Abstract
Introduction: This work aimed to establish the largest UK and Ireland consensus on myopia management in children and young people (CYP).
Methods: A modified Delphi consensus was conducted with a panel of 34 optometrists and ophthalmologists with expertise in myopia management.
Results: Two rounds of voting took place and 131 statements were agreed, including that interventions should be discussed with parents/carers of all CYP who develop myopia before the age of 13 years, a recommendation for interventions to be publicly funded for those at risk of fast progression and high myopia, that intervention selection should take into account the CYP's hobbies and lifestyle and that additional training for eye care professionals should be available from non‐commercial sources. Topics for which published evidence is limited or lacking were areas of weaker or no consensus. Modern myopia management contact and spectacles are suitable first‐line treatments. The role and provision of low‐concentration atropine needs to be reviewed once marketing authorisations and funding decisions are in place. There is some evidence that a combination of low‐concentration atropine with an optical intervention can have an additive effect; further research is needed. Once an intervention is started, best practice is to monitor non‐cycloplegic axial length 6 monthly.
Conclusion: Research is needed to identify those at risk of progression, the long‐term effectiveness of individual and combined interventions, and when to discontinue treatment when myopia has stabilised. As further evidence continues to emerge, this consensus work will be repeated to ensure it remains relevant.
Methods: A modified Delphi consensus was conducted with a panel of 34 optometrists and ophthalmologists with expertise in myopia management.
Results: Two rounds of voting took place and 131 statements were agreed, including that interventions should be discussed with parents/carers of all CYP who develop myopia before the age of 13 years, a recommendation for interventions to be publicly funded for those at risk of fast progression and high myopia, that intervention selection should take into account the CYP's hobbies and lifestyle and that additional training for eye care professionals should be available from non‐commercial sources. Topics for which published evidence is limited or lacking were areas of weaker or no consensus. Modern myopia management contact and spectacles are suitable first‐line treatments. The role and provision of low‐concentration atropine needs to be reviewed once marketing authorisations and funding decisions are in place. There is some evidence that a combination of low‐concentration atropine with an optical intervention can have an additive effect; further research is needed. Once an intervention is started, best practice is to monitor non‐cycloplegic axial length 6 monthly.
Conclusion: Research is needed to identify those at risk of progression, the long‐term effectiveness of individual and combined interventions, and when to discontinue treatment when myopia has stabilised. As further evidence continues to emerge, this consensus work will be repeated to ensure it remains relevant.
| Original language | English |
|---|---|
| Journal | Ophthalmic and Physiological Optics |
| Early online date | 18 Sept 2024 |
| DOIs | |
| Publication status | Published online - 18 Sept 2024 |
Bibliographical note
Publisher Copyright:© 2024 The Author(s). Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.
Data Access Statement
Data will be made available upon request to the corresponding author.Keywords
- child
- myopia management
- adolescent
- myopia
- Delphi
