Objective:

To discuss the current knowledge and gaps in myopia management, including ideal candidates, treatment efficacy, success gauging, and the challenges of adult myopia management due to limited research.

Approach:

• Presentation Overview: Drs. Paul Gifford and Jeanne Saw presented at the 2026 AAO meeting, highlighting knowns and unknowns in myopia management.
• Treatment Parameters: They reviewed age and refraction parameters for various myopia control treatments, including spectacles, contact lenses, atropine, and orthokeratology.
• Efficacy Comparison: The presenters discussed methods to compare treatment efficacy using absolute reduction in axial elongation, diopter thresholds, and percentage outcomes.
• Adult Myopia Insights: They provided data on adult-onset myopia, its prevalence, and the challenges in managing this demographic due to lack of RCT data.

Key Findings:

• Atropine is effective for younger children and higher myopia; orthokeratology shows efficacy for higher myopia, astigmatism, and anisometropia.
• Most treatments appear to have similar efficacy, but few direct comparisons exist in the literature.
• Adult-onset myopia is common, with significant progression observed in young adults, particularly in their 20s.

Interpretation:

Determining the suitability and efficacy of myopia control treatments for individual patients remains challenging, with various metrics for treatment outcomes discussed in the presentation.

Limitations:

• Limited RCT data for adult myopia management.
• Few studies comparing different myopia control interventions.
• Challenges in adjusting treatment goals based on individual patient characteristics.

Conclusion:

The presentation emphasized the need for evidence-based myopia management as standard care while acknowledging significant gaps in current research.

Sources:

• American Academy of Optometry