Sophie Coverdale

Background/Objectives: Perceptions and barriers to myopia management (MM) in childhood have not been fully explored within some countries, including the UK, where there is minimal public health education on myopia. Methods: The aim of this mixed-methods study was to explore perceptions of myopia and MM interventions using focus groups and a survey to obtain qualitative and quantitative data. Topics included the understanding of myopia, perceptions of MM, considerations when initiating MM, lifestyle risk factors, and barriers to uptake of intervention. Results: Parent awareness and understanding of myopia and MM is limited. Many parents felt that they had not been provided with sufficient explicit advice about their child’s diagnosis or treatment. Despite this, parents were aware of some of the protective lifestyle behaviours which may slow myopia progression. The common belief was that myopia can affect a child’s quality of life. The most common reason that MM had been recommended to parents by practitioners was to reduce disease risk. Conclusions: The cost and lack of public awareness that MM interventions are available were the main barriers to the uptake of MM. There is a need to improve practitioner communication of myopia and its management and, subsequently, improve the standard of children’s eyecare.

Objective Many children with progressive myopia are still prescribed single-vision correction. An investigation into UK eyecare practitioners’ (ECPs) perceptions of myopia management was carried out to ascertain factors which may be limiting its implementation and uptake within clinical practice. Methods and analysis Online focus groups were held with UK ECPs. Participants were encouraged to discuss their knowledge of the available myopia management options, their perception of how myopia management is being delivered in the UK and any barriers limiting ECPs' prescribing of these management options in practice. The discussions were transcribed and analysed thematically. Results Focus groups were held with 41 ECPs from primary and secondary eyecare. ECPs felt that provision of myopia management in the UK is variable. Most ECPs believe they have sufficient knowledge, but felt a lack of confidence in decision-making and practical experience. Less experienced ECPs sought more definitive guidance to support their decision-making. ECPs desired clarity on their duty of care obligations and were concerned over possible future litigation if they had not offered, or referred for, myopia management when indicated. The greatest barrier appears to be financial—treatment is expensive and ECPs are uncomfortable communicating this to parents. Many barriers were indicative of systemic problems within UK eyecare, such as commercial pressures, inadequate National Health Service funding and poor public awareness of paediatric eyecare. Conclusion Myopia management is not implemented consistently across the UK. To improve accessibility, changes are required at multiple levels, from individual ECPs through to wider stakeholders in UK eyecare provision.