American Academy of Optometry version October 2019
We developed this world first, clinically focused infographic for the American Academy of Optometry (AAO) meeting in Orlando, Florida in late October 2019. In collaboration with the Centre for Ocular Research and Education (CORE), University of Waterloo, Canada - who printed them, big thanks! - and the AAO Fellows Doing Research Special Interest Group (FDR SIG), we distributed these in the Exhibit Hall. If you've got one of these myopia management infographics in your hand, hot off the press, and are looking for the scientific basis of the information in front of you, you'll find this below. It is designed to support your clinical communication with parents (Side 1) as well as provide a reference for practitioner knowledge in clinical myopia management (Side 2).
Side 1 - Protecting Children from Myopia, is the parent-facing side to help you with clinical communication:
1️⃣ Visual Environment Advice - important for all pre-myopic and myopic kids (and any kids really!)
2️⃣ What Are My Options? A racing car analogy to explain myopia control efficacy
3️⃣ Kids Can Wear Contacts - the benefits of CL wear for kids and the simple message about safety
4️⃣ Why Management is Important - understanding the risks of myopia and benefits of myopia control for lifelong eye health.
There are three key, evidence based messages here.
Firstly that at least 90 minutes a day spent outdoors appears to delay onset, and while there is conjecture, may also help slow progression of myopia. To read more about this, check out our blog Why Outdoor Time Matters in Myopia Development.
Secondly, closer working distance (less than 20cm) and longer near work duration (continuously for more than 45 minutes) have been linked to myopia; read the research here. The 20/20 rule is a simple way to explain that regular breaks can benefit both visual stamina and refractive development - every 20 minutes take a break for 20 seconds and look across the room.
Finally, the recommendation for no more than 2 hours of screen time per day, at least 60 minutes of physical activity per day and not sitting for too long come from the recommendations of the American Academy of Pediatrics and Australian Government Department of Health.
Side 2 - Myopia Management in Practice, features practitioner-facing info for our clinical reference:
1️⃣ The Myopia Journey - risk factors for faster progression
2️⃣ What to Prescribe - a simplified flow chart based on our Clinical Decision Trees and available infographic on the website
3️⃣ Follow-up Schedules - a reference from the IMI Clinical Management Guidelines
4️⃣ Gauging Success - how to tell if your treatment is working in the long term, based on refraction and axial length.
This tile explains factors which lead to faster progression of childhood myopia. Firstly, earlier onset (before age 9) is likely to lead to faster progression and risk of high myopia. Additional factors which then 'fuel' the 'myopia car', in no particular order of effect, include a family history of myopia; less than 60-90 minutes a day spent outdoors; more than 2-3 hours a day, after school time, spent on nearwork; and specific binocular vision disorders. You can read more about these and review the scientific references in our blog Assessing Risk of Myopia Onset and Progression.
A full literature review article written by Kate Gifford in professional journal Contact Lens Spectrum also provides all of these references and more, entitled Preparing your Practice for the Myopia Stampede.
We are currently working on various versions of this double-sided infographic for specific world regions, and collaborating with local partners for distribution - if you didn't manage to grab one of these infographics or didn't attend AAO, watch the Myopia Profile Facebook group for updates on how you can get your own.
Distributed in Optometry Australia Pharma magazine September 2019
Optometry Australia's quarterly professional journal Pharma has published a special Myopia feature issue for September 2019 - link to the full PDF is available HERE. In conjunction with OA, we have developed this infographic to sit alongside and complement the BHVI Myopia Management Guidelines. The infographic is available to all members of Optometry Australia - a hard copy has been posted to you with your copy of Pharma.
The BHVI Guidelines feature the standard eye exam for myopia, risk factors for onset and progression, a list of available treatments, and follow up schedules. We aimed to fill in the gaps in translation to clinical practice with our Myopia Management in Practice infographic, with the following four key principles. Descriptions of each section of our infographic, and references to further reading, are below.
This section is a clear picture of the 'why' of myopia control. The odds ratios of increasing risk of pathology with increasing myopia - where '1' is the risk for an emmetrope - are presented, to help you have this conversation with parents and patients. To read more on this, check out our blog on The 'Why' of Myopia Control.
Every dioptre matters - right across the range of myopia, a new data analysis published recently by Mark Bullimore and Noel Brennan has shown that from 1D to 2D; from 2D to 3D; even from 6D to 7D there is an equally escalating risk of myopic maculopathy of 67%. This is serious stuff! So when we control myopia, reducing progression by 1D in total reduces risk of myopic macuopathy by 40%. This is another clear and important message for our patients and their parents.