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Subspecialties Pediatric, Comprehensive, Refractive

Short-Sighted Control

In a recent review – “Myopia Control 2020: Where Are We and Where Are We Heading?” – Mark Bullimore and Kathryn Richdale of the College of Optometry, University of Houston, Texas, comprehensively explore the efficacy and safety of various behavioral, pharmaceutical, and optical approaches (1). Moreover, the two professors address when to stop or modify treatments.

Reviewing key studies from the last two decades, the authors note that a lot has changed since the publication of the Cochrane review in 2011 (2). Indeed, their analysis covers a lot of ground, including the most important papers on progressive addition spectacle lenses (PALS), pharmaceutical solutions such as atropine, overnight orthokeratology, and soft contact lenses. Children’s age, ethnicity, parental myopia history, and other criteria are all explored when offering recommendations on appropriate implementation of myopia control.

Future predictions for myopia management point to the importance of creating a continuum of care, starting with preventive measures, which can help delay onset, followed by optical and pharmaceutical approaches slowing progression.

Bullimore and Richdale stated in the review: “Myopia has functional consequences in terms of reliance on optical or surgical correction, and an accompanying economic burden. Furthermore, increasing levels of myopia are associated with higher risk of ocular disease, some of which is untreatable.”

Overall, the authors hope the open-access paper offers practical advice to help eyecare practitioners follow the latest evidence-based research when managing pediatric patients – advice that may be crucial given the increasing global prevalence of myopia (3).

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  1. MA Bullimore, K Richdale, “Myopia Control 2020: Where are we and where are we heading?”, Ophthalmic Physiol Opt, 40, 254 (2020). PMID: 32338775.
  2. JJ Walline et al., “Interventions to slow progression of myopia in children”, Cochrane Database Syst Rev, 7 (2011). PMID: 22161388.
  3. BA Holden et al., “Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050”, Ophthalmology, 123, 1036 (2016). PMID: 26875007.

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