One of the biggest stories so far in 2019 is the development of the Myopia Task Force, a group of 14 optometrists that have been charged with taking on the alarming growth rate of myopia in the United States and worldwide with the backing Essilor. Studies have shown that by 2050, 50% of the world’s population will by myopic, and 10% will be highly myopic, with prescriptions over -5.00D.
On this podcast, we interviewed Dr. Moshe Mendeslon, one of the 14 doctors participating on the Myopia Task Force. Dr. Mendelson’s private practice, Silicone Valley Eye Physicians, has a strong focus on myopia management. He sees roughly 40 patients a day, and most of these visits are follow-ups assessing the success of myopia management treatment plans his patients are using.
Dr. Mendelson’s passion for myopia management began early in his career. Upon graduating from the UC Berkeley School of Optometry he went to work at an MD/OD refractive surgery center. During the course of his work, he felt he needed to offer an alternative option for patients that weren’t eligible for or interested in refractive surgery correction, so he began offering orthokeratology contact lenses. This niche specialty grew into a passion, and inspired the private practice and it’s focus on myopia management that he offers today.
With such a background, it’s no wonder that he was tapped by Essilor to participate in the newly formed Myopia Task Force. What are the goals of this committee, which also include such lauded influencers in our profession as Drs. Thomas Aller, David Anderson, Craig Brawley, Mark Bullimore, Alan Glazier, John Lahr, Maria Liu, Pamela Lowe, Pamela Miller, Yi Pang, Earl Smith, Long Tran, and David Trolio?
Goal 1: Develop a Recommended Protocol for Myopia Management
We have a multitude of peer review studies that show the efficacy of 3 different approaches to myopia management, including the ATOM 1 and ATOM 2 studies for atropine, the SMART Study for orthokeratology, and multiple studies on the efficacy of soft multifocal contact lenses. The research is there, but what’s missing is a universal protocol for doctors to reference on approaching myopia. The Myopia Task Force plans to help develop or endorse this protocol, as well as informed consent documents that explain risks and benefits for myopia management treatment options, and outline guidance for doctors for how often follow-ups are needed to assess successful myopia management in their patients.
Goal 2: Change the Mindset of ODs on How They Perceive and Treat Myopia
One of the biggest challenges faced in myopia management is the perception of optometrists in how they discuss and approach this condition. “80% of our OD colleagues do not prescribe or believe in myopia management,” Dr. Mendelson shares on the podcast. Most ODs view myopia as a refractive state that they prescribe single vision correction for year after year, even as changes take place. In most offices, a seven year-old with a -1.00D prescription gets glasses with a -1.00 corrective script. Dr. Mendelson would see this same seven year-old patient, but have a totally different mindset on what to do: he views a -1.00D seven year-old as a -7.00D seventeen year-old, and all the disease risks that are associated with a prescription that high. Because he views the patient from the perspective of what their final, adult prescription will most likely be and what that will mean for that child’s life as an adult, he takes a completely different approach in treating that patient when they are still just a -1.00D seven year-old. This is the change in mindset he wants to see happen in optometry, to get all doctors thinking about the long-term repercussions of the childhood prescriptions sitting in their chair.
How does he see us being able to change the average doctor’s perception of myopia?
It all starts with education. He wants to bring doctors that are practicing more tools and education to understand what is happening and why they should care, but also get more involved in optometry schools and change the curriculum to show more focus on myopia intervention. Some schools are offering classes in myopia management, but he’d like to see courses dedicated to myopia management universally at all optometry schools and for the topic to be a strong focus of the training the next generation of ODs receives.
Goal 3: Educate the Public Directly
Changing doctors’ prescribing philosophies will happen much more quickly if patients know that solutions for myopia progression exist, and come in asking their doctors for this type of treatment plan. The Myopia Task Force is focused on developing creative solutions to get the public more aware of what we as doctors can do to help.
In the past few months, Essilor launched the educational short film, “Out of Focus” showing what a day in the life of a myopic child would look like. This promotion was shown nationwide in movie theatres before feature films and is still being promoted on social media channels to drive awareness.
Educating the public can also happen directly from the exam chair. In Dr. Mendelson’s office, he uses the Brien Holden Institute Myopia Calculator to educate patients and parents about the available treatment options for myopia, and what will happen to their vision if we do nothing.
He also educates medical colleagues in his community to help get the word out to a broader patient base. Dr. Mendelson sends letters to pediatricians about myopia management which include research studies. He also sends them follow-up notes from the patients they share after each visit, proving the efficacy of his treatment. In Dr. Mendelson’s community, he’s seen a noted movement of MDs and pediatricians starting to embrace myopia management, and some pediatricians are even prescribing atropine based on the ATOM 1 and 2 studies.
A big hurdle to public education? Dr. Mendelson agrees we must get FDA approval for treatment strategies for myopia management, and this is the advantage of Essilor’s involvement in his opinion. Having such a strong industry backer gives optometry the resources to get studies published with the goal of FDA approval and acceptance of myopia management across medical healthcare. He believes that if we can demonstrate to the FDA we are controlling axial length with myopia management treatments, he thinks we can win this battle.
You can learn more about the launch of Essilor’s Myopia Task Force and the doctors involved in making this movement happen by checking out this interview panel from the recent Essilor National Sales Meeting!