Essilor forms task force to combat rise of myopia

Myopia task force members at Essilor’s national sales meeting in early January. Back row: Dr. Moshe Mendelson, Dr. Thomas Aller, Dr. Mark Bullimore, Dr. Earl Smith, Dr. Ryan Parker, director of professional education at Essilor. Front row: Dr. Millicent Knight, Dr. Alan Glazier, Dr. Pam Lowe, Dr. Yi Pang, Dr. Pam Miller, Dr. Long Tran.

Phoenix-Essilor looks to establish a recommended protocol for treating and managing myopia by partnering with 14 ODs on a task force.

The company announced its Myopia Initiative in Action (MIA) at its national sales meeting in early January.

“The rate at which the prevalence of myopia is increasing is staggering,” says Millicent Knight, OD, FAAO, FAARM, senior vice president of customer development at Essilor of America.

“True to our mission of improving lives by improving sight,” she says, “we are bringing together some of the industry’s top eyecare professionals with diverse areas of myopia interest and expertise to address this problem together through new research and open collaboration.”

Related: Know the legal aspects of myopia control

By 2050, almost 50 percent of the world’s population will be myopic without action to prevent it, and almost 10 percent of the world’s population will suffer from high myopia (≤-5.00 D).¹

Some 14 ODs are participating in the task force:
• Thomas Aller
• David Anderson
• Craig Brawley
• Mark Bullimore
• Alan Glazier
• John Lahr
• Maria Liu
• Pamela Lowe
• Moshe Mendelson
• Pamela Miller
• Yi Pang
• Earl Smith
• Long Tran
• David Troilo

Nine task force members participated in a Q&A session at a press event during Essilor’s national sales meeting.

Myopia is growing at an alarming rate. What made you take bigger interest?
Dr. Miller: Within the last few years, I have noticed an alarming increase in the number of myopic patients, especially young people. There is a fear that children will have increased problems, such as blindness.

Dr. Glazier: I’ve always taken refractive and developmental impact in mind with myopic patients. The most impactful was peer-reviewed research. The most compelling thing for me was data that showed that for every diopter of myopia, children are at greater risk for health problems.²

It’s not about prescribing, it’s about keeping them healthy for the rest of their lives.

What direction would you like to see profession take?Dr. Smith: It is critical to promote the incorporation of current strategies to slow the progression of myopia in practice. Research has showed that a number of different strategies are successful in slowing progression of myopia in children. By slowing progression of myopia, it is likely that we can reduce the potential for blinding conditions associated with myopia.³

This requires a paradigm shift in the practicing doctor’s office, and it takes a broad-scale effort. It will have positive long-term health impacts.

We have to do more to understand patient and treatment strategy variables that affect the efficacy of treatment. I’m convinced we can do a better job by individualizing treatment strategies. It will take a lot of effort to understand what will affect the impact of myopia in children. It requires a lot of people to be involved. We have to bring new products to the market.

What are key research takeaways?Dr. Pang: I was diagnosed with myopia when I was 7 years old. We have strong evidence that shows myopia can be slowed down in children.⁴ We need more eyecare practitioners actively managing myopia.

So far the most effective methods to slow down about 50 percent.⁵ I hope researchers can find ways to further slow myopia beyond 50 percent.

What can ODs do to stay up to date?Dr. Bullimore: We shouldn’t be just correcting the prescription today but thinking about the long-term visual welfare of that child or any patient. We are getting more into preventative care, and myopia is one important aspect of that.

Now we have atropine, spectacle lenses, overnight ortho-k. We have options. As practitioners, it’s our role to tailor those to our individual patients.

Related: Treating and diagnosing myopia

I’m an academic and a researcher, but I’m still a closet clinician. It’s important to get therapies into the marketplace but also for doctors to discuss with parents.

The risk of macular disease is substantially reduced with less myopia.⁶ If we can lower myopia from 1.00 D, we can lower the risk of macular myopia by 40 percent.^7-11 This is huge. It’s a lifetime benefit.

How does the rise of myopia affect patients?Dr. Aller: Patients are getting more concerned. Some come in knowing what they want, and some know more than some of my colleagues because they have done a lot of research. It’s an opportunity and an obligation to the profession for us to help patients however we can.

How are parents of myopic children affected?Dr. Tran: Parents have a feeling of helplessness. It’s important that we provide them with education and treatment options to improve quality of life of young patients.

What do your eyecare colleagues think about treating myopia medically vs. refractively?Dr. Tran: The sentiment is that this is a reactive type of treatment due to a prescription change. The mindset isn’t there that we should be treating myopia proactively.

How can industry help?Dr. Lowe: The challenge for any industry is to find its why, then how to articulate it. Myopia affects just about every family.12 Sadly, when you poll patients across America, they don’t know when to seek care.13 Myopia is going to be the fluoride to eye care. Patients know to see the dentist twice a year; they don’t know how often to have their eyes checked.

When an informed patient seeks care, I can educate him. It empowers me to use technologies in my office to diagnose or treat. It raises the bar for all industry partners. Industry benefits from that, but mainly our patients benefit from it.

Related: Examining 7 options to control myopia

Dr. Mendelson: We know myopia is progressing, and we know its consequences. It would be wonderful to control the trajectory of a young patient in my chair to keep him below -5.00 D from a public health perspective.

Why now to champion myopia control?Dr. Tran: Research shows that activities affect myopia. For example, digital device usage, not as much outdoor time.14
Dr. Mendelson: Look at China. Children are encouraged to study more, and myopia has increased dramatically.15
Dr. Miller: I see many parents with a child still in a stroller with a video game or device. We’re losing the ability to use imagination as well as moving more toward blindness.

What is the gold standard for treating myopia?Dr. Mendelson: It’s the objective of MIA to determine. Not one method works for everyone.
Dr. Glazier: Right now there are three methods with research.16 ECPs will choose based on the child’s age, family income, abilities, or other factors.
Dr. Aller: Practically every child who is a myope is going to be worse next year unless you do something.17
Dr. Pang: Illinois College of Optometry has myopia clinic. We have a protocol there to follow to treat the patient individually.
Dr. Knight: We are developing something for a child’s future. Very few parents are going to say no, I don’t want what is best for my child. We need to move away from thinking about how people will afford it and more toward being the doctor.

Related: Myopia and public health

Closing thoughtsDr. Tran: We have the opportunity to change the lives of many young patients we see on a daily basis.
Dr. Smith: You spend all your life in a lab hoping to have an effect on patients’ lives. This is the first time in my career where I think my work will have a practical significant impact.
Dr. Pang: We need to help our children and myopic patients. Take action now.
Dr. Miller: We have an incredible opportunity ahead of us. It brings us back to the roots of the profession of optometry to help patients. We need to work as a team to educate colleagues and patients.
Dr. Mendelson: Most of my colleagues view myopia as a refractive error, not a disease. If we can educate our colleagues about the consequences of myopia, they will take myopia more seriously.
Dr. Lowe: I’m looking forward to changing patients’ thoughts about myopia.
Dr. Glazier: I want to impact lives not only refractively but also on the health side.
Dr. Bullimore: Take care of your patients long term. Be part of a broader healthcare message. We have such a great opportunity here.
Dr. Aller: Myopia is beginning earlier, progressing more rapidly, and over a longer period of time. It’s a massive opportunity to do something about it now. It’s a professional obligation to do what you can.

Read more by Gretchyn M. Bailey

References:

1. Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016 May;123(5):1036-42.
2. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012 Nov;31(6):622-60.
3. Walline JJ, Lindsley K, Vedula SS, Cotter SA, Mutti DO, Twelker JD. Interventions to slow progression of myopia in children. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD004916.
4. Smith MJ, Walline JJ. Controlling myopia progression in children and adolescents. Adolesc Health Med Ther. 2015 Aug 13;6:133-40.
5. Cho P, Cheung SW. Retardation of myopia in orthokeratology (ROMIO) study: a two-year randomized clinical trial. Invest Ophthalmol Vis Sci. 2012 Oct 11;53(11):7077-85.
6. Holden B, Sankaridurg P, Smith E, Aller T, Jong M, He M. Myopia, an underrated global challenge to vision: where the current data takes us on myopia control. Eye (London). 2014 Feb;28(2):142-6.
7. Vongphanit J, Mitchell P, Wang JJ. Prevalence and progression of myopic retinopathy in an older population. Ophthalmology. 2002 Apr;109(4):704-11.
8. Liu HH, Xu L, Wang YX, Wang S, You QS, Jonas JB. Prevalence and progression of myopic retinopathy in Chinese adults: the Beijing Eye Study. Ophthalmology. 2010 Sep;117(9):1763-8.
9. Gao LQ, Liu W, Liang YB, Zhang F, Wang JJ, Peng Y, Wong TY, Wang NL, Mitchell P, Friedman DS. Prevalence and characteristics of myopic retinopathy in a rural Chinese adult population: the Handan Eye Study. Arch Ophthalmol. 2011 Sep;129(9):1199-204.
10. Asakuma T, Yasuda M, Ninomiya T, Noda Y, Arakawa S, Hashimoto S, Ohno-Matsui K, Kiyohara Y, Ishibashi T. Prevalence and risk factors for myopic retinopathy in a Japanese population: the Hisayama Study. Ophthalmology. 2012 Sep;119(9):1760-5.
11. Choudhury F, Meuer SM, Klein R, Wang D3, Torres M3, Jiang X1, McKean-Cowdin R1, Varma R4; Chinese American Eye Study Group. Prevalence and Characteristics of Myopic Degeneration in an Adult Chinese American Population: The Chinese American Eye Study. Am J Ophthalmol. 2018 Mar;187:34-42.
12. Liang CL, Yen E, Su JY, Liu C, Chang TY, Park N, Wu MJ, Lee S, Flynn JT, Juo SH. Impact of family history of high myopia on level and onset of myopia. Invest Ophthalmol Vis Sci. 2004 Oct;45(10):3446-52.
13. Willis JR, Vitale S, Morse L, Parke DW III, Rich WL, Lum F, Cantrell RA. The prevalence of myopic choroidal neovascularization in the United States. Opthalmology. 2016 Aug;123(8): 1771-1782.
14. Ku PW, Steptoe A, Lai YJ, Hu HY, Chu D, Yen YF, Liao Y, Chen LJ. The Associations between Near Visual Activity and Incident Myopia in Children: A Nationwide 4-Year Follow-up Study. Ophthalmology. 2018 Jun 19. pii: S0161-6420(17)33464-4.
15. Chen M, Wu A, Zhang L, Wang W, Chen X, Yu Z, Wang K. The increasing prevalence of myopia and high myopia among high school students in Fenghua city, eastern China: a 15-year population-based survey. BMC Ophthalmol. 2018 Jul 3;18(1):159.
16. Walline JJ. Myopia Control: A Review. Eye Contact Lens. 2016 Jan;42(1):3-8.
17. Vitale S, Sperduto RD, Ferris FL III. Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Arch Ophthalmol. 2009 Dec;127(12):1632-9.