Almost all ODs who provide myopia management services practice in metropolitan areas, according to an AOA survey conducted over the summer. Photo: Maria Walker, OD. Click image to enlarge.

With a rising global prevalence rate expected to hit 50% in 2050, efforts to control myopia demand more attention. An increasing number of optometrists are stepping in to care for these patients, a statistic revealed through a recent survey conducted by the American Optometric Association (AOA) Research & Information Committee (RIC). More than two-thirds of doctors across the country who responded to the survey reported providing in-clinic myopia management services, though most believe they would benefit from more guidance on clinical decision-making.

The survey results included responses from 464 optometrists of 41 states and the District of Columbia on questions regarding myopia management techniques and services offered in their practices. Here are some of the findings noted in a report from the AOA Health Policy Institute on the survey data:

• Three of four doctors believe myopia is a disease in need of treatment.
• 93% of doctors providing myopia management are located in metropolitan areas, and 71% of those practice independently.
• The preferred treatment method is soft contact lenses.
• Nearly 80% of ODs reported using atropine for myopia management, and most preferred a concentration of 0.05%.
• Doctors received most of their education on myopia control from CE (43%), individual research (35%) or optometry school (15%).
• One-third of patients who are candidates for myopia management defer treatment, and for 80%, the reason is cost-related.

Several trends were observed regarding doctors’ opinions on when to start treating a patient with myopia. For example, 73% reported believing that annual progression of 0.50D to 0.75D is warranted before intervening with myopia control. Responding doctors also rated refractive error as the most important risk factor in warranting myopia management, followed by the rate of progression/change. When asked when they begin discussing the condition and its management with parents of children with myopia, 87% of doctors reported initiating the conversation between the ages of five and eight (average age: 5.5 years).

In an article on the AOA’s website, Mamie Chan, OD, AOA RIC chair, notes that this survey data serves partly to help doctors see how other clinicians are managing their myopia patients. “As a private practitioner, I am sometimes in a bubble,” she said. “I only see myself and my friends, so it’s good to get a snapshot of what other people are doing and how many people are doing it.”

The other purpose of the survey was to help identify strategies and develop resources that can support doctors who manage myopia. One of the survey questions asked doctors which type of support might allow them to better care for this patient population. They provided the following responses:

• 63% of ODs would like additional education on the science of myopia management and myopia control.
• 57% would like additional education on patient engagement strategies related to myopia management and myopia control.
• 50% would like advocacy for insurance to cover myopia management.
• 46% would like diversity in the cost of interventions.

While most optometrists seem to be embracing myopia management based on these results, it can’t be overlooked that nearly a third of ODs in this survey—most from non-metropolitan areas—still don’t offer the service. “I think there is an opportunity for the AOA—for the Contact Lens & Cornea Section and the Education Center Committee—to capitalize on educating the apparently large group that is not practicing it because they don’t feel the research is there,” Dr. Chan said to conclude the AOA article.

Survey says: doctors of optometry embrace myopia management. American Optometric Association. Published December 1, 2022. www.aoa.org/news/clinical-eye-care/public-health/doctors-of-optometry-embrace-myopia-management?sso=y. Accessed December 5, 2022.