Workforce challenges to implementation of myopia management in Europe: an electronic/telephone expert survey

The European Medicines Agency and the UK Medicines and Healthcare products Regulatory Agency recently approved the first commercial preparation of low-concentration atropine, Ryjunea, for use in children aged 3 years and older to slow the progression of myopia. Whilst optical approaches have been available for several years, the addition of a pharmacological option will increase the involvement of ophthalmologists in paediatric myopia management. However, little information is available about implementation strategies in different European countries. We conducted an electronic/telephone survey with key opinion leaders in myopia management in Germany, the Netherlands, Denmark, the UK, France, Italy, and Spain. We complemented the survey with figures on population size reported by the World Bank and UNICEF, and workforce numbers reported by the International Council of Ophthalmology, the International Orthoptic Association, and national associations, where available. We collated data in categories reflecting the current provision of eye care for children and workforce availability. Prescribing rights for medicines, spectacles, and contact lenses for children, as well as workforce numbers, including paediatric ophthalmologists, optometrists, and orthoptists, vary significantly across European countries. In general, workforce numbers appear low compared with the number of children and young people in each country. Policies and implementation pathways for myopia management in children are required to ensure equitable access. European guidelines for training in myopia management and national pathways and standards of care should be developed and endorsed by professional organisations to enable children and young people at risk of myopia progression to access appropriate interventions in a timely and economical fashion.