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Are we myopic about myopia control?

      The ability to slow down or stop the progression of myopia through pharmacological and optical means is well accepted in the scientific literature. More recently the topic of myopia control is gaining momentum at clinical conferences, with the practitioner now permitted a selection of evidence based modalities to employ in this pursuit, the most promising of which are in the contact lens arena. Yet speaking to my clinical colleagues still yields a sense of hesitation to fully embrace myopia management. I hear concerns that the risk of paediatric contact lens wear must surely outweigh the increased risk of ocular pathology brought about by higher myopia. I am asked – what's the difference between −2.00 and −3.00 anyway? More evidence is needed, I am told. Speaking to academic colleagues reveals a sense of frustration that knowledge gains do not appear to be treated with clinical eagerness – that perhaps they are diluted in translation. There appears to be a delay in years between the theory and the practice of myopia control. This is evidenced in static contact lens wear age demographics and declines in rigid lens fitting over time [
      • Morgan P.B.
      • Efron N.
      A decade of contact lens prescribing trends in the United Kingdom (1996–2005).
      ] – although small increases are recorded in orthokeratology fits, they still account for only 1% of all contact lens fits across the world [
      • Efron N.
      • Morgan P.B.
      • Woods C.A.
      International survey of rigid contact lens fitting.
      ].
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