Michael O'Kane is one of the youngest to be awarded a Fellowship of the College of Optometrists in the UK. He holds many post-graduate qualifications and is due to complete his MSc in August 2022.
Michael is an Independent Prescriber and the clinical director of Specsavers Morningside and Cameron Toll branches. He was a Specialist Paediatric Hospital Optometrist in Edinburgh's Princess Alexandra Eye Pavilion and has provided Myopia Management to children in and around Edinburgh for the last five years. He is the Chairperson of the NHS NES Optometric Educational Advisory Board and sits on the Executive Board of Optometry Scotland as a Specsavers representative.
He was awarded UK Optometrist of the Year 2018 at the Opticians Awards and Optometrist of the Year 2018 at the NHS Scottish Health Awards. The Morningside store was also awarded Technology Practice of the Year 2018 at the Opticians Awards.
We asked Michael why he is passionate about myopia management and raising awareness amongst patients, and his response was:
As an optometrist with a particular interest in paediatrics, I am passionate about ensuring children, and those who cannot advocate for themselves receive the care they need for their eyes and visual development.
Myopia is predicted to increase vastly over the next few decades, and the research by Holden et al. back in 2016 predicted that 50% of the world’s population will be myopic by 2050. That was before the pandemic!
We have already seen from Chen et al.'s (2020) research that children are becoming more myopic and at a younger age. The World Health Organisation (WHO) acknowledged that the projected increases in myopia in the younger population would be primarily driven by lifestyle factors such as reduced time spent outdoors and greater time spent on intensive near vision activity, particularly smartphones.
The pandemic has acted as a catalyst for this spike in myopia worldwide. Bridget & Kuehn (2021) studied children in Hong Kong and saw that the incidence of myopia had increased to 27% in children aged 6-8yrs old rather than 16% seen before the pandemic. We all know from research and first-hand experience that myopia tends to get worse as the patient ages and that the younger someone becomes myopic, the more likely they are to progress faster.
It has long been well documented that people with myopia, especially those with high myopia, are at much higher risk of developing sight-threatening diseases, such as glaucoma and retinal degeneration.
Despite ALL this research and evidence, it is still relatively under appreciated by the public that myopia is anything but an inconvenience – and testimony would show us that most patients are not made aware of the advances in this field by their eye care practitioner. This needs to change.
For the first time, we have a suite of solid and evidence-based options not just to correct the vision of these poorly focussed eyes but to help slow down the progression of myopia in the child's eye – sometimes by up to 60% of what it could have been! This will reduce the lifetime risk of the child developing certain eye conditions and provide them with increased freedom of choice in their life; from being able to see better when they don't have their lenses to having more choice in the ways to correct their vision, and even what careers they could be eligible for as an adult.
We are the custodians of children's eyes. Our responsibility is to inform the child's caregiver of all the appropriate options to best care for their eye health. It is our responsibility to ensure that the caregivers who will make decisions on behalf of their children's ocular welfare are doing so with the correct information, explained in a manner that is appropriate to them. It is vital that we allow informed consent and that all choices that are in the child's best interest are discussed. This includes knowing the limits of the quality of the information regarding any emerging therapies and providing their guardian with an appreciation of what we don't know about these new treatments so that they can compare these options against the established, traditional corrections.
High degrees of myopia can also be associated with congenital conditions, and clinicians must be aware of the various conditions and the associated care pathways. There's a vast range of varying quality of information online, as well as the ubiquitous rise of social media providing a raft of opinions -often muddied and with the possible commercial bias. Clinicians must access measured advice and good educational resources surrounding this new field.
Good clinical information and advice are essential to prevent inappropriate treatment from being recommended and health inequalities from forming within our communities. For this reason, I am proud to sit on the Advisory Board, and I hope to ensure only good quality, practical clinical advice is issued.