Eyecare Practitioner Reluctance to fit Children with Contact Lenses

Purpose: Myopia control strategies in the form of contact lenses and spectacles have been commercially available to eyecare practitioners in the Republic of Ireland (RoI) since 2017 and 2021 respectively. The aim of this research was to determine the level of adoption of these strategies among independent eyecare practitioners in the RoI. Methods: In order to establish the number of practices offering myopia control contact lenses, examination of independent practices’ websites was made to see whether or not they mentioned myopia control. Phone calls were made to practices identified in this way, to ascertain if they were actually offering myopia control contact lenses and to ask practitioners if they were aware of other any other practitioner offering the same service. Those not offering myopia control themselves were asked to whom they would refer a patient. Only two spectacle lens companies had myopia control spectacle lenses commercially available in the RoI at the time of research. Both companies had webpages where potential patients and/or their parents could find the locations of optical practices offering these spectacle lenses. Practices were identified from these webpages and then contacted directly by phone to determine if they were actually offering the lenses to patients. Results: In 2019 approximately two years after the first licensed myopia control soft contact lenses became widely available, 15 independent optical practices were identified as offering these as an option to children with progressing myopia. Just under one year after the myopia control spectacles became available, 40 independent optical practices were identified as offering them to children for myopia control. Conclusion: At the time that the practices were identified, the evidence base for the myopia control spectacles was two-year data from research conducted exclusively on Chinese children. The evidence base for the myopia control soft contact lenses was three-year data from worldwide research, which included white European children. There would appear to be a reluctance on the part of eyecare practitioners to fit children with contact lenses for myopia control, even when there were no other options available and even when the evidence for contact lens efficacy is stronger than that of spectacle efficacy in terms of controlling the progression of myopia