Abstract
Background: With the increasing prevalence of myopia there is growing interest in active myopia control. However, the majority of progressive myopes are still prescribed single vision spectacles. This prospective study aims to elucidate the knowledge and attitudes of optometrists toward myopia control, and thereby identify perceived barriers to the implementation of a risk focussed model of myopia management. Methods: A series of four focus group discussions were conducted involving optometrists in different settings and career stages. Results: The key finding to emerge is a clear disconnect between academic optometrists, optometry students and clinicians in practice. Academic faculty considered themselves competent in managing progressive myopia and believed the optometry curriculumprovides undergraduates with sufficient clinical skills and knowledge to practise myopia control. Final-year optometry students regarded themselves as knowledgeable about myopia control but lack confidence in their ability to practise myopia control, with only one student indicating they would initiate myopia control therapy. The majority of clinicians do not offer myopia control treatments, other than to communicate lifestyle advice to modify risk of myopia progression. Clinicians alluded to a lack of availability of myopia control interventions and identified a range of barriers relating to their training, clinical practice and public health challenges, financial, technological and other constraints that affect the implementation of such interventions. Conclusion: It appears optometrists have to yet embrace myopia control as a core element of the clinical eye care service they provide. Education, training, finance, and time restrictions, as well as limited availability of myopia control therapies were among the main perceived barriers to myopia control. This study revealed a distinct need for alignment between optometric training and the public health need for effective myopia control.
Highlights
Myopia is the most common visual disorder in many parts of the world[1,2], and is predicted to affect almost 5 billion people worldwide by 20501
The key findings to emerge from this study include (i) a clear disconnect in myopia control knowledge, beliefs and practices between academic optometrists, final year optometry students and clinicians in practice; (ii) the perceived need for extra education, training and guidelines on myopia control and; (iii) the existence of a range of public health issues, clinical practice concerns, financial, technological and other constraints that have limited the translation of myopia control management strategies into routine clinical practice
Any strategy aiming to control myopia progression must target parents as well as practitioners, in order to address the myopia knowledge gap that currently exists amongst all stakeholders. Conclusion these focus groups cannot be assumed to be entirely reflective of clinical optometry practice, our findings demonstrate a marked lack of willingness to engage in the practice of myopia control among final year students and clinical optometrists
Summary
Myopia is the most common visual disorder in many parts of the world[1,2], and is predicted to affect almost 5 billion people worldwide by 20501. There is evidence to suggest that children who spend more time outdoors are less likely to be or become myopic[9], with increased time outdoors demonstrated to reduce myopia onset by 11–34%, but with no consistent effect in slowing progression in eyes that are already myopic[9] Other factors, such as more time spent in education[10], and prolonged or continuous near work[11], appear to increase the risk of myopia development and progression. The majority of progressive myopes are still prescribed single vision spectacles This prospective study aims to elucidate the knowledge and attitudes of optometrists toward myopia control, and thereby identify perceived barriers to the implementation of a risk focussed model of myopia management.
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