VMAIL Weekend
recently caught up with Sandra Block, OD, for an update on the World Council of Optometry’s efforts to fight myopia. Dr. Block, the WCO’s president-elect, spoke about the organization’s commitment to address the global epidemic of childhood myopia. In April, the WCO board of directors unanimously approved a resolution advising ODs to include a standard of care for myopia management within their practices. Dr. Block also spoke about the dangers of too much screen time for kids and she offered some sound advice to ECPs who are interested in incorporating myopia management into their primary care practices.

Question 1: I understand the poster outlining the Standard of Care for Myopia Management by Optometrists was a topic of interest at the recent American Academy of Optometry (AAO) conference in Boston. Can you talk a little bit about how the poster was presented and what were the reactions from attending ODs. 

A: WCO was thrilled to have the opportunity to collaborate with CooperVision to advocate for a shift in how myopia is dealt with in current optometric practice. (In March, the WCO and CooperVision announced a global partnership to raise awareness of myopia progression. The partnership established a global resource to include multi-lingual myopia management resources and programming.)  WCO represents optometry around the globe and the development of the Standard of Care for Myopia resolution was an opportunity to reach out to optometrists worldwide with the newly released resolution. 

The AAO meeting was a great place to present the Resolution and the need to maintain a standard of care that was based in sound scientific evidence to a public forum that was well attended and allowed for open conversation. The excitement about myopia was heard throughout the conference in multiple presentations and we were able to advocate for the importance of staying abreast of the best means to address myopia. 

The World Council of Optometry works diligently to serve the needs of its members to stay abreast of the best means to promote, prevent, diagnose, and treat patients with myopia.  We have valued our collaboration with CooperVision to help make the resources available on our website.  We know that there is a great deal of research ongoing, and are pleased to be a resource to our WCO members.

(See the sidebar below for more details about the Resolution.)

Question 2:  Many experts have written that the global myopia crisis is an epidemic, while others have called it a pandemic. What’s your take on the situation?

A: The problem is truly a pandemic problem. I will refer back to my understanding of the two words epidemic and pandemic. An epidemic problem is one that is typically focused in one area such as a single country or community while a pandemic problem is defined primarily by the fact that it exceeds a single location, country, or community. I think that we can all agree that the explosion of myopia has exceeded the level of being referred to as an epidemic and I would qualify myopia as a pandemic since we know that increases are seen on a global level. 

Question 3:  Due to the COVID-19 pandemic, we know that kids are spending more time on electronic devices. What are the dangers of too much screen time? And how can ODs discuss this issue with parents and children? 

A: The COVID-19 pandemic has created so many problems for children, with one of them being that many young people have had to transfer from face-to-face education to internet based academic programming. In addition to the time that they have spent learning on-line, we know that much of their socialization has also increased their device usage. In one study conducted in China, evidence has been shown that the magnitude of myopia increased more in the year of the pandemic in young elementary students. 

It is a true catch 22—how can we reduce the increase in myopia caused by the increased device time without further negatively affecting their academic performance. We will need to encourage the families to better understand the impact of increased device time, the potential influence of the past 18 months on device usage and ensure that parents are educated about myopia management. A comprehensive eye examination is certainly one of the things that needs to be strongly encouraged.

Question 4:  What advice can you offer ODs who are interested in incorporating myopia management into their primary care practice?

A: Optometry is a profession of lifelong learning. There are many places to continue to stay current on the importance of myopia management. The World Council of Optometry website has a lot of useful information available for optometrists. Our purpose in developing this website was to provide the clinician with clear recommendations based on our review of the current literature. The Myopia Moments on the website are focused on the three aspects of myopia management care: Mitigation, Measurement and Management. The Myopia Moments are easily downloaded and are available in multiple languages. Each document pulls the recommendations for myopia management that can be easily integrated in their practice. 

Question 5:  How are practitioners using the resolution and the WCO online resource to help patients with myopia? 

A: While we do not have a method to count the number of practitioners that have changed their practice in response to the resolution, we do know that many of our members have shared the resolution within their countries and the discussion on myopia management is a constant topic for learning programs all over the globe. 

World Council of Optometry Passes Resolution Calling for a Standard of Care for Myopia Management

ST. LOUIS—Furthering its commitment to address the global epidemic of childhood myopia, the World Council of Optometry (WCO) Board of Directors unanimously approved a resolution advising optometrists to incorporate a standard of care for myopia management within their practices. Paul Folkesson, president of World Council of Optometry said, “Myopia is increasing at an alarming rate, as are the risks for vision impairment associated with the condition. With more than five billion people projected to be affected by myopia by 2050, the global optometric community must increase its efforts to combat this public health issue,” he said.

“Significant research has identified a number of interventions to potentially control the progression of myopia. Establishing a standard of care that regularly and consistently applies these interventions, particularly at an early age, may prevent or delay the onset of myopia, or halt or slow its progression.”

The resolution defines the evidence-based standard of care as comprising of three main components:

Mitigation—optometrists educating and counseling parents and children, during early and regular eye exams, on lifestyle, dietary, and other factors to prevent or delay the onset of myopia.

Measurement—optometrists evaluating the status of a patient during regular comprehensive vision and eye health exams, such as measuring refractive error and axial length whenever possible.

Management—optometrists addressing patients’ needs of today by correcting myopia, while also providing evidence-based interventions (e.g., contact lenses, spectacles, pharmaceuticals) that slow the progression of myopia, for improved quality of life and better eye health today and into the future.

It also advises optometrists to incorporate within their practice the standard of care for myopia management, which shifts from simply correcting vision to managing the condition, and also includes public education and early, frequent discussions with parents that explain:

• What myopia is.
• Lifestyle factors that may impact myopia.
• The increased risks to long-term ocular health that myopia brings.
• The available approaches that can be used to manage myopia and slow its progression.

The standard of care resolution can be found in its entirety on the World Council of Optometry’s website, here.

WCO and myopia management category leader, CooperVision, recently announced a global partnership to raise awareness of myopia progression and encourage optometrists to embrace a standard of care to manage the condition. The partnership will establish a global resource to include multi-lingual myopia management resources and programming that currently have not been widely accessible or actively addressed in certain sectors or countries.

“The facts and statistics cited in the resolution and approved by WCO’s board of directors on behalf of our 38 affiliate members, and 45 country member organizations who represent more than 114,000 optometrists, are undeniable,” said Folkesson. “I am calling on all of our country member organizations to pass their own resolution, or take a similar action, to publicly declare their support for the establishment and implementation of a standard of care centered around evidence-based approaches to treat myopia progression.”