The Need for Earlier and More Effective Myopia Management with Carolyn Majcher, OD

At the 2025 American Optometric Association Conference in Minneapolis, MN, Carolyn Majcher, OD, residency director and professor at the Oklahoma College of Optometry, Northeastern State University, presented her lecture on myopia retinal complications and the best management strategies to retain patient vision.1

With global myopia rates rising significantly, several studies and papers have encouraged early diagnosis and effective management. New developments have enabled clinicians to focus more directly on axial length, accommodative responses, and a variety of other ocular health assessments. This has allowed clinicians to provide more accurate, detailed, and repeatable measurements that are critical to the process of detecting and monitoring myopia.2

Majcher addressed some of the warning signs of progressive myopic degeneration, indicating those that she believes warrant more attention and potentially aggressive intervention.

“I think it’s really important that we’re doing imaging on these patients that have high myopia, especially like macular OCTs,” Majcher told HCPLive. “You could easily miss choroidal neovascularization, but if you’re doing OCT angiography, you’re able to pick up neovascularization in its earliest form and other maculopathy complications from myopia such as traction or myopic schisis.”

Majcher also spoke to the importance of educating patients on the signs and symptoms of myopia and best practices to monitor risk, such as regular dilation.

“Sometimes patients that have had high myopia, they’ve had LASIK, so they think they’ve been cured of their myopia. But we’ve taken it out of the cornea, we haven’t taken it out of the retina,” Majcher said. “It’s really important to educate those patients on the signs and symptoms of retinal detachment and these sort of metamorphopsia in their vision, so that we’re routinely dilating these patients looking for early tears, breaks, tears in the lattice, et cetera.”

Majcher encouraged clinicians to take a more proactive stance on myopia prevention, pushing for more optometrists to lean into myopia management as a practice.

“It’s really shocking – myopia over 6 diopters increases your risk of maculopathy by 40 times. Even decreasing that by 1 diopter decreases the risk of having potentially vision-threatening complications,” Majcher said. “Hopefully, it’s motivated individuals to do myopia management, or to refer patients to someone who does want to do it.”

Looking ahead, Majcher discussed future research that she believes would benefit myopia control and the optometric field at large.

“Individuals that have undergone myopic control or management – how has that affected their risk of retinal complications? I don’t think there’s been a lot of literature done on that yet because it’s a relatively new field, but that’s something I’d love to see,” Majcher said. “I think that’s going to be a huge, powerful influence for us as a profession to move forward and make it standard of care, which it really should be.”

Majcher also noted future innovations and advancements in the optometry field, expressing her interest in ongoing and potential studies.

“Probably first and foremost, AI innovations are really exciting and are on the threshold for imaging modalities like OCT,” Majcher said. “There’s renewed interest in education on OCT angiography and implementation and practice. And there’s always imaging innovations that are coming out that I’m excited about, deeper, bigger, wider fields of view, all coming in the future.”

References

1. 1: Majcher C. Motivation for Myopia Management: A Review of Myopic Retinal Complications. Presented at the 2025 American Optometric Association Conference in Minneapolis, MN, June 25-28, 2025.

2. 2: Jones D, Chow A, Fadel D, et al. IMI-Instrumentation for Myopia Management. Invest Ophthalmol Vis Sci. 2025;66(9):7. doi:10.1167/iovs.66.9.7