Myopia's rapidly changing evidence base

When it comes to the subject of myopia, my interest is invariably piqued, not least because I greedily acquired about 10 dioptres of the stuff during a reckless refractive rampage through my teenage years. And, as the photos in my wedding album will attest, myopia has seemingly become a badge of honour in the Beasley bloodline. Indeed, the true parentage of my moderately hyperopic teenager is still viewed with suspicion by Granny Beasley to this day, although she has just stopped shy of demanding a paternity test.

As a researcher in the field of refractive error modulation, albeit with a slant on hyperopia, I have been fortunate to attend events such as the International Myopia Conference, providing the opportunity to absorb the latest outcomes from leading researchers from around the world. However, for clinicians on the frontline in practice, it can be more difficult to keep up with the rapidly changing evidence base in this complex subject area.

Speaking to fellow practitioners from a variety of clinical backgrounds, there is clearly debate about the best approach to take for the patient in the chair. Generally, I find that my peers are keen to get involved with offering myopia management options to patients, but often assume it requires specialist skills and equipment or are concerned about the consequences of giving the wrong advice. On occasion, I also speak to practitioners who, despite their best intentions, may be taking approaches that would not necessarily be considered best practice. At the other end of the scale, we have the intrepid souls who have been leading the way, using off-label interventions long before the CE-marked options started to trickle through, and no doubt vying to get their mitts on a bucketful of atropine at the earliest opportunity. Of course, we also have the sceptics on hand, helping to further the debate and temper the over-zealous where required.

I cannot profess to sit at the table among myopia research royalty, but I feel that I am informed enough to make the right call for patients when the need arises

Clearly there is some middle ground to be found here. I cannot profess to sit at the table among myopia research royalty, but I feel that I am informed enough to make the right call for patients when the need arises. At the same time, I can understand the cynics’ perspective, and believe we are some way off from being able to execute the perfect emergency stop on axial growth. Yet, in my view, doing something has to be better than doing nothing. As interventions continue to evolve, I think it is important to get into the myopia management groove now and keep pace with the newest options as they become available for our patients.