100% Optical

Myopia management in practice: a panel discussion

Eye care practitioners came together at 100% Optical to discuss their experiences of myopia management, and shared their tips for introducing it in practice

child blowing a dandelion
Optometrist and managing director of FYEye Ltd, Jason Higginbotham, took to the stage at 100% Optical to chair a panel discussion about myopia management. He was joined by optometrists and practice owners Bhavin Shah, Brian Tompkins and Sandeep Doshi.

The panel explored how to introduce myopia management to practice, market the service, and communicate to patients and parents, sharing their experiences and learnings along the way.

The first area that the trio explored was when to introduce myopia management to patients.

Optometrist Doshi has been offering myopia management at his practice for more than a decade, and admits becoming “really passionate” about it after fitting his then teenage son (now in his 20s) with orthokeratology lenses.

For Doshi, the conversation has to happen before the child even enters practice. “A discussion with parents at an early stage is really importance, particularly if the parents are myopic,” he said, adding: “This will enable you to encourage them to bring the child in to practice early.

During the discussion, Doshi recommended explaining to parents “the risks that their child could have based on the fact that they are myopic,” as well as, for parents of older children, “the risks related to gadgets that are associated to myopia.”

Having introduced myopia management to his Northamptonshire practice, TK&S Optometrists, a number of years ago, Tompkins agreed with Doshi on when to raise the conversation about myopia, adding that he also talks to young couples about their future children, encouraging children to be brought into practice from six months old.

Shah agreed, adding: “It’s really important to have the conversation beforehand. But equally important is the next step once the child becomes myopic, which is when the conversation moves to being about starting their child on a journey.”

In the latter conversation, Shah emphasised: “It’s really important for the parents to understand what has happened and what the progression might be so they understand what it means to be myopic and how vision may progress over time.”

Sharing tips, the panel agreed that when it comes to talking to patients and parents about myopia management they will raise and educate on a range of areas linked to myopia, including lifestyle factors beyond the familial and genetical.

Doshi will regularly ask patients if they like riding a bike or playing football, for example, in order to encourage them to spend more time outside participating in these hobbies.

On hobbies, Shah highlights the importance of discussions about reading habits too, noting: “We discuss the impact of this on myopia and encourage good reading distance habits.”

“Speaking to parents before their child becomes myopic about lifestyle in order to set them on the preventative road is key. It’s important to be proactive,” Higginbotham emphasised.

What is the minimum practices need to understand myopia management?

As an evolving area of optometry, with research published frequency, the panel aimed to demystify and reassure practitioners about myopia management knowledge.

“When I started myopia management many years ago,” Shah shared, “it was with a child of a friend of mine. Since then, I have honed how I communicate and educate patients, while I have now also ensured that I have the right paperwork, consent form and educational leaflets to hand to accompany any verbal information.”

When it comes to equipment, “all you really need is what you need for contact lenses – a slit lamp and a topographer,” Shah said. However, as this area of his business has grown he reveals that he has now invested in optical biometry to enable him to measure axial length. “But this is not a requirement from the get-go,” Shah emphasised, with agreement from the panel.

For Tompkins, the minimum a practitioner needs is “passion” for the topic. “You have to be passionate and believe that you are helping that person,” he said.

Doshi added that this passion must extend across the whole practice team. “It’s not just about the optometrist in the consulting room, it’s about your professional staff and your support staff, ensuring they are engaged as well,” he said.

Following conversations, it is the patient’s choice whether to proceed with treatment or not. However, the panel agreed, that if they choose not to it is important for the optometrist to record this on the patient record.

Marketing and communication

Just as the trio advise that the myopia management conversation should happen through the whole practice team, each also agree that marketing to current and potential patients before they enter practice is important.

For Doshi, this is a poster in his practice window: “We simply have the words myopia management written on our window so people are aware that we offer it, because how else are people going to know?”

The panel acknowledged that they were early adaptors in myopia management, and practitioners will all be at a different point in their myopia management journey.

For those who have yet to tread the path and do not feel comfortable, Doshi advised: “If you don’t feel conformable providing myopia management, there is no reason why you can’t have conversations about myopia and refer them on to another practitioner for management who has the confidence to offer myopia management.”