“It was one of the first things I learned about”

Clinically, we were taught that myopia is a type of refractive error; that the axial length of the eye is too long, hence the eye naturally focuses light rays in front of the retina. We learnt that the negative lenses used to correct myopia help to focus the light rays onto the retina. Alongside my peers, we were also taught about how the risk of a patient developing myopia can increase as a result of both genetics and environmental factors, such as prolonged periods of close-up work. I was particularly interested to learn how high levels of myopia are associated with a range of ocular conditions, such as retinal detachment.

During my time at university, myopia management was just coming into the mainstream. It was during a period when more products for myopia management were being released onto the market. As a result, I briefly learnt about MiSight contact lenses and orthokeratology. With research and products in the myopia space having grown immensely since I graduated, I’m sure much more is taught about myopia at an undergraduate level today.

While I learned about myopia and the management options available to optometrists during my time as an undergraduate, because I was not practising the clinical theory through seeing patients in-clinic at the time, my true knowledge and experience of myopia management came after graduating, and grew further still when I qualified and began working in practice.

I completed my pre-registration placement in a hospital and encountered less experience with children than others may have on the High Street due to the services available, and the resulting patient demographic. While there was a separate children’s hospital where I would assess young patients, most were referred for binocular vision issues or pathology, as opposed to myopia management, which in most cases is dealt with in a High Street setting.

However, when I qualified and began working on the High Street I started to encounter patients. The first patient I saw who I recommended myopia management for was

during the paediatric clinic I used to carry out once a week as bank work. I recommended the parent to take the spectacle prescription I had given them to an optometry practice and discussed the range of myopia management lenses that practices can offer.

Additionally, in practice I quickly learnt all about the wide range of products available for patients, including MiSight contact lenses, and Stellest and MiyoSmart spectacle lenses. During my time locuming I also came to realise the breath of product range available, as well as about the different options being offered by different multiples.

I realised early on post-qualification that myopia was an area that I would need to maintain, and advance, my understanding of, while also keeping up to date with product developments.

The myopia management game is an exciting area with lots of new and innovative ideas

Management in practice

As a newly-qualified practitioner, what supported my confidence and understanding of myopia and myopia management was consuming education on the topic. I found peer review sessions provided by contact lens manufacturers particularly useful. During the sessions with like-minded practitioners, we would discuss myopia management case scenarios, the options available for each patient case, and the potential outcome if myopia management has or has not been recommended to the patient.

I would encourage newly qualified optometrists beginning to provide myopia management to keep up to date with the research and to raise the topic of myopia management with all patients.

I would also recommend staying in touch with representatives from companies offering myopia management products, and continuing to regularly consume CPD on the topic.

As a qualified optometrist, we should all be able to offer myopia management solutions to potential target patients in practice. We should record the advice given to the patient and the parent/carer, and answer any questions they may have. Recommending non-optical options is important too, including regular breaks from close-up activities, and more outdoor activities.

The myopia management game is an exciting area with lots of new and innovative ideas.