World Council of Optometry calls for a standard of care for myopia management

The World Council of Optometry (WCO) has passed a resolution advising optometrists to incorporate a standard of care for myopia management into practice.

WCO president, Paul Folkesson, called on the profession to “increase its efforts to combat this public health issue.”

The resolution was unanimously approved by the council’s board of directors and recommends optometrists incorporate the standard of care for myopia management within their practice, shifting from solely correcting vision to managing the condition.

The resolution defines evidence-based standard of care as comprising the mitigation, measurement and management of myopia.

The council defined mitigation as the role of optometrists in educating and counselling parents and children in early, regular eye examinations on the factors that can prevent or delay the onset of myopia, such as lifestyle or dietary factors.

The measurement component of the standard of care involves optometrists evaluating the status of a patient during regular comprehensive vision and eye health examinations – such as measuring refractive error and axial length whenever possible – while the management aspect involves addressing patients’ needs by correcting myopia and also providing evidence-based interventions to slow its progression.

The resolution also includes an encouragement for public education as well as early, frequent discussions with parents around what myopia is, the lifestyle factors that might affect its development, the long-term ocular health risks and available approaches to manage myopia and slow its progression.

Establishing a standard of care that regularly and consistently applies these interventions, particularly at an early age, may prevent or delay the onset of myopia, or halt or slow its progression

“Myopia is increasing at an alarming rate, as are the risks for vision impairment associated with the condition,” commented Folkesson, referring to the World Report on Vision, 2019 by the World Health Organization, as well as research that projects that more than five billion people will be affected by myopia by 2050 (Holden et al. Ophthalmology 2016 123(5):1036-1042).

He continued: “Significant research has identified a number of interventions to potentially control the progression of myopia. Establishing a standard of care that regularly and consistently applies these interventions, particularly at an early age, may prevent or delay the onset of myopia, or halt or slow its progression.

“The facts and statistics cited in the resolution and approved by WCO’s board of directors on behalf of our 38 affiliate members, and 45 country member organisations who represent more than 114,000 optometrists, are undeniable.”

Folkesson added: “I am calling on all of our country member organisations to pass their own resolution, or take a similar action, to publicly declare their support for the establishment and implementation of a standard of care centred around evidence-based approaches to treat myopia progression.”

Defining a standard of care

Recently, the WCO and CooperVision announced a partnership to encourage optometrists to adopt a standard of care for myopia management, centred around evidence-based approaches and without bias towards any particular treatment methodologies.

The partnership is set to establish a global resource including multilingual myopia management resources and programming, that is currently not widely accessible or addressed in some sectors or countries.

On the announcement of the partnership, Folkesson had called it a disservice to the “profession, patients and public health” that a standard of care for myopia management had not yet existed, adding: “Myopia is arguably the most widespread epidemic faced by the global optometry community.”

Speaking about the partnership recently with OT, Elizabeth Lumb, head of professional services – MiSight 1 day for CooperVision, said: “Optometrists are well placed to identify children who may be at risk of becoming myopic and offer a clear strategy to delay the onset of myopia with behavioural advice. Optometrists are also able to educate parents on the differences between simply correcting childhood myopia with conventional spectacles or contact lenses and managing myopia with clinically proven interventions.”

“Working together, CooperVision and the WCO have outlined their vision to encourage optometrists to adopt myopia management as a standard of care,” Lumb added.

The WCO’s standard of care resolution can be read in full on its website.

Reflecting on the announcement, Dr Kate Gifford, optometrist, co-founder and lead educator of Myopia Profile, told OT the resolution was a “landmark moment” for primary eye care and myopic children. She said: “There is now an imperative for eye care practitioners to meet the research knowledge and industry innovations in myopia control with changes in clinical practice. This important resolution qualifies, not just the legitimacy, but the imperative of enacting myopia management in practice.”

“The resolution specifically notes that ‘...many optometrists are slow to address the increasing scientific evidence… and adopting proven interventions,’” Gifford highlighted, “At Myopia Profile we are working every day to educate eye care practitioners, provide clinical resources and increase public awareness of childhood myopia management.”

Gifford added: “This is a fast-moving and significant area of eye care - there are a wealth of resources and options to help optometrists keep up the pace.”