Myopia Management Practice: How to Slow the Progression of Childhood Myopia

Childhood myopia, or nearsightedness, does not have to mean stronger glasses every year. Myopia management offers treatment options designed to slow the progression of nearsightedness in children, including MiSight contact lenses, orthokeratology (Ortho-K), atropine and myopia-control glasses. As these options become more widely available, optometrists can move beyond simply correcting vision and help families take a more proactive approach to their children’s eye health.

In Partnership with CooperVision

On the Defocus Media Podcast, Dr. Jennifer Lyerly and Dr. Alicia Barnes explore how to select the right myopia control treatment, educate parents and make myopia management part of everyday eye care.

Myopia Management Options for Children

Barnes’ experience with orthokeratology began roughly 25 years ago, before she thought of it specifically as myopia management. At the time, ortho-k offered patients another way to correct their vision without relying on daytime glasses or soft contact lenses.

When she opened TrueVision Eye Care in 2013, patient demand helped shape the practice. Many families in the community already knew about orthokeratology and expected it to be available. As new research and myopia management options emerged, Barnes continued building on that foundation.

Her experience also illustrates an important lesson for doctors interested in myopia management: you do not have to have everything figured out before getting started.

Choosing the Right Myopia Control Treatment

With more myopia control options available, selecting a treatment requires looking beyond the prescription.

Barnes considers the child’s lifestyle, comfort, and preferences alongside the family’s concerns. A young athlete may appreciate the freedom of orthokeratology, but a child uncomfortable with overnight lenses may be better suited for another option, such as MiSight contact lenses. For children who do not want contact lenses, atropine or myopia-control glasses may also be considered.

Lyerly emphasizes that anatomy, corneal topography, prescription, and daily activities also influence the decision. An avid swimmer, for example, may have different needs from a child with significant astigmatism.

Just as important is including the child in the conversation. Barnes has learned not to spend an entire visit discussing a treatment with the parent only to discover that the child has no interest in it.

Talking to Parents About Childhood Myopia Management

Introducing myopia management does not require turning every comprehensive eye exam into a lengthy consultation.

Barnes recalls times when enthusiasm led to 15-minute explanations that overwhelmed parents who had never heard of myopia management. The practice has since refined its approach: introduce the concept, provide educational materials, and invite families back for a dedicated consultation when appropriate.

Lyerly takes a similar approach. Her goal isn’t for every family to choose MiSight, orthokeratology, or another treatment right away. Instead, she wants every parent to know that myopia management exists.

“We’re presenting it. We’re never pushing it,” she says.

That philosophy extends to cost. Providing financial information early lets families realistically evaluate their myopia control options before committing to a particular approach.

How to Bring Myopia Management Into Your Practice

Successful myopia management extends beyond the exam room. Barnes emphasizes training technicians, front-desk employees, and opticians so the entire team understands the purpose, processes, and pricing behind the service.

Education matters for doctors, too. Lyerly points to CooperVision representatives as a resource for education about MiSight contact lenses and staff training, while Barnes highlights conferences such as Vision by Design for broader clinical and practice-management education.

After a dedicated staff meeting on myopia management, Lyerly noticed parents were already holding educational brochures when she entered the exam room—evidence that the conversation was beginning before the doctor arrived.

For clinicians hesitant to start, Barnes offers straightforward advice: “Just start where you are.”

That may be the episode’s most practical takeaway. Myopia management does not have to begin with a perfect program. It can start by educating the team, introducing the conversation, and ensuring families know that options such as MiSight, orthokeratology, atropine, and myopia-control glasses exist. For Lyerly and Barnes, success begins with making sure parents know they can discuss more with their eye doctor than simply moving to a stronger prescription.