Myopia in the spotlight with Dr Monica Jong

Can you tell OT about your professional background?

I trained as an optometrist in Australia. When I was working in Melbourne and Sydney, I was already seeing a lot of children, teens and young adults with myopia and that sparked my interest in the area. While working as an optometrist, I completed a PhD and considered working in academia, since I have always had a lot of curiosity and wanted to deepen my understanding to do more for my patients.

Many years ago, I saw a job advertisement for the Brien Holden Vision Institute (BHVI). At the time, Professor Brien Holden was working in the space of uncorrected refractive error as well as myopia management.

When I met him, he spoke to me about all these amazing projects that he was leading in different parts of the world that was combining research with humanitarian efforts to address the fact that so many people around the world could not see because they did not have access to comprehensive eye examinations and a pair of spectacles. I saw his vision and I understood what we needed to do, so I started working with him – with no questions asked.

Myopia management was a very new space, and there was a lack of awareness and understanding in the eye care profession, let alone the public. All my optometry friends did not take me seriously at the time – myopia management was on the fringes of optometry.

It was an opportunity to learn from the ground up and combine my clinical knowledge and research skills to drive research, education, and advocacy initiatives in myopia management under the leadership of Professors Brien Holden, Serge Resnikoff, Earl Smith, and other leaders at BHVI. In 2016 we published a paper that showed, for the first time, that half of the world would have myopia by 2050. This really solidified that myopia was a public health issue, leading to other potentially serious ocular diseases and future vision impairment.

I took the next step and moved to industry because industry had the strong networks needed to drive awareness, educate, and to develop the innovative treatments to help those who need myopia management. It’s been a wonderful opportunity to join EssilorLuxottica at a time when they are pursuing many innovations in Medtech and to be part of the team to have launched the first Food and Drug Administration (FDA) authorised myopia control spectacle lens in the US – which will change the trajectory of myopia for many more millions of children. It is an incredible privilege.

EssilorLuxottica

Dr Monica Jong, EssilorLuxottica head of medical affairs for North America

We are speaking during Myopia Awareness Week. What are your key messages for optometrists?

This is an important time, because this is a week where everyone can repeat and reinforce the same message, and it is about repetition when we are trying to drive awareness in myopia and changes in lifestyle. Changing behaviours and mindsets takes a long time.

The entire eye care profession should come together with one voice to raise awareness. It is about taking the first step and talking to parents and children about why myopia should be managed, and that today there are solutions that have proven efficacy, slowing excessive eye growth due to myopia. It is proactively taking a step towards seeing better today and promoting better vision tomorrow.

Today, we have myopia management options demonstrated to be safe, simple, and easy to use. If a child is still wearing single vision spectacles, we have a duty to inform parents that their child’s prescription can be slowed down along with lowering the risk of ocular complications. Children deserve the best start in life – and good vision is part of good health.

 How does being a myope yourself influence your perspective on myopia?

I grew up in a country, Australia, that is sports mad. As a child, you are playing sports every single day in school. Studies have reported that if you cannot see very well or you do not have the appropriate form of correction, that can negatively impact the quality of life. As a child I wanted to fit in like everyone else.

In my family, we always understood myopia and its impact on daily living because on my mother’s side there was a history of high myopia. My parents never wanted us to develop myopia. When I was diagnosed, it was pretty devastating. I can still remember myself as a 10-year-old sitting in the optometrist’s chair in Australia and being told that my vision could be corrected but it would get worse every single year.

As practitioners, we should no longer have to tell our paediatric patients that myopia cannot be addressed. The message should be both positive and proactive, especially when there is proven technology to slow myopia progression. We should be giving parents and children hope. We can do something to slow the increase in the prescription and that this translates to seeing well today and reducing the future risks to vision – every dioptre matters.

Children are developing myopia at younger ages. Managing myopia starting at the time of diagnosis is imperative, given that this is the critical time for fastest progression.

To encourage children to adhere to any treatment, it is important to include the child in the process. The amazing thing is that today we can let children have fun with their vision correction while also providing a treatment that slows myopia at the same time.

Frames for children have evolved from a medical need to be both fashionable and functional – this is important. Myopia management is a journey and will evolve with the child’s lifestyle and clinical needs.

Children deserve the best start in life – and good vision is part of good health

 What does your EssilorLuxottica role as head of medical affairs for North America involve?

My role is to lead our team and work with other experts to examine the emerging science and innovations within the medical technology sector for eye care and translate it into clinical education to support clinical practice and deliver better patient care. It is not limited to myopia – it could be related to dry eye, new imaging devices, ophthalmic lenses, refractive technology, or artificial intelligence. In addition, we also identify knowledge gaps and any unmet needs and work with our research team to conduct clinical trials to support innovation.

There is so much new technology becoming available and clinicians are busy in their clinics caring for patients and often don’t have the time to read every research paper.

So, it is a privilege to be able to support eye care practitioners by providing credible, fact-based education and support the launches of new technology that then become used by the optometrist the next day. It’s exciting to be able to keep learning and share that with my peers.

 Why is early intervention important in myopia?

Myopia management should be offered to all patients immediately when a child is diagnosed with myopia. That is because when a child is diagnosed with myopia, they tend to progress. If we wait even a year to begin myopia management with a six-year-old, by the time they come back at the age of seven, they're likely to have progressed by over one dioptre on average. Myopia management interventions generally have the greatest effect in the earlier stages of myopia progression and tends to be cumulative over time – starting immediately is important.

 What actions can be taken to prevent myopia onset and progression?

There is evidence suggesting that if you increase time outdoors to 2 hours daily, you may delay myopia developing in a child. Spending time indoors and doing intense near work of more than 2.5 hours a day also increases myopic risk. Being proactive is key. The American Academy of Pediatrics has outlined screentime guidelines for children. While these guidelines are more about physical and social development, emerging studies suggest that younger children may be more sensitive to the near work and devices.

The American Academy of Pediatrics guidelines recommend that children under the age of two should avoid screen time altogether and screen time in school-aged children should be limited to less than two and a half hours per day. I believe that in the future there will be even stronger guidance on how we may try to prevent myopia and treat pre-myopia. There are already several research studies reporting on pre-myopia treatments looking at pharmacological and myopia control spectacle treatments. For now, there is robust evidence to support initiating clinical management of myopia with proven treatments as soon as it develops.

In my family, we always understood myopia and its impact on daily living because on my mother’s side there was a history of high myopia

 What are you most excited about for the future of myopia management?

Myopia management should be holistic – it is about looking at the child and the parent preference in addition to the clinical and lifestyle needs. Today myopia has been recognised as a chronic, progressive disease by the FDA as well as the National Academies of Science Engineering and Medicine. Once a child develops myopia, it likely progresses which we know may increase the lifetime risk of sight-threatening ocular complications. There is so much work being done in this space. We are seeing smart glasses for myopia management being released in China that can track treatment adherence.

We also saw presentations at the recent ARVO 2026 meeting reporting a range of new optical treatments for myopia, including from EssilorLuxottica. Scientists have been able to further increase volume of myopic defocus power while maintaining good vision, suggesting we can continue to slow myopia even further. There is also more research emerging on combination therapy, as well as other types of contact lenses and light devices. This space is incredibly exciting to watch considering it was only 20 years ago that Professor Earl Smith and other giants in the field were doing the lens defocus studies in animal models of myopia.

More tools and devices are going to enable us to monitor refraction and axial length in real time. There will be an entire digital ecosystem helping patients make informed decisions about their own healthcare needs, while the eye care practitioner remains the expert prescribing the latest innovations.