Modernising Eyecare Practice in the Assessment and Management of Paediatric Myopia (Short-sight)

Myopia is an eye disorder that presents as blurred distance vision due to elongation of the eye, with the visual deficit commonly corrected using spectacles or contact lenses. Myopia is a progressive condition characterised by ongoing and excessive eye growth through childhood, which makes the eye vulnerable to sight-threatening pathology in later life. The larger the eye grows, the higher the levels of myopia and the greater the incidence of eye disease and sight loss. Factors which promote excessive eye growth include genetics, age and environment. Our research has shown that modern environments and lifestyles are promoting the onset and progression of myopia in UK children; myopia is twice as common in school-aged children in the UK compared to 50 years ago, with children becoming myopic at a younger age. Evidence is available to support lifestyle modifications which successfully delay myopia onset and once children are myopic ‘myopia control’ treatments designed to retard myopia progression are available. However, challenges for eyecare practitioners (ECPs) when implementing interventions include identifying those most at risk of myopia and its progression, monitoring how myopic children’s eye growth compares to ‘normal eye growth’ and measuring treatment efficacy in individual patients. The NHS does not currently fund myopia control interventions and aside from manufacturers’ product-specific information there are few independent resources directed at supporting patients and parents in understanding the risks of myopia and empowering them to act in controlling myopia. The applicants have recently launched the Predicting Myopia Onset and progression (PreMO), a free web-based app for ECPs. The PreMO risk indicator was derived using data from the Northern Ireland Childhood Errors of Refraction (NICER) Study with the algorithm evaluated against data from a mixed ethnicity cohort of children living in the UK and clinical data from children living in Hong Kong. The app provides practitioners with a clinical decision-making tool allowing calculation of a child’s risk of becoming myopic, and monitoring of refractive change and axial elongation against age-matched norms. PreMO generates tailored, bespoke information for patients and parents/carers to empower patients and advance individualised care. As such, the PreMO aligns with the third ISPF theme in supporting ‘Healthy People, Animals and Plants’. A national ECP research consortium (UK Myopia Consortium) has adopted PreMO to develop a UK-wide database to collect real-world data on clinical trends in childhood myopia progression to reveal the efficacy of interventions designed to slow myopia onset and progression. The uptake, success, and impact of PreMO will require wide-spread dissemination targeted at ECPs managing paediatric patients within primary care. Industry sponsorship has been secured to cover initial software development and gain industry buy-in. To date, PreMO has been promoted and targeted towards practitioners based in the UK. To further promote PreMO - optimising reach and impact - we seek funding to employ a Research Associate to engage potential collaborators and ECPs within Europe and worldwide. The applicants have secured £4000 to employ a Research Associate 0.2WTE during the period February – June 2024 to focus on promotion of the PreMO within the UK. Additional funding would allow the same or an additional Research Associate to focus on the European and worldwide audience for further collaboration and uptake by ECPs. The Research Associate will collaborate with the app developers from Wolffsohn Research to coordinate relevant approvals and releases for European and international users. They will also coordinate promotion at upcoming international conferences and events at which the target audience will be in attendance, including preparation and submission of an abstract for presentation at the International Myopia Conference 2024. This activity complements online webinars, blogs and professional presentations which have already been implemented. Baseline and follow-up metrics will measure the impact of PreMO on ECP activity and confidence and on parent and patient knowledge. Widespread uptake will generate a unique, large-scale database of eye data to further optimise a stratified approach to myopia management. Furthermore, the data will provide a rich, novel evidence-base for policy makers both in the UK and further afield