title: Global trends in myopia management attitudes and strategies in clinical practice.
abstract: OBJECTIVE
  Myopia is a global public health issue; however, no information exists as to how potential myopia retardation strategies are being adopted globally.
  
  
  METHODS
  A self-administrated, internet-based questionnaire was distributed in six languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies.
  
  
  RESULTS
  Of the 971 respondents, concern was higher (median 9/10) in Asia than in any other continent (7/10, p<0.001) and they considered themselves more active in implementing myopia control strategies (8/10) than Australasia and Europe (7/10), with North (4/10) and South America (5/10) being least proactive (p<0.001). Orthokeratology was perceived to be the most effective method of myopia control, followed by increased time outdoors and pharmaceutical approaches, with under-correction and single vision spectacles felt to be the least effective (p<0.05). Although significant intra-regional differences existed, overall most practitioners 67.5 (±37.8)% prescribed single vision spectacles or contact lenses as the primary mode of correction for myopic patients. The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost (35.6%), inadequate information (33.3%) and the unpredictability of outcomes (28.2%).
  
  
  CONCLUSIONS
  Regardless of practitioners' awareness of the efficacy of myopia control techniques, the vast majority still prescribe single vision interventions to young myopes. In view of the increasing prevalence of myopia and existing evidence for interventions to slow myopia progression, clear guidelines for myopia management need to be established.
authors.affiliation: Ophthalmic Research Group, School of Health & Life Sciences, Aston University, Birmingham, UK. Electronic address: j.s.w.wolffsohn@aston.ac.uk.
authors.forename: James S
authors.initials: JS
authors.lastname: Wolffsohn
authors.affiliation: Department of Physics (Optics and Optometry), University of Florence, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Calossi
authors.affiliation: School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region.
authors.forename: Pauline
authors.initials: P
authors.lastname: Cho
authors.affiliation: Gerry & Johnson Optometrists, Brisbane, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Gifford
authors.affiliation: Centre for Contact Lens Research, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Lyndon
authors.initials: L
authors.lastname: Jones
authors.affiliation: Eye Hospital of Wenzhou Medical University, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.affiliation: Contact Lens Section, Federal University of São Paulo/Paulista School of Medicine São Paulo, Brazil.
authors.forename: Cesar
authors.initials: C
authors.lastname: Lipener
authors.affiliation: Ophthalmic Research Group, School of Health & Life Sciences, Aston University, Birmingham, UK.
authors.forename: Nicola S
authors.initials: NS
authors.lastname: Logan
authors.affiliation: Point Vision Bordeaux, Ophthalmologic Center, Bordeaux, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Malet
authors.affiliation: Clinical and Experimental Optometry Research Lab (CEORLab) - Center of Physics, University of Minho, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Matos
authors.affiliation: Clinical and Experimental Optometry Research Lab (CEORLab) - Center of Physics, University of Minho, Portugal.
authors.forename: Jose Manuel Gonzalez
authors.initials: JM
authors.lastname: Meijome
authors.affiliation: University of Alabama at Birmingham School of Optometry, Birmingham, AL, USA.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Nichols
authors.affiliation: Ophthalmic Research Group, School of Health & Life Sciences, Aston University, Birmingham, UK.
authors.forename: Janis B
authors.initials: JB
authors.lastname: Orr
authors.affiliation: Menicon R&D Innovation Centre, Fondation Pour Recherches Medicales, Geneva, Switzerland.
authors.forename: Jacinto
authors.initials: J
authors.lastname: Santodomingo-Rubido
authors.affiliation: Clinica Schaefer, Curitiba, Parana, Brazil.
authors.forename: Tania
authors.initials: T
authors.lastname: Schaefer
authors.affiliation: International Association of Contact Lens Educators, Pune, India.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Thite
authors.affiliation: Eye Research Institute Maastricht, University of Maastricht, Maastricht, the Netherlands.
authors.forename: Eef
authors.initials: E
authors.lastname: van der Worp
authors.affiliation: Ophthalmic Research Group, School of Health & Life Sciences, Aston University, Birmingham, UK.
authors.forename: Madara
authors.initials: M
authors.lastname: Zvirgzdina
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005139:Eyeglasses; D014943:Global Health / Q000639:trends*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009216:Myopia / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D000072163:Ophthalmologists; D000072162:Optometrists; D054158:Orthokeratologic Procedures / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Attitudes; Global; Myopia control; Myopia management; Myopia progression; Orthokeratology