IMI-global trends in myopia management attitudes and strategies in clinical practice - A nine-year review.

Purpose: Surveys in 2015, 2019, and 2022 identified a high level of eye care practitioner activity and concern about pediatric myopia, reflected by an uptake of appropriate control techniques. This research provided updated information, examining global trends from 2015 to 2024.

Methods: A self-administered, internet-based questionnaire was distributed in 18 languages to eye care practitioners globally. The questions examined awareness of increasing myopia prevalence, perceived efficacy, prescribing of available strategies and barriers to adoption. Responses were compared with data from previous surveys.

Results: A total of 2,993 practitioners responded in 2024. From 2015 to 2024, practitioner concern had increased in all continents besides Australasia (all p < 0.05), being consistently highest in Asia (8.4 ± 1.8 to 8.6 ± 1.9, respectively). Practitioner activity level had increased markedly in every continent (all p < 0.001), with the greatest change in North America (4.7 ± 3.0 to 7.1 ± 2.6, respectively). Perceived efficacy of soft contact lenses approved for myopia control more than doubled since 2015 (24.4 ± 25.0 % to 52.2 ± 24.0 %, p < 0.001). Combination therapy and orthokeratology were perceived to be the most efficacious interventions, yet single vision spectacles were the most prescribed option. However, the frequency of prescribing single vision spectacles had decreased since 2015 (by -11.1 %, p < 0.001). Globally, cost to the patient remained practitioners' primary reason for not prescribing myopia interventions.

Conclusions: More practitioners are prescribing appropriate control methods to children with lower degrees of myopia than identified previously. However, consistent hindrances need addressing, namely increased affordability and accessibility of effective control options.