Myopia, a growing concern globally, presents many challenges in Australia and New Zealand due to its increasing prevalence and potential impact on eye health.
Specsavers ANZ Optometry Director Dr Ben Ashby delves into the myopia landscape, sharing data and trends seen throughout Specsavers network, and highlights the measures being taken to provide exceptional care to patients affected by myopia.
In the past decade, optometrists have seen a significant rise in the presentation of myopia in patients across the globe, and Australia and New Zealand have been no exception.
Defined by the International Myopia Institute as a spherical equivalent refraction of equal to or less than -0.50D in one or both eyes, with high myopia being equal to or less than -6.00D,1 the implications of myopia extend beyond visual acuity, as it increases the risk of various eye conditions.
By examining prevailing trends in patient data, considering potential risk factors within high myopia demographics, and understanding the impact of treatment, Specsavers has gained a deeper understanding of myopia in the Australasian context and developed a strategy for improving detection and treatment rates.
Figure 1. Average age of first myopic diagnosis of Specsavers ANZ patients aged ≤18 between 2017–2022
THE DATA
Earlier in the year, Specsavers undertook a retrospective review of 2,660,163 Australian and 507,292 NZ deidentified patient records from its practices across Australia and New Zealand. The patients were all aged 18 and under when they presented for an eye test between 2017 and 2022.
With an intention to observe the changing rates of myopia incidence in the five-year period, we were interested to find that the rates of myopia incidence increased from 24.6% to 28.8% of the cohort in Australia, whereas the New Zealand cohort declined slightly from 32.6% in 2017 and 29.8% in 2022.
The average age of first myopic diagnosis reduced across both nations in the period. The average age of first diagnosis in Australia decreased from 14.6 years in 2017 to 13.3 years in 2022 and New Zealand similarly decreased from 14.2 to 13.4 years.
In 2022, the prevalence of high myopia was 3.5% of those diagnosed with myopia in Australia and 4.2% in New Zealand.
While the data is helpful in understanding the myopic trends being diagnosed across our nations over the past five years, the impact of COVID-19 must also be noted. Some suggest the extended lockdowns and increased indoor time may have led to an increased prevalence of myopia in children.2 This may have potentially impacted the trends captured from the year 2020 onwards.
THE STRATEGY
To improve vision and eventual eye health outcomes for children with myopia, Specsavers undertakes a holistic strategy, which includes early intervention, tailored management choices for patients, patient and optometrist education, and ongoing analysis of trends in patient care.
Specsavers optometrists prescribe spectacles and contact lenses for myopia management, and our focus has been to support them in this. Both optometrists and retail team members from every practice have completed combined myopia management training and accreditation, ensuring the best care is available through a child’s whole myopia management journey – from initial sight test, through treatment options and prescription, dispensing and ongoing support and monitoring. To ensure holistic support and service to patients, including parents and children, Specsavers also developed a separate training module for other dispensing and retail team members, focussing on patient communication and explaining the importance of myopia management. This ensures appropriate knowledge and enables all team members to support myopia management in practices.
Therapeutically-endorsed Specsavers optometrists also prescribe low-dose atropine eye drops to manage children with myopia. Currently, approximately 80% of Specsavers optometrists are therapeutically endorsed, and this number is growing each year.
With early intervention in mind, Specsavers has also developed a screening program where participating practices can book Children’s Vision Screening Kits and organise screening days at their local schools and community centres. Approximately 25% of children have an undiagnosed vision problem that may affect their learning or participation in school, and these screenings are designed to pick up the major causes of this, such as refractive error, ocular alignment issues, and colour vision or stereopsis concerns.
THE IMPACT
Specsavers Port Lincoln in South Australia recently held a Children’s Vision Screening event at a local school that uncovered several children who had undiagnosed vision problems which are now being managed.
Optometrist and practice co-owner, Selina Nguyen said the event was a huge reminder to the team of the importance of early intervention.
“Realising that something is wrong with a child’s vision can often rely on parents and teachers to watch out for warning signs, which is increasingly difficult in today’s age. The reality is that no level of myopia is safe and as optometrists, we need to do all we can to protect the vision of our next generation. On top of that, if kids are coming to us with myopia, we really want to stop it from getting any higher,” said Ms Nguyen.
“When managing children and parents, we do all we can to make the experience very warm and open, so they feel a part of the family and they aren’t afraid of the testing environment or to ask us about anything. That personal touch not only shows that we care but also unlocks a level of vulnerability and trust, which is crucial in providing initial and continued management for myopia,” she added.
NEXT STEPS
As myopia continues to pose challenges to eye health in Australia and New Zealand, proactive optometry practices play a pivotal role in mitigating its impact. Optometry can achieve tailored myopia management strategies for patients and Specsavers will continue to train, test, diagnose, and manage myopia, while monitoring trends in patient care to uncover opportunities for further enhancement. We encourage the broader optometry community to continue to embrace similar patient-centric models of care, and we are committed to sharing major learnings and insights with the sector as we change lives through better sight.
Dr Ben Ashby is the Director of Optometry Australia and New Zealand at Specsavers. He has responsibility for clinical performance, optometry professional development, professional services, and the development of clinical systems. He is actively involved in the research, development, and implementation of sustainable models of eye care delivery that improve patient outcomes and reduce avoidable blindness.
References
- Flitcroft, D.I., He, M., Jonas, J.B., et al., IMI – Defining and classifying myopia: A proposed set of standards for clinical and epidemiologic studies. Investig Ophthalmol Vis Sci. 2019;60(3):M20-M30. DOI:10.1167/iovs.18-25957.
- Mackey, D.A., Lee, S.S., When 2 Epidemics Collide—COVID-19 and Myopia. JAMA Ophthalmol. 2023;141(4):340–341. DOI:10.1001/ jamaophthalmol.2023.0074.
