Is optometry ready for myopia control? Education and other barriers to the treatment of myopia [version 2; peer review: 1 approved, 2 approved with reservations]

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 disconnect in myopia control knowledge and practices between academic optometrists, final year optometry students and clinicians in practice. Academic faculty believe the optometry curriculum should provide undergraduates with the clinical skills to practise myopia control, however, although students were knowledgeable in relation to myopia associated risk factors, some students had not yet undertaken any practical form of myopia control in their undergraduate degree. Furthermore, students may not receive hands-on myopia control experience during their supervised practice placement, as 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.