Eye care practitioners (ECPs) in Africa continue to prescribe single vision lenses for progressive myopia despite an awareness of other alternatives, according to a study published in Contact Lens and Anterior Eye. Their perceptions of the efficacy of various modalities to slow myopia are incongruent with the current, best accepted evidence, according to the report.
Researchers administered a survey to 330 ECPs including optometrists (n=307), ophthalmologists (n=13), opticians (n=4), and others (n=6) spanning 23 African nations. The team sought to gauge practitioner concern regarding the increasing prevalence of pediatric myopia and their willingness to adopt different myopia management modalities.
Overall, ECPs reported that the increasing prevalence of pediatric myopia in their practice was a major concern. They responded that myopia control soft contact lenses were the most effective at slowing myopia progression (53.9±27.1%), followed by single-vision spectacles (53.1±30.9%) and orthokeratology (52.8±28.0%). The ECPs reported multifocal soft contact lenses (40.4±25.8%) and pharmaceutical agents like topical atropine drops (39.5±27.1) to be the least effective in slowing myopia progression.
ECPs expressed awareness of other myopia control strategies, but still primarily prescribed single vision (64.3±29.9%), bifocal (10.0±14.3%), and progressive (8.0±13.0%) spectacle lenses. ECPs least commonly reported prescribing soft multifocal contact lenses (0.7± 3.0%). Overall, clinicians cited cost (27.3%) and safety (17.0%) as the rationale behind their decision to prescribe single vision lenses.
The authors recommend clear practice guidelines and continuing education on myopia to guide patient management in Africa.
“Evidence-based resources such as the International Myopia Institute white papers can be used as guides to create country-specific resources for eye care practitioners through media such as clinical practice guidelines and continuing professional education,” according to the investigators. “In addition, schools and training centers for eyecare professionals in Africa should be encouraged to include myopia control education in their curriculum.”
Study limitations include a low response rate and a disproportionate number of responses representing Nigeria and Ghana.
Nti AN, Owusu-Afriyie B, Osuagwu UL, et al. Trends in myopia management attitudes and strategies in clinical practice: survey of eye care practitioners in Africa. Cont Lens Anterior Eye. Published online April 12, 2022. doi:10.1016/j.clae.2022.101597.