED STANDARD OF CARE

For the practice setting, it is recommended that the following key elements should be included when managing a patient’s myopia:

1. Use a myopia management program for patients with pre myopia or myopia based on the best available evidence.
2. Explain to patients and their parents or carers what myopia is and discuss the increased risks to long term ocular health associated with myopia.
3. Discuss, formulate, and implement an agreed management plan with the parent or carer and patient (child), including discussion of the evidence-based available myopia management options to mitigate axial length elongation; risks (lifestyle and family history) of myopia progression; provision of verbal and written information describing the risks and benefits of treatment, duration of treatment, review frequency, when to cease treatment and rebound effects.
4. Document a review/recall for patients with myopia that demonstrates progression.
5. Monitor the impact of treatment.
6. Recognise personal limitations and refer patients to a suitable optometrist or ophthalmologist if the required myopia management services cannot be provided.

Joe Tanner, Professional Services Manager at CooperVision ANZ, has called on the industry for full support of the recommended standard of care. “The Child Myopia Working Group is an important initiative whose aim was to deliver a standard of care for child myopia management. It is time to change how myopia is managed with intervention starting as soon as possible. We call on the profession to adopt the recommended standard of care to ensure myopia management is universally practised and available to every child.”

The Child Myopia Working Group is a collaboration of leading optometrists and ophthalmologists from Australia and New Zealand. The Group was established in 2018 to deliver a recommended standard of care for the management of myopia in children with the aim of slowing its progression. Enabled by CooperVision ANZ, members are (in alphabetical order): Dr Rasha Altaie, Ophthalmologist, Vice President of the Cornea and Contact Lens Society of New Zealand, Auckland, New Zealand; Luke Arundel, Optometrist, Chief Clinical Officer, Optometry Australia, Melbourne, Australia; Jagrut Lallu, Optometrist, Past President of the Cornea and Contact Lens Society of New Zealand, Hamilton, New Zealand; Margaret Lam, Optometrist, National President, Optometry Australia; Dr Loren Rose, Paediatric Ophthalmologist, Senior Clinical Lecturer Macquarie University, Sydney and Canberra, Australia; Andrew Sangster, Optometrist, Board Member of The Orthokeratology Society of Oceania, Wellington, New Zealand; and Chair– Scientia Professor Fiona Stapleton, Head, Eye Research Group, School of Optometry and Vision Science UNSW, Sydney, Australia.

To download a free copy of the report, visit www.childmyopia.com.