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    Fast forward 10 years: How will we treat myopia?

    Liverpool, UK—The British Contact Lens Association meeting features several panel discussion on a theme. Topics included a look into the future for managing myopia and contact lens discomfort. In addition, improve the success of your multifocal contact lens fits with expert suggestions.

    Related: Myopia and public health

    Panel roundups

    Myopia

    Professor Brien Holden, BAppSc, PhD, DSc, chief executive officer of the Brien Holden Vision Institute, says that that in 10 years, optometrists will be in the myopia management business. He posed this question to the panel:

    What do you think will be the best combination in 10 years’ time being delivered by optometry?

    Professor James Wolffsohn: I suspect it will be a contact lens with myopia-controlling optics, but with a drug release as well. If you push any one treatment to the extreme, it presents side effects which are undesirable. Having multiple type of treatments in lower doses will be desirable.

    Dr. Noel Brennan: There will be multiple options—contact lenses but nothing that looks like what we’re using today; drugs but nothing that looks like what we’re using today; indoor lighting that captures what we’re missing from the environment. We’ll use all of these in some way.

    Dr. Kate Gifford: We’re going to have things available that we don’t know about now. I don’t think we’re going to have any one panacea, and we will need to have multiple options.

    Dr. Pauline Cho: We did a survey asking patients if ortho-k, contact lenses, and glasses show the same effect, which one would they choose. More than 50 percent chose ortho-k. Some chose spectacles plus contact lenses. Patients do want options.

    Dr. Holden: Why aren’t companies pushing it in the marketplace?

    Dr. Cho: Patients look to ortho-k as a very successful treatment. But with glasses, you don’t see the effect right away. It may take years.

    Shelly Bansal: We will see a semi-rigid daily disposable overnight ortho-k lens. You get all the benefits from each modality.

    Dr. Ian Flitcroft: My wish list is that we’ll have a fully informed population with supportive politicians and algorithms identifying which kids are at risk. We will see them and measure axial lengths. We’ll hit them with drugs first, then get them into contact lens designs.

    Dr. Nicola Logan: A tailored approach to each particular child and a contact lens with a drug delivery system. You may not need to wear the lens every day. Do it, then stop, then try something else. Do short bursts of treatments. Keep a changing approach.

    Dr. Janis Orr: A more tailored approach, including getting kids outside, pharmaceutical delivery and myopia control lenses.

    Dr. Loretta Szczotka-Flynn: I’d be interested in genetic testing to individualize and determine if I should use a multifocal contact lens or drugs. Ten years might not be long enough for this to come to pass.

    Patrick Caroline: Hopefully we’ll have clarity. Right now we have three different approaches. We need clarify why these strategies all seem to influence the myopia story. Until we get choroidal clarity on what’s happening with optical defocus and these other techniques, we won’t understand it. We know these treatments work, but we don’t know why they work.

    Dr. Holden: It is absolutely essential that any child who is young and myopic is fitted with contact lenses that will bring the center forward.

    Related: Brien Holden on contact lens myopia management

    1 Comment

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    • JamesJordan
      I think Pat Caroline said it best, we don't know. So it's just guessing right now and that's not very scientific. The other question is what will it matter to control myopia without citing the generalities of diseases that have been associated with myopia which are also poorly understood.

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