Approach to Myopia Management

The article presents a thorough and structured examination of myopia, emphasizing its rapid rise as a global public health issue, especially in children and adolescents. It begins by highlighting epidemiological data that forecast a dramatic increase in the prevalence of myopia, with projections estimating that nearly half of the world’s population will be affected by 2050. The concern extends beyond refractive error, as high myopia significantly increases the risk of vision- threatening conditions such as retinal detachment, myopic maculopathy, glaucoma, and cataract formation. Consequently, the focus of modern clinical practice has shifted from simple visual correction to proactive, evidence-based myopia management aimed at slowing axial elongation of the eye.

The article explores the key concept of “mindset”, referring to the cognitive framework through which individuals perceive their abilities and challenges. Drawing from Carol Dweck’s theory, it distinguishes between the fixed mindset, which assumes abilities are innate and unchangeable, and the growth mindset, which views effort and learning as central to development. This psychological dimension is integrated into the clinical context, emphasizing that the mindset of both the clinician and the patient can significantly influence therapeutic success— encouraging holistic engagement, motivation, and compliance.

Scientifically validated myopia control strategies are extensively discussed. These include low- concentration atropine eye drops (notably 0.01–0.05%), specially designed peripheral defocus spectacle lenses (such as DIMS, HAL, and CARE technologies), multifocal soft contact lenses with varying addition powers, orthokeratology (Ortho-K), and extended depth-of-focus (EDOF) lenses. The article highlights

the importance of a personalized approach, starting with a comprehensive examination typically at age six. This assessment should incorporate cycloplegic and non-cycloplegic refraction, binocular vision evaluation, and axial length measurement, which is considered a key metric in monitoring myopia progression.

Equally important is the structure of the care delivery model, which involves collaboration among ophthalmologists, optometrists, opticians, pharmaceutical partners, and academic institutions. Patient interviews are stressed as crucial, as they help align treatment with lifestyle needs and individual expectations, ensuring higher adherence and satisfaction.

Furthermore, the article reviews recent clinical studies supporting the superiority of combination therapies—such as atropine with DIMS or Ortho-K lenses—over monotherapies. It also introduces emerging technologies, including DOT (Diffusion Optics Technology) lenses designed around contrast manipulation, and the Repeated Low-Level Red Light (RLRL) therapy, while noting the need for further research into their long-term safety and efficacy.

In conclusion, the article underscores that effective myopia management is inherently multifactorial and patient-centered, demanding both scientific precision and empathetic communication. Genetics, environmental factors (such as near work and time spent outdoors), binocular vision status, and patient motivation all influence treatment outcomes. Therefore, the best treatment is not merely the most advanced, but the one that is most compatible with the patient’s lifestyle and is used consistently. This integrative, strategic approach not only addresses the clinical dimension of myopia but also reflects a broader vision of sustainable ocular health in the modern world.