Is optometry ready for myopia control? Education and other barriers to the treatment of myopia

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 curriculum provides 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.