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How does one make myopia control mainstream? Join renowned optometrist, Dr. David Kading, as he deeply delves into myopia control’s impact on vision. In this podcast, Dr. Kading discusses how myopia affects our eyesight, revealing eye-opening insights that shed light on this concern. Gain a fresh perspective on myopia’s consequences and its pivotal role in shaping our vision.
Key Objectives
What is Myopia (Nearsightedness)?
Dr. Darryl Glover:
Today, I’d like to delve deep into the subject of myopia. Let’s start from the very beginning. Many people hear this term but don’t truly understand what it means. Could you explain it from the basics, and then we’ll evolve the discussion from there?
Dr. David Kading:
Certainly, most of us are familiar with myopia as nearsightedness. However, the complexity of myopia goes beyond just a refractive error. In optometry school, that’s primarily how it was presented. However, the truth is that it’s a progressive condition, more aptly described as a disease.
Indeed, it’s chronic and progressive, leading to tissue degradation. We can’t just see it as a condition causing blurry vision, although that is a symptom. Myopia is a disease-causing eyeball elongation, leading to reduced vision, progressive vision loss, and a heightened risk of other diseases. We often notice this as increasing prescriptions. The real challenge in eye care becomes evident in the long term, based on the choices made throughout life, akin to conditions like diabetes. And it’s preventable with myopia control. All we need to do is take the proper steps.
Myopia is a Public Health Crisis and Epidemic
Dr. Darryl Glover:
One point you emphasized, which I hope everyone grasps, is referring to it as a “disease.” This term changes the narrative significantly. It’s not merely a refractive error; it’s a disease. This shift in perspective should prompt everyone to ask: “What can I do about this? What is myopia control? Educate me more.” Moving forward, I’d like to understand why eye care professionals should prioritize discussing myopia. Recognizing it as a disease should make this conversation mandatory in every eye exam.
Dr. David Kading:
To provide some context with numbers: In Singapore, 75% of the population is myopic. In Hong Kong, it’s 80%. In mainland China, it’s around 90%, and in South Korea, a staggering 97%. In the United States, the figure is approaching 50%.
Think about the implications. China views this as a significant concern, even for their military’s future. They may soon lack eligible fighter pilots if current trends persist. With half of our population potentially having a doubled risk or even more, we’re on the cusp of a refractive crisis.
Beyond just the practitioner’s perspective, consider the patients. It’s not always about instilling fear, but about understanding the real-world impact. Think of a child with a considerable refractive error. They can’t identify friends across a swimming pool. This affects the quality of life – in sports, music, and general interactions. And this is just general myopia, not even touching upon high myopia.
Myopia Control/Management Instruments and Solutions
Dr. Darryl Glover:
Having touched on myopia’s impact, how can we bring this discussion to the forefront? How can we make myopia control more engaging? Our eye care professionals need to understand the importance of and engage in this conversation sincerely.
Dr. David Kading:
It really boils down to belief. If you’re skeptical, you won’t address it. But if you genuinely understand the issue, it becomes unavoidable. We’ve observed this problem intensify over time. In my mentor’s museum in Oregon, which houses eyeglasses from centuries ago, there aren’t any glasses for myopic corrections—only hyperopic. This indicates how the prevalence of myopia has surged in recent times. Particularly during the pandemic, we’ve noticed a significant uptick, both in your practice and mine.
To mainstream myopia discussions, we must first recognize its magnitude. And the good news? The solution isn’t as complex as we might think. Consider instruments available now, like the Oculus Myopia Master or the Maya Topcon. They offer various functionalities. When investing in a new instrument, choose one with axial length measurements. Just as we adapted to OCTs for glaucoma, integrating these tools will set your practice apart and reinforce your understanding.
Moreover, addressing myopia doesn’t have to be intricate. For instance, do you fit multifocal contact lenses? Orthokeratology is nearly as straightforward. Some studies even suggest an 80-90% success rate with the initial two lenses—a figure that surpasses my success rate with soft multifocals.
We need to change our mindset. Myopia management isn’t solely about vision correction. Take atropine as an example; it’s not about perfect vision. If we stick to the notion of “perfect vision,” we’ll miss the point. It’s essential to realize that some treatments might compromise vision clarity slightly. It’s about managing expectations. For instance, I consider it a win when I achieve 20/30 vision with myopia management using ortho K or a soft multifocal. We must focus on slowing down myopia (myopia control) progression rather than refining the prescription.
What are the Best Resources for Myopia Control?
Dr. Darryl Glover:
Given this insight, could you share some resources that might help our peers better understand and incorporate these practices?
Dr. David Kading:
I host the “Myopia Podcast,” available wherever podcasts are found. We recently celebrated our second anniversary, which was birthed from my longing to discuss myopia with experts during the pandemic. I also have another older podcast, “The O.I. Show,” focused on general optometry. The myopia discussions originated there, and it was driven by my passion to understand the topic better and share that knowledge. Through these podcasts, we’ve discussed various aspects of myopia management with over 60 episodes featuring researchers, clinicians, and industry specialists.
Soon, we’ll be launching “TheMyopiaWebsite.com” which will be an invaluable resource. Furthermore, we’re introducing the “Myopia Newsletter.” A tool I frequently recommend is the Brian Holden Vision Institute’s myopia calculator. Every optometrist manages myopia in one way or another. By presenting the projections of this calculator to parents, we can provide insight into their child’s myopia progression, making a profound impact.
Other resources include the Hoot, which helps educate practitioners and parents on myopia management, and I’m also affiliated with Treehouse Eyes. They aim to enhance myopia control/management practices, train staff, and provide comprehensive resources for professionals and patients.
Dr. David Kading’s Vision for the Future
Dr. Darryl Glover:
David, considering your vast contributions to optometry, when the time comes for you to retire, how do you want to be remembered in this profession?
Dr. David Kading:
At my core, I’d love to be remembered for my generosity. My faith in Jesus and my role as a father and a husband are paramount to me. Professionally, I aspire to uplift and inspire others to realize their potential and equip them with the tools to achieve it. My consulting work embodies this essence, pushing individuals to recognize that they can aspire for more and aiding them on their journey.
Are you currently providing myopia control services in your practice? If so, can you share what these services entail? Additionally, if you happen to know of any great guests who would be interested in appearing on our show, please don’t hesitate to reach out to us at defocusmedia@gmail.com with your recommendations.
