Trends in myopia management attitudes and strategies in clinical practice: Survey of eye care practitioners in Africa

Augustine N Nti; Bismark Owusu-Afriyie; Uchechukwu Levi Osuagwu; Samuel Kyei; Godwin Ovenseri-Ogbomo; Kelechi C Ogbuehi; Mhamed Ouzzani; Kingsley E Agho; Khathutshelo Percy Mashige; Edgar Ekure; Bernadine N Ekpenyong; Stephen Ocansey; Antor O Ndep; Chukwuemeka Junior Obinwanne; David A Berntsen; James S Wolffsohn; Kovin S Naidoo

doi:10.1016/j.clae.2022.101597

Trends in myopia management attitudes and strategies in clinical practice: Survey of eye care practitioners in Africa

Cont Lens Anterior Eye. 2023 Feb;46(1):101597. doi: 10.1016/j.clae.2022.101597. Epub 2022 Apr 12.

Authors

Augustine N Nti¹, Bismark Owusu-Afriyie², Uchechukwu Levi Osuagwu³, Samuel Kyei⁴, Godwin Ovenseri-Ogbomo⁵, Kelechi C Ogbuehi⁶, Mhamed Ouzzani⁷, Kingsley E Agho⁸, Khathutshelo Percy Mashige⁹, Edgar Ekure¹⁰, Bernadine N Ekpenyong¹¹, Stephen Ocansey⁴, Antor O Ndep¹², Chukwuemeka Junior Obinwanne¹³, David A Berntsen¹, James S Wolffsohn¹⁴, Kovin S Naidoo¹⁵

Affiliations

¹ The Ocular Surface Institute, University of Houston College of Optometry, Houston, TX, United States of America.
² Clinical Optometry Programme, School of Optometry and Vision Sciences, Cardiff University, United Kingdom.
³ Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; African Vision Research Institute, Discipline of Optometry, University of KwaZulu-Natal, Westville Campus, Durban 3629, South Africa.
⁴ Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
⁵ Department of Optometry, Centre for Health Sciences, University of the Highlands and Islands, Inverness IV2 3JH, UK.
⁶ Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand.
⁷ Optometry Research Group, LPCMME, Université Oran 1, B.P 1524, El M'Naouer 31000 Oran, Algeria; IRLCM: Innovation-Recherche en Lentille cornéenne de l'Université de Montréal, 3744 Rue Jean-Brillant Bureau 110, Montréal, QC H3T 1P1, Canada.
⁸ Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; School of Health Science, Western Sydney University, Campbelltown, NSW 2560, Australia.
⁹ African Vision Research Institute, Discipline of Optometry, University of KwaZulu-Natal, Westville Campus, Durban 3629, South Africa.
¹⁰ Salus University Pennsylvania, USA.
¹¹ Epidemiology & Medical Statistics Unit, Department of Public Health, University of Calabar, Calabar, Nigeria.
¹² Health Education & Health Promotion Unit, Department of Public Health, University of Calabar, Calabar, Nigeria.
¹³ Cornea, Contact Lens, and Myopia Control Unit, De Lens Ophthalmics Family Eye and Vision Care Center, Suite G14, Febson Mall, Plot 2425, Hebert Macaulay Way, Wuse Zone 4, Abuja, Nigeria.
¹⁴ Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom.
¹⁵ African Vision Research Institute, Discipline of Optometry, University of KwaZulu-Natal, Westville Campus, Durban 3629, South Africa; School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia. Electronic address: naidook6@ukzn.ac.za.

PMID: 35428590
DOI: 10.1016/j.clae.2022.101597

Abstract

Purpose: There remains a lack of information on the perception and adoption of myopia control strategies among African eye care practitioners (ECPs). This study provides an African perspective to similar previous studies conducted in other parts of the world.

Methods: A self-administered survey in English and French was distributed to ECPs across Africa. The items on the questionnaire assessed their level of concern about the increasing prevalence of paediatric myopia, perceived efficacy, opinions on, and adoption of various myopia management modalities.

Results: Responses were obtained from 330 ECPs working in 23 African countries. Respondents were highly concerned about the increasing prevalence of paediatric myopia in their clinic (median 8/10) and perceived approved myopia control soft contact lenses as the most effective at slowing myopia progression (mean perceived reduction in myopia progression ± SD; 53.9 ± 27.1%), followed by single vision spectacles (53.1 ± 30.9%), and orthokeratology (52.8 ± 28.0%). Multifocal soft contact lenses (40.4 ± 25.8%) and pharmaceutical agents such as topical atropine drops (39.5 ± 27.1%) were perceived as least effective in slowing myopia progression. Although ECPs reported being aware of various myopia control strategies, they still mainly prescribed single vision spectacles to a large proportion (64.3 ± 29.9%) of young progressing myopes. Nearly one-third (27%) of ECPs who prescribed single vision lenses stated they were concerned about the cost implications to patients. Other reported concerns included safety of, and inadequate information about myopia control options.

Conclusions: African ECPs continue to prescribe single vision lenses for progressing myopes despite being aware of the various myopia control options. Practitioners' perceptions of the efficacy of several modalities to slow myopia progression do not align with the current best evidence. Clear practice guidelines and continuing education on myopia control are warranted to inform and guide the management of myopic patients in Africa.

Keywords: Africa; Attitudes; Myopia; Myopia control; Myopia management; Myopia progression.

MeSH terms

Africa / epidemiology
Atropine / therapeutic use
Child
Contact Lenses, Hydrophilic*
Disease Progression
Humans
Myopia* / epidemiology
Myopia* / therapy
Surveys and Questionnaires

Substances

Atropine