When it comes to myopia …..
I sometimes ask who is the more short-sighted! Our myopic patients or us as the profession of UK Primary Eye Care providers, who surely by now have seen enough information on the subject of myopia progression control/management to understand for the majority of our young myopic patients where their adult prescription ends up is not written in stone.
Alongside the understanding that the future course of myopic progression for our patients may well bring serious pathology and reduction in the quality of life should be a realisation that we have opportunities to alter the course of the disease (yes, myopia can be classed as such) and enhance visual wellbeing in their adult years.
You may have noticed I talked about “the profession of Primary Eye Care Providers” as I don’t believe we, as individuals, deliberately hide our knowledge and expertise, deciding this patient/patient’s responsible adult is not capable of understanding the subject, or we being part of one of the world’s best undergraduate and post-graduate eye care education systems, take pleasure in prescribing/dispensing the most simple basic visual correction in the shortest possible time with every patient.
No, it’s the system! I actually think the UK NHS eye care system in the form of the General Ophthalmic Service and its influence on eye care practice is in 2020 constraining us as individuals from being able to provide better care, education and recommendations to our patients. The horrible irony is that a system the world envied in the middle of the last century, when it comes to the ocular and economic health of individuals and society in the years to come will be causing unintended adverse consequences.
Somehow we need to replicate the changes we made in patient education, so that just as now progressive, photochromic and coated spectacle lenses are thought of as mainstream and OCT imaging is almost an ‘opt-out’ in practices, to the discussion about myopia progression management.
Therefore if setting-up a myopia management clinic is too big a step to take currently, or are wary of appearing to sell particular products, let’s at least commit to no paediatric myope and his/her responsible adult leaving our practices in 2020 unaware of basic advice on specific outdoor time, near work time and distance limits. Let’s find written information that can be handed out and document advice given in the exam room, or a note to the (never so vital) DO on the hand-over so they will fulfil that obligation and they document it.
This is the least we can do, it is evidence based, will convey the care we undoubtedly feel, but don’t always have time to communicate and avoid a lot of very awkward questions from our patients in the years to come.
– Andrew D Price FBDO (Hons) CL MBCLA COA, CEO – The ADP Consultancy
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