The prevalence of Myopia is growing at epidemic levels in many parts of the world and, in every country, will be far more common within the next thirty years [1][2].
Myopia, or short-sightedness, will increasingly become a major threat to sight for hundreds of millions of people globally [3]. Therefore, diagnosing, monitoring, and managing the disease will be essential.
The World Council of Optometry (WCO) has already stated that myopia should no longer be considered just a refractive error and it must be considered an eye condition that all children should be screened for [4].
They suggest the following approach from optometrists, ophthalmologists, and other eye care professionals:
Mitigation - optometrists should educate and counsel parents and children, during early and regular eye exams, on lifestyle/dietary/other factors to prevent/delay the onset of myopia.
Measurement - optometrists evaluating the status of a patient during regular comprehensive vision and eye health exams (e.g., refractive error and axial length whenever possible)
Management - optometrists should address patients' needs of today by correcting myopia while also providing evidence-based interventions (e.g., contact lenses, spectacles, pharmaceuticals) that slow the progression of myopia for improved quality of life and better eye health today and into the future.
Not only does this involve correcting vision, but it also includes public education and early and frequent discussions with parents that explains what myopia is, lifestyle factors that may impact myopia, the increased risks to long-term ocular health that myopia brings, the available approaches that can be used to manage myopia and slow its progression.
Providing Myopia Management
There are a number of tests that need to be carried out to conduct effective and meaningful myopia management (MM). These tests include, as a minimum [5]:
Measure the refractive error (refraction)
Measure the corneal curvature (keratometry)
Questions about the patient's ocular history and their family’s ocular history as well as lifestyle questions
All practices already have access to these tests without having to invest in any new devices.
Most sources also suggest, however, that measuring the axial length is not only important but it is vital [6][7]. It is suggested that without optical biometry (the measure of axial length optically without contact with the eye), it is not possible to conduct a clinically valid assessment of the effectiveness of myopia management and the real risks to the patient long-term, particularly where Orthokeratology lenses or ‘night’ lenses are used.
It is my view that the wider ophthalmic profession globally is already understanding this need. The fact that major technology manufacturers are releasing devices with optical biometry included is clear evidence of this shift towards measuring axial length. Topcon, Haag-Streit, Oculus, and Essilor are the first so far to sell myopia management devices. All of them have optical biometry. Some measure refraction, but not all. Some have keratometry built in and some have questionnaires built in, but all measure axial length.
However, there is clear evidence (from a range of polls within a webinar that I conducted with 600 optometrists) that 94% of professionals do not currently have access to optical biometry.
Anecdotally, the main reasons for this lack of access to such technology are that devices are currently too expensive, and there is limited space for them in most practices. Therefore, I believe the Occuity AX1 Axiometer™ will have a huge place in the market. It provides the one measurement that almost all eye care professionals do not have access to axial length.
The AX1 is small, portable, handheld, and affordable. Thus, it provides the best option for practices wanting to engage in myopia management.
The market is only going to grow. It will continue to do so for decades to come and will remain an essential part of eye care from now on. The axial length measurement will become as essential a part of an eye examination as measuring visual acuity by reading letters on a chart. The market is huge and is getting bigger. No one in the profession and eye care markets can ignore myopia.
The potential for volume sales of the Occuity AX1 Axiometer™ is massive. Many high street chains are currently starting to test their models for providing myopia management and, with their multiple consulting room practices in almost every town and city, they will need multiple devices in every practice.
With economies of scale, I foresee many Occuity AX1 devices being found in every major practice and in multiple numbers per practice. It will fit into consulting rooms without taking up space and will be readily available to take rapid and repeatable axial length measurements. It can sit in pre-test areas as well and will be easy for assistants to take measurements on older children and young adults.
Globally, this represents a vast number of potential sales. The sooner that the Occuity AX1 comes to market, the sooner it can corner market share and be the ‘gold standard’ product in this area.
If you want to learn more about the technology behind the Occuity AX1 Axiometer™ click here.
Please note the AX1 is currently in development and is planned for release in 2024.
Writer: Jason Higginbotham, a renowned optometrist with over 30 years of experience in the industry, has written extensively on optometry and myopia management as the Managing Editor of MyopiaFocus.org.