There was a time when children walked into my practice for a routine eye exam and their parents politely nodded and, sometimes, released a small sigh, as they helped their -2.00 D child select their first pair of glasses.
After all, myopia for most families is perceived as a kind of rite of passage. But we optome- trists know better. We’ve read the data. We’ve seen the axial length increase. We’ve watched more than a few -2.00 D elementary school kids turn into -6.75 D pre-teens before middle school graduation, and we know what’s coming next.
So, how do we educate parents who aren’t alarmed, aren’t worried, and aren’t asking about their child de- veloping a condition that can dramatically increase their lifelong risk of vision loss? This article provides some successful parent-facing scripts and action steps I’ve used.
Begin With What They Know
My first move is never to alarm the parent by saying, “Nearsightedness, also known as myopia, is a progressive disease.” This is because it’s my experience that parents are more amenable to calm than doom.
Instead, I sit next to them and ask, “What do you know about nearsightedness?” Often, they’ll reply, “Just that she can’t see the white board (at school/in class).” And that’s my door in to say the following:
“You’re exactly right! That’s what is noticed first: blurry distance vision. But here’s the thing. Nearsightedness, also known as myopia, isn’t just about needing glasses. It’s about how fast the eye is growing. And when that growth continues to accelerate too quickly, year after year, it can stretch the back of the eye. That stretching increases the chances of some serious problems, such as retinal detachment, glaucoma, or macular degeneration, later in life.”
At this point, the parent typically leans in, revealing a shift from mild curiosity to deep parental attention.
Some parents love data. Others glaze over the moment you say, “axial length graph.”
For the former, I keep a few simplified growth curves handy to show how untreated myopia progresses over time. Specifically, I circle where their child sits on the curve now and the fact that it’s possible to flatten the curve.
Introduce Interventions
Next, I say, “So, fortunately, myopia is a condition we can influence.”
For my younger patients (ages 5 to 8) missing teeth, I often say, “Just like baby teeth need care even though they’ll fall out, a child’s eyes need support now, so they’ll be healthier for the decades ahead.”
Because I practice in Florida, the Sunshine State, families often fill my exam room with the distinct aroma of sunscreen. As a result, I present the analogy of “using sunscreen now to reduce the risk of skin conditions in the future” to the parents of my older children when it comes to controlling myopia.
At this point, the parent usually jumps in with, “So what do we do about it?”
Present the Options
This part of the consultation is an informed-consent discussion that begins the development of a care plan. Specifically, I walk parents through the tools we have, all of which are nonbranded and grounded in clinical research. To explain their utility, I use simple explanations:
• Orthokeratology lenses. “These are contact lenses, worn during the night to gently reshape the cornea, which slow myopia progression. The lenses come out in the morning, and your child’s vision stays clear all day. No glasses, no daytime contact lenses, no dealing with foggy lenses at recess or swim lessons. And the best part? These contact lenses are doing double duty: correcting vision and helping slow the speed at which the eyes are growing.”
I usually hear, “Wait. So, she sleeps in them and doesn’t wear anything during the day?”
“Exactly!” I reply. “It’s like a retainer for the eyes, only better, because we’re protecting her long-term vision.”
• Multifocal soft contact lenses. “These lenses are designed to reduce eye elongation while offering all-day clarity. This is because they have a built-in design that gently signals the eye to slow its growth. Like regular soft contact lenses, these lenses are worn during the day and are not noticeable. A lot of kids like that they don’t have to think about this intervention; they simply wear their lenses, and we track the progress together.”
I hear this common concern in response: “Are these hard for kids to manage?”
My answer: “If your child is responsible with routines, like brushing their teeth and doing homework, they’re usually great candidates. Also, we teach them everything they need to know before they go home with their lenses.”
• Low-dose atropine drops. “These are a pharmacological option used at bedtime by younger and contact lens-averse children. These drops are shown to significantly slow myopia progression in many children, and they’re invaluable for younger kids who might not be ready for contact lenses yet.”
Parents invariably reply, “Are there side effects?”
How I respond: “Very mild ones in a small number of kids; sometimes a bit of light sensitivity. But we start with the lowest dose and check in regularly. If this intervention is not the right fit, we adjust our approach. We can always change the treatment plan.”
• Behavioral adjustments. “Screen time reduction, more outdoor play, and frequent breaks during reading or close work support all the medical interventions mentioned and are great for your child’s overall health, too.”
The parent who maintains the family schedule often inquires, “How much outdoor time are we talking?”
My response: “Ideally, 2 hours a day. I know that’s a stretch sometimes, so even a little more than what they’re getting now can help.”
I finish this part of the conversation by saying, “It’s not about one perfect solution. It’s about finding the right fit for your child and your family. We’ll build this together.”
It’s gratifying to see parents visibly relax when they realize they’re not getting a sales pitch, but rather an invitation to partner to help their child maintain healthy vision. That said, it’s important to remember that this is not going to be a one-time conversation. It’s a relationship. As a result, my team follows up with parents after the treatment consultation, not just to book the next appointment, but also to answer any additional questions, address any hesitations, and reinforce the message: Intervention matters.
In a myopia management practice, education occurs in hallway conversations, reminder calls, and after-hours text exchanges because of the fact that you and your staff remember a child’s name and their favorite Pokémon character.
The Goal Is Confidence, Not Compliance
Ultimately, my job as an OD isn’t to make every parent immediately say “yes” to a myopia management program. It’s to make sure no parent thinks myopia isn’t a big deal. When they leave my practice understanding that their child’s vision is part of a longer story than this year’s glasses prescription and that they have the power to shape that story, that’s when I know my staff and I have done our jobs effectively.
In a world where more and more children are growing up myopic, helping parents see the big picture may be the most important thing we do. OM
