Myopia management has come a long way—from simply correcting vision to actively slowing progression and protecting long-term eye health. In Canada, greater awareness and access to treatments have changed the way Optometrists approach childhood myopia.
Dr. Jeff Goodhew (pictured above with Dr. Tina Goodhew), partner at Abbey Eye Care in Oakville, Ontario, has seen this evolution firsthand. He’s made myopia control a core part of his practice and has worked through the challenges of implementing a comprehensive program. In this Q&A, he shares how he got started, the strategies that work best for his patients, and the role of technology and education in delivering better outcomes.
1. Why did you decide to incorporate myopia management into your practice, and how has it evolved over time?
When a child’s myopia progresses, the question parents pose is always “is there anything we can do?” For the majority of my career my answer was a discussion on lifestyle factors and then simply increased their prescription and booked them back in for their next appointment. Beginning around 2017, we had available to us for the first time Health Canada approved devices to help slow down myopia progression here in Canada. So we went from correcting their vision, to controlling their myopia and protecting the future health of their eyes. In my mind, it was a real turning point in the evolution of children’s vision care here in this country.
2. The Canadian Association of Optometrists (CAO) recognizes myopia as a significant public health issue rather than just a vision inconvenience. How do you ensure that your practice aligns with the CAO’s recommendations on myopia management?
In our clinic we decided years ago to make myopia management the standard of care for all of our patients that were at risk of developing myopia or progressing. When CAO moved in the same direction it served as validation that we were on the right path and it also broadened myopia management within the public domain, making our recommendations carry that much more weight.
3. What myopia management strategies do you find most effective in your practice?
Here in Canada, we are fortunate to have all of the optical and pharmaceutical options to manage myopia. I wouldn’t say one therapy is more utilized than others. That decision tree that ultimately leads to a therapy recommendation has many variables including preference of the child and parent, prescription, cost and maturity level of the child. All of these together lead to a discussion with the parent and child and a decision that all parties are comfortable with.
4. Early intervention is critical for slowing myopia progression. How do you educate parents and children about myopia management?
With regards to educating parents, we have taken a team approach. The doctor in the exam room has refined his/her talking points to 3-4 mins. A hand-off then occurs to one of our myopia champions to continue the conversation and provide the parent with any necessary ancillary information. The myopia champion then becomes the trusted source of information between the parent and the clinic if follow-up questions arise. Education starts with yourself and your team: this ensures a well-informed experience for the parent and the child.
5. Technology plays a growing role in myopia management. What diagnostic tools and technologies do you use to assess and track myopia progression?
We have been big proponents of measuring axial length to track myopia progression since we got our first measuring device in 2018. It is absolutely essential when using Ortho-K but also very helpful for other therapies. It is a nice metric you have in the beginning to assess risk for the future and for tracking to see if the therapy is working or to borrow from COVID-19, to track if we are “flattening the curve.” As far as new technology goes, we are educating ourselves around red-light therapy so if it becomes Health Canada approved we are ready to bring it into our clinic.
6. What challenges have you faced in implementing a comprehensive myopia management program, and how have you overcome them?
I think the biggest barrier we faced with successful implementation of our myopia management program was getting all of our policies, procedures and protocols in order. It took a team effort of the doctors and the staff to get our SOP’s (scope of practice) documents in place. Once that occurred, we were all “singing from the same playbook” and the patient journey through our clinic became a better experience and less stressful for our team. I would encourage my colleagues to utilize some of the great resources that can be found on MyopiaProfile.com and attend education events such as the Myopia Summit here in Canada.
Biography:
Dr. Jeff Goodhew is an optometrist and partner at Abbey Eye Care, an independent full-scope practice in Oakville, Ontario. With his wife and business partner, Dr. Tina Goodhew, he has established practices across three provinces, gaining experience in both private and corporate optometry. Dr. Goodhew provides comprehensive eye care but has developed specialized expertise in myopia management, glaucoma, and dry eye treatment. He is also deeply engaged in the optometry profession, having served for nine years on the Ontario Association of Optometrists’ board of directors, including a term as president from 2014 to 2016.
