European trends in attitudes and strategies for myopia management in clinical practice

Abstract

BACKGROUND: Surveys conducted between 2015 and 2022 showed growing concern among European eye care practitioners about myopia management, though adoption of effective strategies varied. This study updates findings from 2024, analysing trends in attitudes and strategies for myopia management across Europe from 2015 to 2024. METHODS: A cross-sectional online survey targeting European eye care practitioners was distributed in multiple languages through professional bodies. It assessed awareness of myopia prevalence, perceived efficacy and adoption of different myopia control strategies, and reasons for non-adoption. RESULTS: Between 2015 and 2024, a total of 3,179 responses were collected from European practitioners, representing data across four survey years. Concern about pediatric myopia varied significantly in 2024 (P < 0.001), with Portugal reporting the highest concern (9.4 ± 1.0) and Sweden the lowest (5.9 ± 2.2). Orthokeratology combined with low-dose atropine was perceived as the most effective approach (60.8 ± 29.6), followed by solo orthokeratology (60.1 ± 25.0) and approved myopia control soft contact lenses (55.9 ± 23.4). Single-vision lenses (15.9 ± 22.9) and undercorrection (7.1 ± 16.6) were rated least effective. Since 2015, single-vision lens prescribing has declined, while myopia control spectacles and contact lenses, and combination therapies have increased. The major reasons preventing the prescription of myopia control methods in 2024 were cost (29.6 %), treatment availability (11.4 %) and inadequate information/knowledge (9.3 %). Factors such as patient age, refractive error, and parental myopia influenced treatment choices, with the factors being less influential in Russia compared to other countries (all p ≤ 0.001). All European countries reported that adopting measures to control myopia progression in 2024 were thought to improve patient loyalty (much more/more: 57.7 %) and improve job satisfaction (much more/more: 73.3 %), but it was perceived not to increase practice revenue (much more/more: 43.3 %). CONCLUSIONS: European practitioners are increasingly adopting evidence-based myopia control strategies, with most countries reporting relatively similar management practices. Offering myopia control enhanced patient loyalty and job satisfaction. However, barriers such as cost and perceived limited efficacy still impede broader adoption.