The International Myopia Institute (IMI) has released its latest set of reports, with topics including a survey of prescribing patterns, instrumentation, and light therapies.
Report authors attended the BCLA Clinical Conference and Exhibition to present key findings from the fourth set of reports.
The IMI was founded in 2015 following a meeting of the World Health Organization and Brian Holden Vision Institute where, for the first time, myopia was recognised as a serious health concern.
Professor James Wolffsohn, dean of optometry at Aston University and chief scientific officer of the IMI, explained that the institute began producing whitepapers in 2015 to help practitioners keep up to date with the research on myopia.
He said of the reports: “They are a really useful resource. When you are talking with a patient and they ask a challenging question, you can go and see – is there evidence for that at the moment? What is the direction of travel in terms of our understanding? Or maybe we don’t know about that yet and that’s something that future research needs to fill in.”
Myopia management over time
Each set of reports includes the results of a survey of myopia management, featuring responses from more than 3000 practitioners around the world.
Over the years, the survey has revealed a reduction in the number of young progressive myopes prescribed single vision spectacles, and a “massive increase” in the uptake of myopia control spectacles after they entered the market, Wolffsohn explained. This provides a benchmark of how new technologies are being adopted.
Wolffsohn explained: “What we’ve seen over the years is there has been a wider uptake of myopia control treatments.”
This rise has been seen in contact lenses, initially in orthokeratology, and then in spectacles when myopia management products came to the market.
“There is a little bit of plateauing in the last couple of surveys, which suggests there is still more work to do, and about a third of patients are still put in a single vision treatment,” he added.
There can be cost issues and other issues that factor into a decision to take up myopia control strategies, which is also explored in the surveys.
It is important to think about what a myopia control treatment can mean for the individual child. Wolffsohn emphasised the need to offer myopia management to all families – giving them the information needed to make a fully informed decision on affordability.
“It may not be right for them at this current time, but they need to know about it,” he said.
Instrumentation, light therapies, and interventions
Papers included in the set of reports include focuses on instrumentation, considering measuring axial length and what treatments might work best for individual patients, as well as “challenging” practitioners to look at what technology is needed at different stages.
Another paper looks at light therapies, Wolffsohn said: “We know light is important. We’ve known for many years, and for hundreds of years people have commented that children who spend more time outdoors have less refractive error. But actually, understanding that right from the animal models through to the implications of clinical practice is really important.”
The reports also look at myopia management interventions, how effective they are, and how this effectiveness should be reported.
Further reports explore public health and updating the epidemiology to understand how many people are myopic now, and what the predictions are for the future.
Answering questions
The IMI produces summaries for the papers to provide a quick overview of the subjects, along with an infographic on myopia and interventions.
“I find that really useful to go through with parents,” Wolffsohn said. He added: “It takes them through the why, the what, and the risk factors."
Talking through the infographic can help to dispel parent or guardian concerns regarding myopia and encourage discussion around the right treatment option for the patient.
The reports are open access and will be published through the year and collated in an issue of the Journal of Investigative Ophthalmology and Visual Science.
“I would encourage people to make them accessible,” Wolffsohn said, recommending downloading the reports to a desktop.
He added: “I find these reports really useful when someone asks me something and I’m not quite sure; you can dip back in very quickly to that section and go: ‘Oh, well this is what we know today.’”
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