My research journey - building a myopia management clinic

If you had told me twenty years ago, when I first qualified as an Optometrist, that one day I’d be running a specialist myopia management clinic and pursuing a PhD in the field, I’d have been very surprised. Back then, myopia management wasn’t even mentioned in my degree course. It simply wasn’t something we talked about, let alone something we could offer patients. But as with many things in science and healthcare, change arrived quickly and for me, it started with a single patient.

After qualifying, and while working in community practice, I saw a young patient whose short‑sightedness was progressing rapidly and whose parents were extremely concerned as they were very short sighted themselves. At that time, emerging research was beginning to suggest it might be possible to slow the worsening of myopia in children. This idea fascinated me. The possibility that we could prevent children becoming highly myopic, reducing their lifelong risk of eye problems and making day‑to‑day life easier, felt both exciting and important.

That encounter sparked a curiosity, and I started digging deeper into the research, following new developments eagerly. And before long, that growing interest pushed me toward a big career change when I applied for a role at the University of Bradford. I wanted to be somewhere I could learn, contribute, and hopefully help shape this new field.

Setting up one of the first myopia management clinics in the UK

In 2016, I set up the Myopia Management Clinic at the University of Bradford, this was one of the first dedicated clinics of its kind in the country. Looking back, it felt a little bit like stepping into the unknown and we were very limited with the interventions that were available but I was determined to offer families evidence-based, high-quality care in an area that was rapidly evolving. The clinic has continued to grow and in 2023 I received the British Contact Lens Association (BCLA) award for Myopia Management Practitioner of the Year which was a lovely recognition of all the hard work that has gone into the clinic.

In the clinic, we offer more than standard eye tests. We provide specialist contact lenses and spectacle lenses designed to slow myopia progression, along with in-depth measurements, imaging, and analysis of the eye growth. Very soon we’ll be among the first clinics in the UK to offer a pharmacological treatment option: low dose atropine. It’s exciting to see how far things have come in just a decade. Some of our earliest patients, children who first came in ten years ago, are now young adults, many studying at university themselves. Seeing them grow up, enjoy the freedom that contact lens wear offers and feeling like we have made a difference to their health in is one of things I enjoy most about the clinic.

We still have lots of questions to answer

But working closely with families also highlighted just how much we still don’t know. Parents often asked me, “When can we stop the treatment?” It was a completely reasonable question, but the evidence simply wasn’t there. We were relying on assumptions, usually based on general growth patterns rather than robust science. Most myopia management treatments are licensed only for children, so continuing in adolescence or early adulthood is possible but technically off‑licence.

Another important question kept coming up too, “Is it too late to start?” We were seeing young adults, even university students, whose eyes were still growing and whose myopia was still progressing. We simply didn’t have the evidence to know if intervening at this age would help. Eventually these unanswered questions pushed me toward a decision I had been considering for some time; completing a PhD so I could contribute to this field myself.

Beginning a PhD at 42

In 2022, I began a part-time PhD alongside my role at the university as a Clinical Teaching Fellow. It felt daunting at first, juggling work, home life, research, and everything else but I knew the questions I wanted to answer, and I knew the work could genuinely help patients. I was fortunate to secure industry funding to supply the specialist contact lenses, which allowed me to design a randomised controlled crossover trial. The aim was to see whether the contact lenses typically used in children have the same effect in young adults aged 18–23. Research tells us that, although myopia progression slows after age 16, a significant minority of people continue to progress into adulthood, especially those doing lots of close work or studying.

The study so far

Before the trial could begin, we first had to find eligible participants: young adults whose eyes were still growing. To do that, we screened 200 students and tracked their eye growth for a full year. Most myopia progression is caused by the eye growing too long, so this is what we measured.

From that pool, 38 students entered the main study. Each participant was randomly assigned to one of two groups: one wearing the specialist myopia management lenses for the first year and the control lenses for the second, and the other doing the opposite. We’re now midway through the second year of the trial, and if all goes to plan, data collection should be finished in early 2028. No research has ever been published on myopia management interventions in this age group, so our study will be the first to explore it. We’re also analysing how well young adults adapt to wearing these specialist lenses, something else that hasn’t been studied before.

Looking ahead

Running the myopia clinic and conducting this research has taught me that science doesn’t stand still and neither should we. The field is evolving rapidly, and I feel incredibly fortunate to contribute to a body of knowledge that will ultimately benefit young people well into the future. Every child, teenager, and young adult who walks through our clinic doors brings a unique story and a new set of questions. My hope is that, by the time this study ends, we’ll have stronger, clearer answers to offer them, grounded in evidence rather than educated guesswork.

Photo 1: Kathryn Webber

Photo 2: Interior of the Myopia Management Clinic