Eye-care professionals
A SERVICE BLUEPRINT
Start a Myopia Management Service: A Clinical Workflow
For eye-care teams: map a myopia service’s assessment, teaching, handoffs, urgent support and review process before opening the appointment book.Map the service roles and handoffs ↓
Build a myopia service around reproducible assessment, shared decisions, safe treatment delivery and reliable follow-up. Define clinical responsibility, training, equipment access, referral routes and transparent fees before enrolling families. A service is ready when the whole pathway works, not when a device has arrived.
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Define the service before choosing the equipment
A myopia-management service should have a clear clinical purpose: assess the child, explain options, deliver suitable care and monitor outcomes and safety over time. Start by defining which patients and treatments the team can support competently, and where referral is needed.
Write a pathway for a family arriving with a first concern. Identify who collects the history, who performs and interprets the examination, who discusses options, who teaches the routine and who owns follow-up. Include the route for a family who chooses monitoring or another provider.
A named clinician should retain responsibility for clinical decisions. Delegated tasks need suitable training, supervision and local scope-of-practice compliance. A technician's completed measurement and a clinician's interpretation are distinct steps.
The IMI clinical-management report provides a foundation for assessment and informed care. Its 2025 Digest updates the discussion toward individualized, proactive management and sustained attention to safety, vision and acceptance. Treat a consensus report as guidance to implement thoughtfully, alongside current product labeling and professional requirements. [1] [2]
Build an assessment that can be repeated
A useful baseline supports future comparison. Record relevant history, prior correction and treatment, visual needs, examination findings and the methods used. Obtain prior records when possible rather than asking families to reconstruct a trend from memory.
Define how the team obtains reliable refraction and, where available, axial length. Set instrument quality checks, training and documentation standards. The IMI instrumentation report distinguishes measurements of optical function and ocular structure; buying one device does not provide the whole assessment. [3]
Plan how a child who finds a test difficult will be supported. Time, communication needs and repeat attempts affect capacity. An appointment template should allow an assessment to remain clinically useful without encouraging staff to accept a poor reading to stay on schedule.
Specify which findings require additional evaluation or referral. The pathway must handle ocular-health concerns, unexpectedly poor vision or measurements that do not fit the routine presentation. A service aimed at slowing progression still needs to recognize when a different clinical question comes first.
VISUAL GUIDE 1 / 3
Map the service by handoff and accountable role
Examines and interprets findings
Booking and measurement team supply accurate context
Discusses suitable options and consent
Family receives clear instructions and fee scope
Confirms suitability and treatment plan
Trained staff teach and verify the practical routine
Assesses safety, vision and progression
Team books follow-up and escalates concerns
Directs urgent care or referral
Named person closes the communication loop
Test the handoffs with a family journey
Run a rehearsal before promoting the service. Use a fictional case with no personal data, then walk through booking, preparation, examination, decision-making, teaching, resupply and review. Each team member should know what information arrives and what they must pass on.
Ask the front desk what happens when a parent reports symptoms while requesting a routine appointment. Ask the teaching team what happens if the child cannot demonstrate the skill. Ask the clinician how an unexpected measurement is checked. Ask who notices when a review is not booked.
The rehearsal should include declining or deferring treatment. A family needs a clear next step even if they do not enroll in a package. Avoid designing a pathway that becomes vague as soon as a sale is not made.
Use the gaps to revise the process. A missing handoff is easier to repair during a rehearsal than after a family has left with a product, incomplete instructions and no follow-up date.
Match the modality to the household and the service
The treatment conversation should connect examination findings, evidence, preferences, practical workload, adverse effects and cost. It should not begin with whichever device or product the practice most recently acquired.
Map the work involved for each option your service offers. Spectacle-based care still requires appropriate fit, instructions and follow-up. Contact lenses require a teaching and safety pathway. Medication introduces prescribing, pharmacy and tolerability issues. Overnight lenses need design-specific fitting expertise and monitoring.
Do not assume that combining treatments automatically provides an appropriate next step. The clinician needs to assess the evidence for the exact combination and the child's situation. More tasks can also create more opportunities for an unsupported routine.
The service should be able to explain alternatives and referral options. If the team cannot safely deliver a modality, that limitation belongs in the discussion. Clear scope is a quality feature, not a reason to pressure the family toward the only product available.
VISUAL GUIDE 2 / 3
Every modality brings a different delivery workload
Spectacle-based
- Before use
- Suitable prescription, fit and instructions
- Continuing work
- Fit, usable vision, wear and clinical reviews
Soft contact lenses
- Before use
- Clinical fitting and observed handling
- Continuing work
- Supplies, safety response, fit and progression review
Overnight Ortho-K
- Before use
- Design-specific training, fitting and family teaching
- Continuing work
- Ocular health, lens condition, visual performance and progression
Medication
- Before use
- Prescribing, product verification and counseling
- Continuing work
- Supply, tolerability, response and continuation decisions
Design the consultation around an informed choice
Reserve time for the family's actual questions. A treatment's average trial effect does not describe every child's outcome, and a consent signature does not establish understanding.
Explain the purpose, expected benefits, limitations, risks and practical demands in plain language. Separate clinical recommendations from commercial terms. Ask what the child and caregiver want to know before closing the discussion.
AHRQ's informed-choice training emphasizes checking understanding as the conversation proceeds. Ask the family to describe the main options and next steps in their own words; clarify rather than simply repeat the same explanation. Provide suitable language and accessibility support. [4]
Document the discussion and the decision, including the plan when treatment is deferred. Avoid templated claims that imply every family received identical counseling. A concise individualized note should show why the chosen plan fits the clinical question and household circumstances.
Make teaching and urgent support operational
A teaching appointment should end with an observed skill and a clear help route, not only a handout. Decide how the team will check that the child and caregiver can manage the specific prescribed routine and what happens if they cannot.
Provide written advice that matches the actual product and prescription. Version control matters: an outdated lens-care sheet or an old pharmacy instruction can undermine an otherwise careful consultation.
Create a practical route for symptoms and out-of-hours concerns. Staff should know how to escalate without making clinical judgments outside their role. Families should know where to seek urgent assessment if the usual practice cannot be reached.
Include continuity when a trained person is absent. Identify who can cover reviews, interpret data, teach skills and answer a clinical question. A service that relies on one person's memory is vulnerable even when that person is experienced.
VISUAL GUIDE 3 / 3
A launch rehearsal must reach a safe next step
Booking, language, access and expected fees are understandable.
Equipment, competence, teaching and the actual product are available.
Clinical escalation and out-of-hours routes are defined.
Review, resupply, cover during absence and referral are tested.
Explain the financial scope before enrollment
List the services and products included in any fee. Distinguish the assessment, fitting, routine reviews, replacements, emergency evaluation and external costs. Explain what happens if a treatment changes, is stopped or cannot be used.
Verify coverage for the specific payer rather than implying that the clinical purpose guarantees reimbursement. The separate billing guide provides a verification process.
For uninsured or self-pay patients, review the applicable good-faith-estimate requirements. CMS describes the requirement to provide expected charges in qualifying situations before care. A promotional package description may not contain all the information required for that estimate. [5]
Use language the family can act on. “Contact us if your situation changes” should include a real contact and an explanation of which questions the team can answer. Financial uncertainty should be raised before the family is committed to a routine they cannot sustain.
Review quality across the whole pathway
Choose a small set of process checks before launch. Examples include whether the next review is booked, whether instructions are current, whether an incomplete teaching session has a documented plan, and whether the clinician has acknowledged unexpected findings.
Review outcomes without turning every number into a promise of treatment success. Clinical trend interpretation needs the method, interval, age, treatment use and safety context. The monitoring guide develops that work.
Ask families what was unclear. A well-equipped clinic can still lose people between a clinical decision and a practical task. Repeated calls about the same instruction may reveal a teaching or design problem rather than a family problem.
The American Academy of Orthokeratology and Myopia Control (AAOMC) offers professional education and resources. Use appropriate training, manufacturer support and professional development to maintain competence. Academy inclusion here does not imply endorsement of this service model. [6]
Launch the pathway you can deliver reliably
Start with the scope, staffing and capacity you can support. Make expansion dependent on demonstrated competence and a functioning follow-up system, not only demand.
Keep referral arrangements current. A family should not have to discover the limits of the service after an urgent problem or an unsuitable treatment trial. Record where the next stage of care will happen and how relevant information will reach that clinician.
Use the launch worksheet to test a complete journey, including a difficult handoff. It is an organizational aid, not a substitute for local clinical governance, legal requirements or professional judgment.
A service is ready when the team can explain what happens next for each family and can carry out that next step safely.
Your service launch review
Discussion prompts only. Checks stay on this open page; nothing is submitted or saved. This sheet does not diagnose, choose treatment or determine urgency. Do not delay urgent care to complete it.
CHECK THE EVIDENCE
Sources & references
Research, professional guidance and patient resources. Checked October 22, 2026.
- 1IMI Clinical Management Myopia Guidelines ReportInternational Myopia Institute · 2019
- 2IMI 2025 DigestInternational Myopia Institute · 2025
- 3IMI: Myopia Management InstrumentationInternational Myopia Institute · IOVS · 2025
- 4Making Informed Consent an Informed ChoiceAgency for Healthcare Research and Quality
- 5Providers: Payment Resolution with PatientsCenters for Medicare & Medicaid Services
- 6Practitioner Education and ResourcesAmerican Academy of Orthokeratology and Myopia Control (AAOMC)
General education. This article does not replace an eye examination, individual advice, or the prescribed care plan.
