Puzzle solving

How has the academic landscape changed in myopia while you have been working in the field?

I’ve been working in the field of myopia research for the last 20 years. When I started out there was a relatively small group of academics worldwide that were working on this topic. Much of the work was done on animal models of myopia. We are now really at a pivotal point where the interest in the area has expanded. Within the last five years there has been a huge change in terms of the number of people working in the area.

At the 2017 International Myopia Conference in Birmingham, the numbers were much, much greater than they have been in previous years. There has been greater translational research, right from the animal models through to clinical trials. Very recently within the last year we have seen the first CE-marked optical intervention for myopia control introduced to the UK market, MiSight. 

We are starting a new multi-centre study in April throughout the UK using low-dose atropine on UK children. It will be exciting to see how it works and, if it does, how we can drive that forward so it is accessible for optometrists in practice. We are now at a stage where we can see the impact that the research is making to optometry clinical practice.

"Myopia slows down and stops progressing at some stage and we need to understand why this is. If we know what makes the eye stop growing, perhaps we can intervene so that it happens earlier"

What do you think are the key pieces of information that we still need to know about myopia?

We still don’t fully understand the mechanisms behind why myopia develops in the first place – what triggers it to develop? – and then, once it does develop, why does it keep progressing? Myopia slows down and stops progressing at some stage and we need to understand why this is. If we know what makes the eye stop growing, perhaps we can intervene so that it happens earlier.

At the moment, we can slow down the growth of the eye by optical and pharmacological methods, however we don’t understand the mechanisms behind these and why some children respond well to these interventions whereas for other children their myopia continues to progress.

Why is this an area that interests you so much?

I became myopic at age 10 with no family history of it. It was quite an unexpected finding and I wondered what was it that triggered my myopia. As an optometrist working in practice you see a lot of kids who are myopic and you can correct them with a pair of glasses or contact lenses. You see the benefit of that but having the ability to do something about it and try and alter the growth rate of the eye, to slow down the progression of myopia, is really rewarding.

I like finding things out and understanding mechanisms. Myopia control is a challenging area that has been previously side lined but there is now momentum in this field and I am looking forward to seeing some exciting developments in the next few years.