Myopia: A Behavioral Approach for Prescribing and Vision Therapy

Myopia has reached serious epidemic proportions in many developed countries throughout the world, and is a public health issue with which the optometric profession is deeply concerned. Different clinical approaches are available to the optometrist for treatment of myopia. For the majority of patients, prescribing minus lenses to achieve 20/20 visual acuity at distance does little to prevent a patient from becoming more myopic or to improve vision function in the broadest sense, though it provides immediate improvement in distance visual acuity. A behavioral optometric clinical approach is presented in this paper to give the doctor a clear-cut strategy offering more alternatives to the patient with myopia. Employing this approach has the potential to prevent patients from developing myopia to levels higher than -2.00 diopters, reversing minus lens powers in patients that come to the optometrist already wearing a minus lens prescription, and reducing dependency on using minus lens prescriptions. Vision therapy is addressed as a procedure to improve a patient’s vision function in addition to visual acuity. Book retinoscopy is employed as a valuable technique to arrive at a training eyeglass prescription. At the completion of treatment, a patient typically improves in distance visual acuity, reduces minus lens powers, develops increased confidence in vision capabilities (with and without minus lens wear), develops an awareness and appreciation for additional aspects of vision such as space, forms, colors, patterns, periphery, and feels empowered that they have learned how to improve distance vision through self-initiated control.