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Madara Zvirgzdina, Janis B Orr, Nicola S Logan, James Wolffsohn; Current trends of myopia management strategies in clinical practice. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2487. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Myopia is a global public health issue, however, no information exists as to how research findings on retardation strategies are being adopted in clinical practice.
A self-administrated, internet-based questionnaire (SurveyMonkey, USA) was distributed, in 6 languages, through professional bodies to eye care practitioners globally. The questionnaire consisted of 9 questions regarding their awareness of the increasing prevalence of myopia and the implications of this; their perception of the relative efficacy of the available myopia management strategies; their prescribing frequency of each type of correction; the annual progression rate of myopia they believe requires management; their preferred management strategies dependence on patient’s age and refractive error; and their rationale for prescribing single vision spectacles as primary method of management.
Nine hundred and seventy-one responses were received from Africa (n = 6), Asia (n = 291), Australasia (n = 119), Europe (n = 339), North America (n = 133), and South America (n = 82) respectively. Where possible (n ≥ 30), a sub-analysis of individual countries was conducted. Concern was higher (median 9/10) in Asia than any other continent (7/10, p < 0.001), and Asia considered itself more active in implementing myopia control strategies (8/10, p < 0.001) than Australasia, Europe (7/10), North America (4/10) or South America (5/10). Orthokeratology was perceived to be the most effective method of myopia control, followed by increased time spent outdoors and pharmaceutical approaches, while under-correction and single vision spectacles were perceived to be least effective (p < 0.05). Although intra-regional differences existed, 63.0 (±37.8)% of practitioners prescribed single vision spectacles or contact lenses as the primary type of correction for myopic patients globally. The main justifications for their reluctance to prescribe anything other than single vision were increased cost (35.6%), inadequate information (33.3%), and the unpredictability of the outcome (28.2%).
Regardless of the practitioners’ awareness of the relative efficacy of various methods available, the vast majority still prescribe single vision interventions to young myopes. In view of the increasing prevalence of myopia and the existing evidence for interventions to slow myopia progression, clear guidelines for myopia control needs to be established.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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