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Catch up on the top stories in optometry during the week of September 8-September 12.

Takeaways from this week in optometry: September 8- September 12

Articles

Long-term atropine use to treat myopia associated with increased risk of ocular complication in schoolchildren in Taiwan

A total of 293 optometrists, practice owners, and managers were involved in the survey.

Myopia treatment trends outlined in The Vision Council's recent report

Researchers conducted this study to determine how often and why spontaneous soft drusen regresses without atrophy in patients who had intermediate or atrophic age-related macular degeneration.

New study examines soft drusen regression without atrophy and drusen ooze

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In this episode of the You and Eye podcast, Miriam Korik, OD, and Justin Kwan, OD, FAAO, delve into the evolving landscape of myopia management within optometry, reflecting on its transition from a niche specialty to a crucial component of primary care. Drawing on their experiences and insights, they discuss the growing prevalence of myopia and the pressing need for more optometrists to integrate effective management strategies into their practices. Kwan shares practical advice for new graduates and seasoned practitioners alike, emphasizing the importance of collaboration and support when introducing myopia management techniques. They explore various methods for starting this process, even in practices without advanced technology, while also highlighting the value of utilizing available resources and consultants. This dialogue underscores the significance of proactive eye care in addressing the myopia epidemic and equips optometrists with actionable steps to enhance their practice.


I mean jumping right in. I feel like when I was in school, which wasn't too long ago, I graduated in 2020, myopia management was considered more of a specialty. And how do you feel it has shifted in recent years to kind of become more primary care optometry.


Yeah, Miri, I think part of that stems with our faculty having grown up with ortho-k in the 90s. And then there were some FDA approvals of ortho-k, and then it was sort of like almost happenstance, that they're like, we don't need to flatten these base curves and it seems their myopia has slowed down. And then as the science, and, you know, larger bodies like the International Myopia Institute, having published more and more, we found out from faculty today that they started formalizing it into the curriculum around 2016 so I think you were just entering into your school years.


And then lately, you know, as you look at the census and try to measure the size of the myopia problem, both in children and adults alike. We kind of take that Brien Holden [Vision Institute] estimate and try to bring it closer to home. So yeah, the global number is what it is, but here in North America, nearly half of the population will have myopia by 2030 so that's about five years away, a lot sooner than that 2050, year that you typically hear about. So I think to answer your question, man, myopia can't be a specialty because it's too big of a problem for just like a few 100 doctors to focus on like we literally need 10s of 1000s of optometrists and a good chunk of our ophthalmology colleagues to be all in hand, all hands on deck. Otherwise, we can't help these 19 million children.


I agree. I mean, it's so prevalent. Like, think about a typical day in clinic. How many myopes do you see? And you know, if you're, especially if you're doing pediatrics, like, how many myopic kids do you see? So now that it's considered more primary care, how do you feel that new grads, or even long-time practicing optometrists, [should] get started with introducing myopia management into their practices?


Just like anything new, it can feel challenging or hard; it definitely feels different to do something you haven't done before. But I think also with most things, the mindset and mentality matter a lot. And might be a little cliche to say, like most of it's in your head, but I think we definitely can do new things better if we don't do it alone, right? And and so whether it's one staff member, the owner, OD, anybody, as long as they kind of get where you're going and why you deeply care about these children with myopia, and kind of bring that evidence-based and standard-of-care support, I think can be much easier. So you don't have to do all things when you get started. You can start with MiSight 1-day, you can kind of learn how to do atropine; ortho-k has changed a lot in the past couple decades as well. The key is to just get started.

But I think a big part of that is we have to set our fees. So that that often is the first hurdle to clear. And definitely, all of these wonderful companies have reps and consultants that can train your staff and help you with your first few patients at no charge. And that's, I think the beauty of the profession is that we all can work together in this space.


So stemming from when you said, like, first introducing [myopia] to the practice, how do you recommend a practice [gets started]? Because, like me, coming from New York, you know, there's a lot of opticals here that might not have a topographer. How would you recommend a practice without a topographer start? Like with just atropine and soft contact lenses? Is it possible to do ortho-k with just Ks [keratometry] from the auto refractor?


Yeah, I think possible and good are, you know, maybe two different answers. It's certainly possible to start with the auto Ks. And, you know, I think most of the profession are using larger diameter ortho-k lenses now, because you're like, "Oh, the HVID ruler doesn't give me a great estimate, and my topographer would be more accurate." But as long as you use like an 11.0 diameter or larger, and you work off your auto Ks, that's a great starting point, but you really would do your patients a better service [to use a topographer], in case you need to troubleshoot, let's say, two out of your 10 patients, but in large part, the technology has gotten so good that you could probably get started with one patient without a topographer, and then make sure you definitely plan to acquire one in the near future.


Got it. And I feel like you can always, like, send those readings out to a consultant, like, email them, and they can kind of like help you troubleshoot a little bit?


Absolutely. And I think the consultants definitely appreciate as much data as possible. Now that we have our iPhones that do stills and short videos of the fluorescein pattern, and then making sure we get that overrefraction over the ortho-k lens is a critical piece as well. But yeah, our consultants are well set up and so experienced. Obviously, they do thousands of fits a month that they can kind of speak from that experience to help us with our onesies and twosies.


Right. I feel like nowadays there's so many creative ways to do it, like how you said, you know, taking a video, even on the iPhone.


Oh, a quick tip on that is, I learned, you have to use portrait mode if you're going to do stills and video there. Yeah, yeah.

Miriam Korik, OD, and Justin Kwan, OD, FAAO, discuss the shift of myopia management from a specialty to a vital aspect of primary care optometry, emphasizing the need for more practitioners to integrate effective strategies and collaborate for better patient outcomes.

You and Eye: Myopia cannot be viewed as a specialty in today's practice setting

Myopia isn't just a speciality anymore - odds are, you've seen it in your practice. Justin Kwan, OD, FAAO, who is senior manager of myopia management in CooperVision's professional and academic affairs group, shares his journey to passionate myopia management champion in practice and in industry. Drs. Kwan and Korik discuss the minutia of management; talking to parents about myopia control options, how to set fees, and how to get the word out about the new service in your practice.

Prefer to listen on the go? You can follow the podcast on 

Follow Dr Korik on social media:
Instagram: 

https://www.linkedin.com/in/miriam-korik-81b492111/

https://www.youtube.com/channel/UCuIVJVZ17AJFEo8fqXK_gZg

Justin Kwan, OD, FAAO, shares his journey from optometrist to myopia management advocate and provides some tips for getting started on your own journey.

You and Eye: Mastering myopia management - with Justin Kwan, OD, FAAO

It's time for back-to-school eye exams, and host Miriam Korik, OD, teams up with Eyes Up host Damaris Raymondi, OD, FAAO, to chat about how to handle pediatric eye exams efficiently, thoroughly, and confidently.

You and Eye: Tips & tricks for streamlined pediatric eye exams - with Damaris Raymondi, OD, FAAO

Vitto Mena, Jr., OD, MS, advanced clinical director with Special Olympics, and international sports vision association member, as well as the sports vision director with Optical Academy, sat down with 

 editor Kassi Jackson to share highlights from his presentation, "

My child is not old enough for contact lenses: guess again

," which he presented during this year's Vision Expo West in Las Vegas.

This transcript has been lightly edited for clarity:

Hi everyone. I'm joined today by Dr. Vitto Mena, advanced clinical director with Special Olympics and international sports division association member, as well as the sports division director with Optical Academy. 

He's here to share highlights from his discussion titled, "

," which he's presenting during this year's Vision Expo West in Las Vegas. 

Thank you for being here, Dr. Mena. Would you please just share with us the key takeaways from your presentation?

With this course, what I want to pretty much take home is that age is nothing but a number. Right? 

We always think that in order for a kid to have contact lenses, they need to be at a certain age. And that's not really the case. The reason why is because—at least for me, I practice in the state of New Jersey—what happens is when a child gets their glasses for the very first time, either they don't like they don't like to wear them because they just don't like glasses on their face, or maybe mom and dad might have picked a pair of glasses that the child didn't like but the insurance covered so that's we're gonna wear. 

So what happens is if you have contact lenses, not only are they going to be able to perform better in the classroom, they're also going to be able to perform better in the sports world in the sport that they played. 

So the youngest that I've ever put a contact lenses on, the child was actually 5 years old. Now 5 is pretty young, so I would usually have mom do insertion and removal. But I have plenty of 6 year olds that do it by themselves. 

So the take home is that if we're able to get these these kids in contacts, they're not only going to learn better in school, but they're going to be able to play better and minimize injuries that occur when it comes to sports.

Vision Expo West

Vitto Mena, Jr., OD, MS, shares highlights from his VEW 2022 presentation, "My child is not old enough for contact lenses: guess again."

VEW 2022: Guess again, your child is NOT too young for contact lenses

One in 3 children worldwide has myopia, and the prevalence is rising so steadily that if it continues as predicted, there will be more than 740 million pediatric cases by 2050.

Pediatric myopia and the urgent need for early intervention 

Boston event will shed light on cerebral/cortical visual impairment (CVI), a leading cause of pediatric blindness

First-ever CVI awareness day to be held in Boston in September

Ocular salvage and preservation of vision are essentially dependent on early diagnosis, and several studies have been conducted to identify the factors leading to delayed diagnosis at presentation.

Parental lag time is primary reason for delayed diagnosis and treatment of retinoblastoma 

Santen introduces low-dose atropine in Germany, marking a significant advancement in myopia management for children amid a global epidemic.

Santen begins European rollout of low-dose atropine for myopia in Germany

New research reveals collagen mimetic peptides may effectively restore ocular tissue stiffness, offering hope for myopia and other eye diseases.

Healing damaged collagen in the eye with topical polypeptides in patients with myopia 

Erin Tomiyama, OD, PhD, FAAO, offers actionable advice for myopia management and perspective for practitioners ready to refine their approach.

CCS 2025: Clinical pearls and forward thinking are the key to success in myopia management

 continues to gain momentum in clinical optometry, and at the Collaborative Care Symposium, Erin Tomiyama, OD, PhD, FAAO, offered actionable advice and perspective for practitioners ready to refine their approach. This session, which Tomiyama copresented with Mark Bullimore, OD, PhD, and Prethy Rao, MD, emphasized the importance of early intervention, lifestyle-informed treatment planning, and growing opportunities in the field.

Practical guidance for treatment selection

Tomiyama stressed that choosing the right myopia management modality requires an individualized approach. Factors such as patient age, rate of progression, lifestyle, and even parental familiarity with certain treatments all play into decision-making.

“For kids who enjoy water sports, orthokeratology (ortho-K) works really well—they get clear vision without needing to wear lenses in the water,” she explained. “Sometimes parents are more comfortable with treatments they’ve used themselves, which can improve [adherence].”

Initial treatment may begin with atropine drops for younger children not ready for contact lenses. As patients mature and seek more independence, transitioning to soft multifocal lenses or ortho-K becomes feasible. Regardless of modality, frequent follow-ups allow optometrists to monitor adherence and treatment efficacy, making adjustments as needed.

Tomiyama expressed excitement about the potential introduction of FDA-approved low-dose atropine and myopia control spectacle lenses in the US. “Spectacles are part of our daily toolkit, and their arrival will help more practitioners feel confident offering myopia management,” she said. “It could broaden access significantly.”

FDA regulation would also reduce variability in compounded atropine formulations, offering more consistency for both clinicians and families.

Artificial intelligence is expected to play a larger role in myopia management, from identifying ideal candidates for specific therapies to tracking progression. “A quick AI-generated summary could save time and support faster clinical decision-making,” Tomiyama noted.

Tomiyama closed with a call to action: “Just practice myopia management. Get started and grow your confidence. We’re shaping long-term outcomes—starting in childhood.”

Videos

In honor of the Myopia Management Navigator’s one-year anniversary, Dr. Tucker shares clinical insights, practical tips, and business opportunities for optometrists looking to expand their scope and elevate patient care through evidence-based myopia management.

Celebrating the 1-year anniversary of the Myopia Management Navigator

In celebration of the 1-year anniversary of the 

, Ashley Wallace Tucker, OD, FAAO, FSLS, Dipl ABO, shared valuable insights into her experience with myopia management and how optometrists can benefit from this dynamic tool developed by the World Council of Optometry in collaboration with CooperVision.

Tucker described myopia management as the most rewarding aspect of her full-scope practice, particularly the opportunity to impact children’s lives. She initially focused on orthokeratology, drawn to its immediate “wow factor,” but as more treatment options became available, she embraced a broader range of management strategies. This evolution in care aligns with the expanding clinical tools now available to optometrists.

A significant focus of the interview was the Myopia Management Navigator, which Tucker regards as an exceptional starting point for practitioners new to this area. The Navigator is structured around the WCO’s "3 Pillars of Myopia Management"—mitigation, measurement, and management. Each section of the Navigator is designed to guide optometrists through these steps in a clinically meaningful and easy-to-navigate way.

 offers communication tools and educational resources that can be shared directly with patients and parents.

 includes guidance on tracking refractive error and axial length, which are crucial for effective monitoring.

, the most complex pillar, provides a breakdown of treatment modalities, helping clinicians tailor options based on individual patient needs.

Tucker emphasized the Navigator’s regular updates and research-based foundation, making it a trustworthy resource for staying current in a rapidly evolving field.

Beyond clinical care, Tucker addressed the business opportunity myopia management presents. As optometrists already possess the expertise in refractive care, embracing this specialty not only improves patient outcomes but also supports sustainable practice growth. She encouraged her colleagues to recognize the value of their services and to confidently charge appropriately for their knowledge and time.

A key takeaway from Tucker’s experience is the importance of communication. She urges optometrists to initiate conversations with parents, even if there’s initial hesitation. Educating families about actionable options can be profoundly empowering and establishes the optometrist as a trusted source of progressive care.

In closing, Tucker reiterated the Navigator’s value, not just for clinical decision-making, but also as an ongoing educational tool. Whether you’re new to myopia management or a seasoned practitioner, the Navigator can enhance your approach and elevate the care you provide.

You can use the Myopia Management Navigator 

In honor of the Myopia Management Navigator’s 1-year anniversary, Dr Tucker shares clinical insights, practical tips, and business opportunities for optometrists looking to expand their scope and elevate patient care through evidence-based myopia management.

Empowering optometrists to take hold of myopia management

Following a discussion on low-dose atropine, Paul Karpecki, OD, FAAO, shares his views on what the future of myopia management looks like.

Looking to the future of myopia management: Taking a multifaceted approach

 is evolving rapidly, with growing global awareness and an increasing arsenal of treatment options. In a recent discussion on the 

FDA's acceptance of Sydnexis's NDA submission for SYD-101

, a non-compounded atropine drop indicated for myopia, Paul Karpecki, OD, FAAO, emphasized how the perception of myopia has shifted—from a benign refractive error to a serious medical condition with long-term ocular health implications.

This transformation has been fueled by a wealth of research and advocacy. In 2024 alone, key institutions such as the American Academy of Ophthalmology, the American Optometric Association, UC Berkeley, the National Eye Institute, and Prevent Blindness released consensus reports reinforcing the significance of myopia as a public health concern. Over 1,000 studies support these findings, particularly regarding the risks associated with axial length elongation.

Epidemiological trends underscore the urgency: one in three children worldwide is now myopic, a figure that aligns with Brien Holden’s now-validated projections for 2050. Myopia’s associated risks are stark. Individuals with -6.00 D of myopia are 41 times more likely to develop myopic maculopathy, 22 times more likely to suffer a retinal detachment, and 14 times more likely to develop glaucoma. Even low myopes (-2.00 D and above) face a 10-fold increased risk of maculopathy.

The speaker highlighted the critical need for early detection and intervention, noting that myopia can often be predicted by age four. A cycloplegic refraction showing +0.50 D at that age may indicate a trajectory toward high myopia, while +1.00 to +2.00 D is considered safer.

Looking ahead, successful myopia management will depend on having a broad toolkit. This includes pharmaceutical options like the Sydnexis low-dose atropine formulation, which offers a practical, non-invasive treatment ideal for younger children. The convenience of nighttime instillation enhances compliance, particularly for families with young, pre-verbal children.

Other modalities—orthokeratology, myopia-control spectacles, and combination therapies—will continue to play essential roles. Treatment plans should be tailored based on the child's age, degree of progression, and family motivation. If a single intervention fails to sufficiently slow progression, a multi-pronged strategy may be required.

Ultimately, the future of myopia management lies in personalized care supported by ongoing research, parental engagement, and a growing array of therapeutic options.

Melissa Barnett, OD, FAAO, FSLS, FBCLA, discusses keratoconus management, diagnosis, and other key insights at CRU 2025.

Prioritizing early diagnosis of keratoconus

Melissa Barnett, OD, FAAO, FSLS, FBCLA, director of optometry at University of California Davis, discusses keratoconus diagnosis, management, and key insights in a presentation given alongside John D. Gelles, OD, FIAO, FCLSA, FSLS, FBCLA, at CRU 2025. In an interview with 

she emphasizes early detection as critical for effective treatment.

Can diagnose keratoconus without advanced equipment

Use indicators like: - Retinoscopy - Vision changes - Increased astigmatism - Differences between auto refraction and refractive astigmatism

Advanced techniques include corneal topography and tomography

Crucial for halting keratoconus progression

Prevents vision loss and potential corneal transplant

Especially important before pregnancy, as cornea changes during this period

Progresses more rapidly in younger populations

More aggressive progression compared to older patients

Provide educational materials for patients and parents

Barnett stresses the importance of understanding keratoconus, detecting it early, and utilizing available treatments to preserve vision and prevent progression. The focus is on comprehensive care, patient education, and leveraging both diagnostic techniques and treatment options to manage this corneal condition effectively.

Conference

CRU 2025: Prioritizing early diagnosis of keratoconus

Dr Paul Karpecki sits down to discuss Sydnexis's atropine formulation and what an FDA approval would mean for myopia management.

Inside the MOA of SYD-101, the potential first FDA-approved formulation of low-dose atropine

recent FDA acceptance of the new drug application for atropine 0.01% (SYD-101, Sydnexis)

 marks a significant milestone in the field of 

, and Paul Karpecki, OD, FAAO, clinical investigator of the STAR study. SYD-101 is a low-dose atropine formulation designed to slow the progression of myopia in children. The drug has completed Phase 3 pivotal trials (although the results have not been published yet), and the FDA has set a PDUFA (Prescription Drug User Fee Act) date for October 23, when a final approval decision will be made. If approved, SYD-101 will be the first FDA-approved therapeutic specifically for myopia progression.

One of the key differentiators of SYD-101 from traditionally compounded atropine is its stability. Atropine, as a molecule, tends to be unstable and acidic, which can lead to variability in compounded formulations. Research has shown significant inconsistencies in the concentration of compounded atropine, with variations depending on the manufacturer and the specific batch. These inconsistencies can impact the efficacy and safety of the treatment. In contrast, SYD-101 has been developed with a stabilized formulation to ensure consistency and effectiveness, which is a critical factor in gaining FDA approval.

The availability of an FDA-approved prescription atropine solution provides multiple advantages over compounded atropine. First, it allows for a standardized, reliable treatment option that parents can obtain through traditional pharmacy channels. Second, it opens the possibility of insurance coverage, which could make the treatment more accessible to a larger population. Given that myopia affects approximately 28 million children in the United States and carries long-term risks such as glaucoma and macular myopathy, the potential approval of SYD-101 represents a major advancement in myopia control.

In addition to its stability, the 0.01% formulation of SYD-101 is particularly noteworthy because it has been shown to be effective in slowing myopia progression while minimizing side effects. Higher concentrations of atropine, such as 0.05% or 0.5%, are associated with increased risks of visual disturbances, including glare and difficulty with near vision. The lower concentration in SYD-101 balances efficacy with a reduced likelihood of these adverse effects, making it a more tolerable option for pediatric patients.

The potential FDA approval of SYD-101 is an exciting development for eye care providers who are seeking reliable and standardized solutions for myopia management. By offering a prescription-based, stable, and effective treatment, this new therapeutic option has the potential to improve long-term visual outcomes for millions of children while addressing the significant challenges associated with compounded atropine. As the PDUFA date approaches, the optometry community will be watching closely, hopeful for the approval of this  treatment.

Paul Karpecki, OD, FAAO, sits down to discuss Sydnexis's atropine formulation and what an FDA approval would mean for myopia management.

Pediatrics

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