Recent Innovations In Myopia Management

Did you know myopia is now one of the fastest-growing childhood vision problems worldwide? Watch this exclusive interview to discover how new treatments are changing the game.

If your child is short-sighted or you’ve noticed their vision changing, this interview with Paul Graham, Principal Optometrist at Harmony Vision Care on the Gold Coast, is a must-watch. Discover how myopia management is evolving, the latest international research, and why early action matters for long-term eye health.

Learn why controlling myopia progression is just as important as correcting vision
Understand the role of lifestyle factors — screen time, outdoor play, and school environments
Explore INNOVATIVE treatments such as RED LIGHT THERAPY and how they’re being used alongside Ortho-K, contact lenses, and myopia-control glasses
Hear about promising research into AI tools that help predict myopia risks and guide treatment plans
 Find out what parents should be asking their optometrist about safeguarding their child’s future vision

Disclaimer:
The content provided in this video is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare professional with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have seen or heard in this video. The information shared is based on personal experience and general knowledge and should not be considered actionable health advice. Reliance on any information provided in this video is solely at your own risk.

TRANSCRIPT

0:00 In considering, if your child is found to have myopia, then there should always be a discussion around progression control.
0:1010 secondsI just don't think it's satisfactory anymore to only talk about correction and not consider what's going to be happening in the future to that person.
0:2020 secondsIf you're not being told about myopia control, certainly start asking those questions.
0:3030 secondsIf you've got kids or know someone who does, you've probably heard by now that myopia is a condition that progressively affects children's eyesight.
0:3939 secondsIt leads to nearsightedness in the short term and potentially puts your child at greater risk of serious eye disease later in life.
0:4949 secondsSeptember is in fact, myopia month.
0:5151 secondsSo today, once again, I'm with Harmony Vision Care on the Gold Coast.
0:5656 secondsPaul is going to discuss some of the existing treatment options, but also some of the new innovations that are happening in myopia management.
1:051 minute, 5 secondsSo if you'd like to help your son, daughter, or a young family member to have the best vision outcomes as they grow up and their eyes develop, then this video is for you.
1:151 minute, 15 secondsBut first, who am I? My name is Paul Salway. I'm the owner of Optics Digital Marketing.
1:191 minute, 19 secondsWe're an agency that assists independenteye care practitioners to grow their clinic. So hi, Paul. Good to catch up with you again. Yeah, likewise.
1:291 minute, 29 secondsMy Myopia month. Briefly, can you tell us what is it and what do you think is the goal? The goal is to really increase the awareness around myopia.
1:381 minute, 38 secondsPrevalence is certainly increasing.
1:401 minute, 40 secondsWe see that in our practice and the mountains of research that's being done on it.
1:451 minute, 45 secondsAnd because of our knowledge of myopia rather than just being a nuisance because
1:511 minute, 51 secondsyou can't see clearly, if you allow myopia to get to a point where it's considered to be high myopia, so people who are -5.50 and above.
2:012 minutes, 1 secondAnd what's coupled with that is that they have a much larger eyeball.
2:062 minutes, 6 secondsWell, that results in effectively the tissue in the eye not being healthy when you age.
2:112 minutes, 11 secondsAnd so you're high risk of eye disease, like glaucoma and macular problems and retinal detachment.
2:182 minutes, 18 secondsAnd so any degree of myopia starts to increase your risks on those things. But the biggest concern is when you get up into high and very high degrees of myopia.
2:272 minutes, 27 secondsAnd so if we have a look at the reasons why we think it's becoming an epidemic, then we've got to create a lot more awareness from a public health point of view around what's happening to our kids.
2:392 minutes, 39 secondsAnd do you think that parents and patients have become more aware of myopia over recent years?
2:462 minutes, 46 secondsWhen I was growing up, you didn't really hear much about this, but now I think there is a lot more awareness of it.
2:522 minutes, 52 secondsDo you think that this is because of campaigns by the optometry profession, or do you think people are just noticing it more often in their lived experiences?
3:043 minutes, 4 secondsYeah, look, I certainly think there are certain pockets where there's a high level of awareness.
3:093 minutes, 9 secondsSo in certain demographics where myopia has always been for a long time a
3:153 minutes, 15 secondsfairly prevalent part of a culture or a lifestyle, then there's a lot more understanding and knowledge around that something else can be done about it.
3:253 minutes, 25 secondsOutside that, you certainly do hear snippets of it.
3:283 minutes, 28 secondsBut I was thinking about it the other day that if this is driven by the lifestyle issues
3:353 minutes, 35 secondsof not spending enough time outdoors and spending too much time inside on devices, then we need to really ramp it up to a whole level where the school
3:453 minutes, 45 secondsenvironment is being changed or timetabling and how we do things.
3:503 minutes, 50 secondsAnd certainly in parts of the world, like China, they've gone to great lengths to change classroom settings and how the timetable is run and all the rest of it.
3:593 minutes, 59 secondsSo I I think we've got a long way to go still. In Australia, we don't have the same level of prevalence as elsewhere.
4:074 minutes, 7 secondsSo it's probably from us because we have a natural outdoors lifestyle, and we're not living as big a built environments as people in other countries.
4:184 minutes, 18 secondsSo yes, I think generally there is starting to become more awareness, but I think we've got a long way to go.
4:234 minutes, 23 secondsHave you noticed that parents are asking you about specific treatments earlier than before?
4:304 minutes, 30 secondsI have populations of parents who are on the front foot because of their own personal history.
4:364 minutes, 36 secondsAnd so we're often getting kids checked as a precautionary check just to make sure everything's okay.
4:424 minutes, 42 secondsAnd there are certainly families who are quite diligent at bringing kids back who we might have one child who's becoming more myopic, but the other one isn't, but the other one is still getting regular checks because of concerns around it.
4:554 minutes, 55 secondsWe still do get, and I'm still surprised, we still get people coming in who are wearing more standard corrections.
5:035 minutes, 3 secondsAnd it's only that they found us that that standard correction that they started with has increased dramatically and it's worried them. And that's when they started questioning what else can be done.
5:125 minutes, 12 secondsSo it's still a bit of a mix. Okay.
5:155 minutes, 15 secondsWell, that's probably a good seg-way to my next question, which is about some new treatments that you've introduced into your practice there.
5:255 minutes, 25 secondsAnd here I'm talking about repeated low-level red light therapy. So can you tell us how that works and what you're seeing from that?
5:365 minutes, 36 secondsAnd maybe what is the clinical evidence from international studies so far? We've probably got two or three years of really good data on it now.
5:435 minutes, 43 secondsI think it's the device has been around for longer than that.
5:475 minutes, 47 secondsIt takes a long time for something to build up momentum to eventually make it to market.
5:525 minutes, 52 secondsSo basically, it's a device that you look into and it base the eye with a specific way wavelength of red light.
6:016 minutes, 1 secondIt's low intensity. Everything that we're doing when it comes to trying to slow down myopic progression is trying to change what's happening at a retinal level.
6:136 minutes, 13 secondsIt's changes in growth hormones at the retina that seem to trigger the increases in eye length that result in myopia and blurry distance vision.
6:246 minutes, 24 secondsAnd they all work in slightly different mechanisms. The exact mechanisms are still being researched.
6:326 minutes, 32 secondsRed light therapy seems to change the metabolism and thickness of the choroid, and it changes in the choroid, which sits underneath the retina.
6:416 minutes, 41 secondsSo it's this pink layer here that seems to be responsible.
6:476 minutes, 47 secondsAnd that's the thing that changes a lot when you first start becoming more myopic.
6:526 minutes, 52 secondsAnd red light therapy seems to be changing that, which then governs how the sclera itself changes, which is what's involved in remodeling to make the eye bigger in most cases.
7:037 minutes, 3 secondsThere's a little bit of evidence that some people using red light therapy do get a little bit of shrinking, and we're still finding out what those of the exact numbers are.
7:127 minutes, 12 secondsSo the exact mechanism, it's doing something to the choroid to change growth. But it's a fairly simple procedure.
7:207 minutes, 20 secondsYou're looking at a red light for three minutes, twice a day, five days a week is the ideal compliance.
7:287 minutes, 28 secondsAt the moment, because it's a relatively new treatment, we're tending to use it as an adjunct therapy.
7:357 minutes, 35 secondsAnd an adjunct therapy means that someone is already in a pre-existing myopia control device using an optical device.
7:467 minutes, 46 secondsSo Ortho-k night time contact lenses, or they're wearing daytime myopia control multifocal soft contact lenses, or they're wearing some of these newer spectacle myopia control lenses.
7:597 minutes, 59 secondsAnd they may may still be getting some progression that is larger or faster than we're comfortable with based on what we're trying to see where this person might end up when they're older.
8:108 minutes, 10 secondsAnd so we're using the red light as an additional therapy to piggyback on top of that to try and really flatten that progression out even further.
8:198 minutes, 19 secondsSo just to be clear, so this is not something that people necessarily do in your clinic.
8:268 minutes, 26 secondsIt's actually a device that they purchase and take home and use. Is that right? Correct. Yeah.
8:338 minutes, 33 secondsSo the one that's currently TGA approved in Australia is Eyerising International.
8:398 minutes, 39 secondsAnd so you work through a practitioner who does a number of screenings, a number of necessary measurements.
8:478 minutes, 47 secondsWe then talk about red light therapy on an individual basis based on their individual situation.
8:548 minutes, 54 secondsAnd if it's deemed or agreed upon that this might be a strategy that's suitable for a person, then they They then deal with Eyerising to trial the device, and then there's an ongoing subscription to use it.
9:079 minutes, 7 secondsAnd it's all Eyerising monitors the use of the device. We know that people, how often they're using it.
9:159 minutes, 15 secondsBeing a red light, a low-level laser, effectively, they have a lot of safety mechanisms in place in terms of making sure
9:249 minutes, 24 secondsthe device only runs for three minutes, making sure that you can't do it less than four hours apart, and then making sure you have two-day breaks in between a five day sequence of treatments.
9:359 minutes, 35 secondsSo it's not something that somebody could just go on to Amazon and buy it.
9:399 minutes, 39 secondsThey actually have to go through a controlled consultation process with a practitioner like yourself. Absolutely.
9:459 minutes, 45 secondsAnd you need to be using devices that have had a considerable amount of research and development from a safety point of view. Right.
9:549 minutes, 54 secondsOkay. And can you mention some of the international work that's been done around red light therapy as it pertains to myopia?
10:0310 minutes, 3 secondsYeah. So whenever we talk about myopia control, we're looking at effectiveness.
10:1010 minutes, 10 secondsHow much does this particular modality or protocol that you're following change?
10:1610 minutes, 16 secondsHow quickly your eye is getting longer compared to when I do research, they always compare it to people who are wearing just standard myopia correction.
10:2410 minutes, 24 secondsSo if we briefly step aside and go, well, what's Myopia correction.
10:3010 minutes, 30 secondsMyopia correction is purely just wearing a pair of glasses so you can see clearly again. Myopia control is doing something to try and slow down the changes in your myopia.
10:4010 minutes, 40 secondsAnd myopia management is the broad base on what are we doing for a particular patient?
10:4610 minutes, 46 secondsWhat are all the different things that we're actually looking at to actually manage correction, manage control, those sorts of things?
10:5310 minutes, 53 secondsAnd so if we look at efficacy, then some of the evidence coming out is that it's quite an effective strategy for slowing progression, irrespective of what correction you're currently wearing.
11:0711 minutes, 7 secondsAs an adjunct therapy, it's starting to emerge on the different pre-existing lenses that we might use, Probably the strongest one that they've got so far is people who are already wearing Ortho-k.
11:1911 minutes, 19 secondsThe reason they've probably got the research on Ortho-k already is Ortho-k is probably one of the longest standing myopia control strategies that we've had.
11:2611 minutes, 26 secondsI almost feel like it was the one that really kickstarted the whole interest in being able to slow down myopia internationally.
11:3711 minutes, 37 secondsAnd interestingly enough, you've got pre-existing Ortho-k wearers, and people who have already got high myopia seem to be the ones who respond the strongest on average.
11:4811 minutes, 48 secondsNow, remember, it's a bit hard to extrapolate it to every single individual.
11:5111 minutes, 51 secondsBut if you're looking at population data, those early results seem to be quite impressive.
11:5611 minutes, 56 secondsSo it's just a matter of We've got to be careful that we don't have everyone thinking that every individual is going to respond the same way.
12:0712 minutes, 7 secondsSo if I'm hearing you correctly, you're saying that sometimes using combination therapies, using the more traditional
12:1612 minutes, 16 secondsmyopia solutions, in addition to some of the newer ones, that can actually lead to more efficacy, better results, that thing.
12:2812 minutes, 28 secondsYeah.
12:2812 minutes, 28 secondsAnd what we need to I remember that myopia control has been around in a version or not in terms of stronger interest in the literature, probably for 10 or 15 years.
12:4112 minutes, 41 secondsIt's been something that I've been interested in my practice for probably longer than that.
12:4512 minutes, 45 secondsThe research into adjunct therapies is considered relatively new, but only being done for a few years.
12:5312 minutes, 53 secondsSo there's certainly some signs that can be promising that if you're getting someone who needs a bit more of their control over progression compared
13:0213 minutes, 2 secondsto just what they're getting out of our first-line treatments, then it's certainly looking promising, but it's still I watch this space on which one's better and which one's best and how much.
13:1213 minutes, 12 secondsAnd when should you actually present that as an option. Right. So in your clinic, like now, you're introducing red light treatments.
13:2213 minutes, 22 secondsBut I think there are certain eye drops that have been popular for a while as an adjunct therapy. Do you want to talk about that?
13:3213 minutes, 32 secondsYeah. So atropine is both a first-line treatment and can be used as an adjunct therapy.
13:3813 minutes, 38 secondsWe've typically used it as an adjunct therapy for co-managing a patient who's already in a more another optical first-line treatment.
13:4813 minutes, 48 secondsWe don't tend to use the atropine as the first-line treatment because the percentage is that you require in terms of the concentration,
13:5713 minutes, 57 secondswhen you bring that concentration down low enough that you less of the side effects in terms of sensitivity to bright light, large pupils, those sorts of things, then
14:0614 minutes, 6 secondsthe efficacy is fairly similar to our other first-line optical treatments, which also correct vision at the same time.
14:1214 minutes, 12 secondsSo we tend to lean into, well, if we're going to have to correct your vision in order for you to see, clearly, why not use a myopia control strategy?
14:2014 minutes, 20 secondsAnd if that's similar efficacy to a medium and low dose atropine, then let's just run with that.
14:2714 minutes, 27 secondsBut then, yes, our other strategy has been to then refer for getting atropine at the same time if we're not getting the changes we're after or the lack of change that we're after.
14:3914 minutes, 39 secondsExcellent.
14:4114 minutes, 41 secondsWell, if you're getting value from this interview so far, then please hit the like button.
14:4614 minutes, 46 secondsIt's a simple thing, but it really helps other people to discover this information on the YouTube platform. All right, Paul.
14:5214 minutes, 52 secondsWell, looking ahead, so what research developments excite you the most?
14:5814 minutes, 58 secondsI've been hearing things about how practitioners are using AI to predict risk factors and a whole range of things, whether that be glaucoma, dry eye.
15:0915 minutes, 9 secondsIs the profession also leveraging AI to assess myopia risks?
15:1615 minutes, 16 secondsYeah, look, and certainly, I know you can see the Revo behind me. I'll get my pointing right. That's my biometer.
15:2515 minutes, 25 secondsSo that's what I measure a number of different eye measurements on with regards to myopia, in particular, we get eye length, we get corneal curvature.
15:3515 minutes, 35 secondsWe're measuring the state of the macular with it.
15:3815 minutes, 38 secondsAnd that has algorithms in it now where you can type in how many family members have myopia, What's the current person's?
15:4715 minutes, 47 secondsWhat's the person's current prescription? We're obviously measuring eye length data in there.
15:5215 minutes, 52 secondsIt's factoring in corneal curvature and comparing it to these research risk profiles.
15:5915 minutes, 59 secondsSo Now, the challenge we've got is that that's not a bad starting point, and we can graph changes and those sorts of things.
16:0716 minutes, 7 secondsBut there's some arguments that it's not yet quite specific enough to myopic populations to really give us really strong, strong guidance.
16:1816 minutes, 18 secondsThere's certainly very, very useful tools and so much better than what we had even just a few years ago. So yes, I think that's the space that is really going to change.
16:2616 minutes, 26 secondsIt's predicting those people who might be at risk of becoming myopic, but also going, okay, is this someone that we might need
16:3516 minutes, 35 secondsto consider a double strategy right from the very go rather than starting with something and waiting?
16:4116 minutes, 41 secondsI mean, at the moment, that's the process as well. You are myopic. You're at medium to high risk of progressing.
16:4916 minutes, 49 secondsLet's get you into some myopia control.
16:5216 minutes, 52 secondsAnd then we watch to see how effective that is before we start considering layering adjunct therapies because it all costs money to the patient, and it's all a time basis.
17:0217 minutes, 2 secondsSo we've got to manage the cost and lifestyle in all of this as well.
17:0617 minutes, 6 secondsBut if we can have AI starting to be a lot more individual, being able to give us more guidance on the individual patient, that would be fantastic.
17:1617 minutes, 16 secondsAnd that's where I can really see the space starting to expand.
17:2317 minutes, 23 secondsis that a common tool that's used in optometry practices in Australia right now?
17:2917 minutes, 29 secondsOr do you You said a little bit ahead of the curve in that field. I think my hope is probably the one where there's enough collective interest in it.
17:4117 minutes, 41 secondsThere's research into it.
17:4317 minutes, 43 secondsThere's the equipment manufacturers And obviously, if there's a commercial aspect to it, then that obviously helps drive innovation.
17:5017 minutes, 50 secondsAnd in my practice, where we're dealing with lots of different niche things that we're dealing with, then that's the most obvious one for us.
18:0118 minutes, 1 secondI probably wouldn't see it in other areas yet.
18:0318 minutes, 3 secondsBut although I can imagine happening in the dry eye space because that's another area that's expanding very, very quickly.
18:1018 minutes, 10 secondsAnd for optometrists involved in co-management of things like glaucoma, I can only assume that that's going to be increasing in optometry as well.
18:2218 minutes, 22 secondsAll right.
18:2318 minutes, 23 secondsWell, so for anyone who's hearing about some of these new developments that are coming on stream,
18:3318 minutes, 33 secondsthey might be thinking, well, is it really worth investing the money in Ortho-k or something like that right now?
18:4118 minutes, 41 secondsWhat's your take on this? I mean, are the traditional myopia therapy is going to be with us for a while?
18:4718 minutes, 47 secondsI'm talking about Ortho-k, myopia control, spectacle lenses, soft contacts.
18:5318 minutes, 53 secondsDo you think those are going to be an important part of your whole strategy for a while to come? Yeah.
19:0019 minutesAnd if we have a look at the mix, then what that allows us to do is to customize the treatment for individual patient based on a number of different goals around that patient's lifestyle.
19:1319 minutes, 13 secondsSo we can change things based on age. Are they involved in sport and activities?
19:1919 minutes, 19 secondsWhat's their ability to be able to use content lenses, Ortho-K you need to be able to see clearly.
19:2619 minutes, 26 secondsSo we're always going to have some optical correction. So Yes, I assume there's going to be some evolution over time.
19:3419 minutes, 34 secondsBut ultimately, if you're not seeing clearly, we need the first point of pause. We need to correct that.
19:3919 minutes, 39 secondsAnd the other thing we need to look at is that compliance with anything in health and medicine is a really critical factor.
19:4919 minutes, 49 secondsIf you need to be taking blood pressure medication or diabetes medication, you've got to be taking it every day.
19:5819 minutes, 58 secondsAnd your ability to manage your health condition is not going to be as good if you're not doing it.
20:0220 minutes, 2 secondsAnd so any therapy that requires someone to do something day after day,
20:0920 minutes, 9 secondsday after day, sometimes the easiest things are if we can get a pretty good result with an optical device that rewards you with clear vision, then it makes compliance so much easier.
20:2020 minutes, 20 secondsSo I certainly see that being a part of the space for a long time.
20:2320 minutes, 23 secondsAnd to be honest, from an evidence-based point of view, they're the ones with the longest and strongest evidence so far. So they're always going to be considered.
20:3120 minutes, 31 secondsIt's the one that everything gets compared back to.
20:3520 minutes, 35 secondsAnd so if you're making very conservative decisions, then you're going to go with the ones that have the longest level of evidence.
20:4420 minutes, 44 secondsThat's all the optical devices that we're currently using, like Ortho-k, soft contact lenses and some of the dims and whole technology in spectacles.
20:5520 minutes, 55 secondsRight. Well, Paul, before we finish, Any last thoughts for people out there
21:0421 minutes, 4 secondswho may be thinking about myopia control and perhaps trying some approach that they haven't thought of before?
21:1321 minutes, 13 secondsLook, the Probably a couple of things come to mind is that I look at a lot of the vision problems that we developed, that developed during childhood and teenage years.
21:2221 minutes, 22 secondsI step back and go, well, why would this develop? What problem is the body trying to adapt or to solve to? And we look at, well, what does myopia do?
21:3121 minutes, 31 secondsMyopia makes near vision less stressful because you become well-focused at near distances without much effort.
21:4221 minutes, 42 secondsAnd so a big part myopia control and myopia prevention is tomake sure that you're getting outside.
21:5021 minutes, 50 secondsWe really need to be... This is a lifestyle problem.
21:5321 minutes, 53 secondsMyopia is increasing in numbers because of massive changes in our lifestyle, and it's going to require a really concert concerted effort in families to reduce
22:0322 minutes, 3 secondsthe amount of device use, reduce the amount of indoor activity, increase the amount of time you spend outside.
22:0922 minutes, 9 secondsAnd it really does require a concerted effort because it's very easy to fall into the trap of being on a phone and being on a device, being indoors.
22:1722 minutes, 17 secondsAnd so that's probably a big one that we really need to push harder on, I think.
22:2122 minutes, 21 secondsAnd I think we said earlier, it would be great to see schools changing the strategy.
22:2722 minutes, 27 secondsIf it's really going to be the epidemic, where half the population is myopic, then we need to be doing it really at all levels.
22:3322 minutes, 33 secondsAnd when kids spend such a considerable part of their day at school, I think that's an opportunity for things to do.
22:4022 minutes, 40 secondsAnd then I think the next part is that in considering if your child is
22:4722 minutes, 47 secondsfound to have myopia, then there should always be a discussion around progression control.
22:5522 minutes, 55 secondsI just don't think it's satisfactory anymore to only talk about correction and not consider what's going to be happening in the future to that person.
23:0423 minutes, 4 secondsSo if you're not being told about myopia control, certainly start asking those questions. Okay.
23:1023 minutes, 10 secondsWell, so how can listeners get in touch with you at Harmony Vision Care?
23:1623 minutes, 16 secondsSo we've got website we've got our phone , if you're around the Gold Coast or Northern Rivers area, and you can make booking things online through our website.
23:3223 minutes, 32 secondsWe're on Facebook and Instagram as well.
23:3423 minutes, 34 secondsBut in terms of getting in touch with us, the website and the phone numbers are the best place. All right.
23:4023 minutes, 40 secondsAnd once again, don't forget to hit the like button and subscribe to the channel if you want to be notified when Paul releases more highly valuable YouTube videos like this one.
23:4923 minutes, 49 secondsAnd as he said, follow Paul's Facebook business page and Instagram account to see
23:5623 minutes, 56 secondshim post updates on the latest news, promotions and events for his Varsity Lakes practice. All right, Paul.
24:0224 minutes, 2 secondsWell, thanks for connecting and thanks everyone for watching. Have a great day and please spread the word about Myopia Month.
24:1224 minutes, 12 secondsAnd get outside. And get outside. All right. Bye for now. Thanks, mate.

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