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College of Optometrists guidance: managing childhood-onset myopia

Updated: Apr 20, 2023

“By undertaking myopia management, a reduction in the extent of myopia may provide a reduction in the risk of developing serious eye conditions later in life. [1]

That quote from The College of Optometrists underlines the importance of myopia management, particularly in the case of children. The comment arose as part of a guidance note issued by The College and aimed at the growing number of optometrists offering myopia management solutions.

It is important to note that myopia management is not the same as simply issuing glasses or lenses that enable a child to see distant objects clearly. That is an essential step in managing a child's welfare. But simply prescribing glasses will not on its own do anything to tackle the underlying problem which has caused the development of myopia in the first place and could lead to further deterioration throughout childhood, teenage years and even into early adulthood. Myopia management takes matters a step further, directly intervening with a view to slowing down myopia's progression, hopefully leaving individuals with a lower level of myopia in adult life than would otherwise be the case.

As you would expect from The College of Optometrists, patient care is at the heart of the advice. So they highlight the importance of optometrists having appropriate training and expertise in the available methods of myopia management. Still, they also call for parents and patients to be fully aware of their options and give informed and explicit consent to planned courses of treatment.

Explanations should; The College say, not only set out the options available but also the short and long-term benefits and risks of each option. Optometrists should also discuss what might be the implications of delaying treatment whilst at the same time ensuring that expectations of treatment outcomes are managed in a clear and balanced way.

Interestingly as part of their guidance, The College also sets out how optometrists should measure outcomes, suggesting that rather than a reliance on the refractive error (lens prescription) in isolation, axial length (a measurement of the length of the eyeball from the front to back) monitoring should be the preferred method. They say this is particularly appropriate when an ortho-K treatment plan, which involves wearing gas permeable lenses at night to flatten the cornea gently, is put in place. Reassuringly, the advice confirms that children can wear contact lenses from an early age, provided parents and children are given proper advice on lens safety.

If you're a parent whose child has been diagnosed with myopia or if they are struggling with their distance vision, we hope you found MyopiaFocus helpful. Please join our community or sign our petition to get the government and NHS to recognise myopia as an ocular disease/severe ocular condition and fund myopia management for children.

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