Practice of Evidence-Based Myopia Control Treatments Still Lacking

Optometrists are increasingly using myopia control contact lenses as a means of treating myopia progression among children, according to an anonymous survey of optometrists in Ireland published in Ophthalmic and Physiological Optics. However, over two-thirds of practitioners still do not offer this form of evidence-based treatment, according to the report.

Researchers retrospectively analyzed electronic medical record data from 33 optometry practices (patients, 12,484) between 2017 and 2021 to determine clinicians’ prescribing habits for soft myopia control contact lenses in children with myopia. The team determined the likelihood of being prescribed a soft myopia control contact lens and examined factors that could influence a clinician’s decision to prescribe these lenses.

Among the patients included in the analysis, 2263 individuals were fit with contact lenses — and 137 were fit with myopia control contact lenses. A total of 10 practices reported prescribing myopia control contact lenses of any type. A majority of these lenses were soft peripheral defocus lenses (≈99%) and their use increased from 3% in 2017 to 27% at the study’s conclusion in 2021.

Children fit with the myopia control lenses were younger (12.2 vs 15.4 years) and had more myopia (-3.46 vs -3.03 diopters [D]) compared with participants who underwent treatment with standard contact lenses. The year of the examination (OR, 2.54; 95% CI, 2.13-3.03), younger age (OR, 1.52; 95% CI, 1.39-1.64) and higher myopia (OR, 1.25; 95% CI, 1.11-1.39) were the highest predictors of myopia control contact lens treatment.

“The reasons for poor engagement by independent practices are unclear and may include business models that prioritize product sales over revenue generated by services, but multiple barriers to optometrists engaging in myopia control practice in Ireland have previously been reported,” according to the researchers. “Most notably, the clinical environment, chair time concerns, inadequate training and lack of equipment have all been identified as significant factors.”

Study limitations include the opportunistic sampling of independent practices, the retrospective nature, and inability to determine whether the refractions were performed under cycloplegia. 

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.