The Australia and New Zealand Child Myopia Working Group has released a new report outlining its recommended Standard of Care for myopia control, stating that evidence-based management is critical to addressing the looming eye health epidemic.
On Monday 14 November, the working group – a collaboration of leading optometrists and ophthalmologists – released ‘The Australia and New Zealand Child Myopia Report 2022/23 – Reducing the Risk to Vision’, which is an adjunct to the inaugural 2018 Child Myopia Report.
The group was established in 2018 to deliver a recommended Standard of Care, which it has now presented in this latest report while highlighting shifts in trends and awareness and understanding of myopia during the past four years.
According to the report, the Standard of Care describes the key elements the working group believes must be included without prescribing how or when to employ specific options or techniques.
The group recommended a shift from not only correcting vision but to also include a discussion between the eyecare practitioner and the parents and carers that explains what myopia is, lifestyle factors that may impact myopia, and the increased risks to long-term ocular health that myopia brings.
It also recommended discussing with caregivers the available approaches that can be used to manage myopia and help to slow its progression.
Since 2019, the profession’s peak body Optometry Australia has undertaken a review of the Entry-Level Competency Standards for Australian optometrists.
The Child Myopia Working Group report said these standards do not provide management techniques or protocols of specific diseases such as myopia, as these should be available to the profession through avenues other than the Entry-Level Competency Standards. Optometry Australia recognises that best practice for myopia management, supported by the contemporary evidence base, should be followed.
NSW-based paediatric ophthalmologist and founding member of the Child Myopia Working Group Dr Loren Rose said there was an urgent need for a greater focus on managing myopia and increasing awareness of the importance of children having regular eye exams.
“By doing so this will enable every child diagnosed with myopia to be managed with the recommended Standard of Care,” she said.
“A myopia management Standard of Care is critical, given that each year of delay in developing myopia substantially reduces the chance of a child developing high myopia in adulthood.”
New Zealand optometrist and fellow founding member Mr Jagrut Lallu added: ”For Australia and New Zealand, the forecast rate of myopia by 2050 is estimated to be 55% and we currently have an estimated 36% of the population affected.
“Furthermore, Australia is expected to have 4.1 million high myopes and New Zealand over 600,000 high myopes by 2050, unless myopia management is implemented by everyone. These forecasts highlight the scale of the problem that is facing the profession given Australia in 2020 had an estimated 1.1 million, and New Zealand over 200,000, high myopes.”
What does the Standard of Care look like?
For the practice setting, the Child Myopia Working Group recommended that the following key elements should be included when managing a patient’s myopia:
- Use a myopia management program for patients with pre myopia or myopia based on the best available evidence.
- Explain to patients and their parents or carers what myopia is and discuss the increased risks to long term ocular health associated with myopia.
- Discuss, formulate, and implement an agreed management plan with the parent or carer and patient (child), including discussion of the evidence-based available myopia management options to mitigate axial length elongation; risks (lifestyle and family history) of myopia progression; provision of verbal and written information describing the risks and benefits of treatment, duration of treatment, review frequency, when to cease treatment and rebound effects.
- Document a review/recall for patients with myopia that demonstrate progression.
- Monitor the impact of treatment.
- Recognise personal limitations and refer patients to a suitable optometrist or ophthalmologist if the required myopia management services cannot be provided.
Mr Joe Tanner, professional services manager for CooperVision ANZ, said the Child Myopia Working Group is an important initiative.
“It is time to change how myopia is managed with intervention starting as soon as possible. We call on the profession to adopt the recommended Standard of Care to ensure myopia management is universally practised and available to every child,” he said.
The establishment of the Australia and New Zealand Child Myopia Working Group has been enabled by CooperVision Australia & New Zealand.
More information can be found here.
More reading
Aussie myopia study reveals who benefits the most from low-dose atropine
Private screening to offer glimpse into new myopia documentary
Essilor Stellest myopia control lens launches in Australia and New Zealand
