OT speaks with Richard Edwards, of the Optical Consumer Complaints Service, about how to avoid conflict in practice when offering myopia management
09 June 2023
Myopia is a rapidly evolving field of practice, with more than 1000 articles published on the topic between 2019 and mid-2020.
In the context of both developments in research and the public understanding of myopia, there is a responsibility on eye care professionals to act as guides to their patients in this expanding area of practice.
How can practitioners avoid conflict while navigating this role? OT spoke with Richard Edwards for his advice on how to avoid myopia management complaints.
Communicating clearlyAlthough the Optical Consumer Complaints Service (OCCS) has not received any official complaints about myopia management yet, Edwards told OT that anecdotally he has heard of practices where patients have returned asking why they were not made aware of this therapeutic option.
“The limiting factor in our profession’s ability to make the most of what is really quite ground breaking technology will be our ability to have the right conversations,” he shared.
Edwards believes that there are parallels with refractive surgery, where “someone is buying into a world without glasses.”
“The point I make in that scenario is that when people are buying into a dream, you have got to be really good at your consenting because they may not be listening to you very much – they are already over the line,” he said.
“People have to understand what they are buying into,” he shared.
In Edwards’ view, a key distinction that practitioners should convey to patients is that myopia management limits progression rather than stopping it altogether.
“I think it is really important that parents understand what the process is – that this is a touch on the brakes to slow down myopia. It is not cessation,” he said.
Offering choiceEdwards also discourages practitioners from making assumptions about what a family can or cannot afford. All patients and their families should be made aware of myopia management as an option, he emphasised.
The AOP has produced an information leaflet on myopia management that can be given to patients and their parents.
The leaflet includes a detachable consent form, which can be signed by the parent and kept with patient records to demonstrate their understanding of the advice given by a practitioner.
Written in language approved by the Plain English Campaign, the patient leaflet supports the practitioner’s explanation of myopia and myopia management options.
Optometry Today also provides a wealth of resources on myopia, with CPD articles available to access through the Education Library.
Keeping up-to-date with the latest research and continuing professional development on myopia management also puts practitioners in a better position to advise their patients.
Edwards shared that the understanding of myopia and what interventions can do is changing.
“I think that because of the rate at which we are making new discoveries there is a vulnerability if practitioners don’t have their fingers on the pulse in terms of how the field is evolving,” he said.
Making sure that support staff have an understanding of myopia management also limits the risk that a patient will be misinformed, Edwards added.
He recommends thorough record keeping of myopia management conversations both inside and outside the testing room.
“It helps to create a log so if someone comes back with an issue you have the evidence to show what happened,” Edwards highlighted.
Edwards observed that the economic climate has created a “perfect storm” when it comes to consumer complaints.
“At the OCCS, we are undoubtedly starting to see the influence of the cost of living crisis on the behaviour of consumers. I think society is a bit febrile and money is tight,” he said.
“Myopia management is not an insignificant investment on the part of the parents,” Edwards highlighted.
He shared with OT that it is helpful for practitioners to take an approach where complaints are seen as a learning opportunity.
“If something has gone wrong – whether it is a minor thing or a serious thing – always take the opportunity to reflect and make your processes better.”
The future of myopia management
SK: It would be exciting to see if we are able to predict which children are most likely to be benefit from myopia management. We know from research that not every child responds to treatment. Considering the costliness of these treatments, this would be hugely beneficial in ensuring we are not offering myopia management to children who may not benefit from it.
EM: I think more practitioners will be undertaking myopia management as a matter of routine in practice. Patients and parents will be more aware of what is possible, and research and product development will move forwards to support clinicians.
I hope that accurate ocular biometry, specifically the measurement of axial eye length, will become more widely available. This will provide clinicians with a sensitive measurement of myopia progression.
It will enable the success of a particular treatment, or a change in myopia management intervention, to be realised much more quickly than by monitoring refractive error alone. It will also enable the establishment of a large dataset on the normal eye growth rate of the human eye.