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Overcoming Barriers to Myopia Management

By Glenda Aleman Moheeputh, OD
 
 Myopia is a global health problem that will continue to have a significant societal and economic impact on our world. It has been estimated that by the year 2050, as many as half of the population may be affected.¹ As eyecare practitioners, we have been trained to think of myopia as a refractive error that is best corrected with spectacles or contact lenses. However, in order to truly implement the best myopia control solutions, it would be beneficial to consider myopia as an eye health issue with larger repercussions.

The fact is, we already know that children with myopia are at a substantially higher risk of developing retinal eye disease, including retinal detachment, glaucoma, cataract and myopic maculopathies.

And with the prevalence of myopia and high myopia increasing at a startling rate, the visual impairment impact figures related to uncorrected myopia remain staggering. Visual impairment due to uncorrected myopia leads to an estimated global productivity loss of approximately $250 billion per year. Those numbers are only expected to grow.²

Although awareness surrounding this expanding global eye health problem has increased significantly during the last decade, only a relatively small percentage of eyecare practitioners are actively implementing myopia management therapies in their practices, and it is alarmingly disproportionate to the problem at hand. As optometrists, we are on the front line of this worldwide problem, so we must determine what stands in the way of better implementation practices in our offices.

What barriers are preventing more practices from adopting myopia control treatment options – and how can the be overcome?

After conducting a recent social media survey, poor receptiveness (on behalf of parents), the financial burden to doctors, and an overall lack of awareness were three of the biggest barriers that eyecare practitioners felt they faced in implementing myopia management.

Let’s look more closely at each and how practitioners can potentially overcome them.

Poor Receptiveness
Among the burdens that eyecare practitioners cite, poor receptiveness — particularly from the parents of their young myopic patients — is a noted fear. Doctors express that a common response from parents is, “Why has no one ever told me about this before?”

The fact that they have never heard of myopia may raise some concern on behalf of parents who feel they are uncertain about the diagnosis.

The best way to overcome pushback is with education. By creating a dialogue with the patient’s parents, doctors are able to explain what myopia is, the risks involved in the diagnosis, treatment options, as well as gauging their level of experience and understanding of the condition. Pamphlets and resources are another great way to expand the parents’ knowledge on myopia. Parents might be apprehensive at first, but ultimately, they just want to better understand the diagnosis and treatment.

Although there may also be some parental resistance to the financial burden, in my own practice, I have found this to be the least of the concerns. Once parents understand that this is a real problem and they trust the clinician, the financial aspect ends up playing the smallest role in the decision-making process. Therefore, the doctor-patient relationship — including the development of a certain level of confidence — is a key element in successful myopia management. Doctors must have the trust of the parent and the patient to be able to successfully treat myopia.

Financial Burden
On the doctor’s side, the financial burden may also stand in the way of focusing on myopia management. The cost of specialized equipment — including a corneal topographer, orthokeratology contact lenses, and instruments for biometry to measure the axial length and monitor its elongation — can deter eyecare practitioners from making that initial investment. However, when you take into consideration how many myopic patients you have, as well as how much this specialty can grow your practice, you are quite likely to be able to recoup those costs much more quickly than expected.

Keep in mind that equipment can be financed. Take the time to calculate your numbers and determine how many patients you would need to see to be able to pay for the equipment to help further alleviate concerns. Forecasting this information typically sets practices up to understand how quickly they can expect to see a return on investment.

In addition to equipment, there are also certifications that should be completed, which require an investment of both time and money. Although this may also feel like a barrier, it’s important to remember that the right equipment goes hand-in-hand with knowledge and education. Taking these extra steps to improve upon your ability to treat myopia will ultimately pay off with better patient outcomes.

An Overall Lack of Knowledge
A general lack of knowledge surrounding myopia control methods also remains a barrier. Doctors have expressed that they do not feel as though they know as much as they should about myopia treatments as well as the business aspects surrounding the implementation of myopia management programs. Despite being such a prevalent concern, for many eyecare practitioners, myopia management was not covered in depth in school. Therefore, doctors must find ways to educate themselves.

Taking the time to read white papers and listen to lectures and webinars from experts in the field is an important first step in becoming more comfortable and better educated on the latest findings in myopia.

The American Academy of Orthokeratology and Myopia Control is also a great source of educational materials. Joining social media groups with a myopia management focus can also help give you insight into what other practices are doing. Seeking out colleagues who have already developed myopia management programs can help you determine how to lay the groundwork to build this specialty at your own practice. Should you desire more personalized education, you might also consider the assistance of a consultant. Both this and connecting with colleagues via social media or other channels can assist on the business management side of myopia.

The Bottom Line
The bottom line is that to continue progressing in myopia management, we must all do our part in becoming better educated and overcome potential barriers. Each of us can play a role in reducing myopia progression with more focus on management.

Dr. Moheeputh is passionate about the specialty of myopia control and is certified in numerous myopia control lenses. She currently practices in Miami, Florida, and offers practice consulting to give eyecare professionals the education, resources, and tools to succeed in the implementation of myopia control.

REFERENCES:

1.  World Health Organization. The high impact of myopia and high myopia. WHO; 2015. Available at: https://www.who.int/blindness/causes/MyopiaReportfor Web.pdf.
Accessed March 5,2021.

2.   Naidoo KS, Fricke TR, Frick KD, et al. Potential lost productivity resulting from the global burden of myopia: systematic review, meta-analysis, and modeling. Ophthalmology. 2019;126(3):338-346.