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Practice patterns to decrease myopia progression differ among paediatric ophthalmologists around the world
  1. Ari Leshno1,2,
  2. Sonal K Farzavandi3,
  3. Rosario Gomez-de-Liaño4,
  4. Derek T Sprunger5,
  5. Tamara Wygnanski-Jaffe1,2,
  6. Eedy Mezer6,7
  1. 1Ophthalmology, Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel
  2. 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  3. 3Ophthalmology, Singapore National Eye Centre, Singapore, Singapore
  4. 4Hospital Clínico/Instituto Castroviejo, Universidad Complutense de Madrid, Madrid, Comunidad de Madrid, Spain
  5. 5Department of Ophthalmology, Pediatric and Strabismus Section, Indiana University School of Medicine, Indianapolis, Indiana, USA
  6. 6Ophthalmology, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
  7. 7Ophthalmology, Bruce and Ruth Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
  1. Correspondence to Dr Eedy Mezer, Ophthalmology, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel; emezer{at}


Introduction Myopia is a worldwide epidemic. Plethora of treatments are offered to decrease myopia progression. In this study, we compared between different geographical areas worldwide the practice patterns used by paediatric ophthalmologists to decrease the progression of myopia.

Methods Global responses to a questionnaire were analysed (n=794) for demographic variations. Pharmacological, optical and behavioural categories were defined as effective or ineffective based on the current scientific peer reviewed literature.

Results Treatment rates varied significantly between geographical regions (mean 57%, range 39%–89%, p<0.001). Nearly all participants who treat myopia used at least one form of effective treatment, regardless of location (98%, p=0.16). Among those prescribing pharmacological treatments, European physicians offered the lowest rate of effective treatment compared with other regions (85% vs mean 97%). Rates of effective optical treatment varied significantly between locations (p<0.001), from 16% (Central-South America) to 56% (Far East). Most treating respondents advocated behavioural modifications (92%), between 87% (North America) and 100% (Central Asia). Nearly all respondents used combinations of treatment modalities (95%)—mostly pharmacological, optical and behavioural combination. However, combination rates varied significantly between regions (p<0.001).

Discussion The utility of treatment to decrease myopia progression differs significantly across the world both in type, combination and efficacy.

Conclusion Paediatric ophthalmologists involvement and proficiency in myopia progression treatment varies around the world. This may entail promoting continuous medical education and other incentives to increase the number and proficiency of paediatric ophthalmologist to have a more effective impact to control the myopia epidemic in children.

  • child health (paediatrics)
  • public health
  • treatment medical
  • optics and refraction
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  • TW-J and EM are joint senior authors.

  • Contributors AL wrote the statistical analysis plan, cleaned and analysed the data and drafted and revised the paper. T-WJ initiated the project, designed data collection tools and revised the paper. SKF, designed data collection tools and revised the paper. RG designed data collection tools and revised the paper. DTS initiated the project, designed data collection tools and revised the paper. EM initiated the project, designed data collection tools, analysed the data and drafted and revised the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Sheba Medical Center Institutional Board approval number 5227-18-SMC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

  • Author note TW-J and EM share senior authorship.

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