Curbing the epidemic of myopia, particularly severe myopia, has become a priority because of its public health and socioeconomic consequences. Managing Myopia - One Child at a Time begins with a review of the recent literature on the epidemiology of myopia and the means of controlling its progression available to date. Based on their experiments and clinical experience at the University of Montreal School of Optometry reference center ("the Montreal Experience"), the authors then outline the recommended approaches according to the different optometric and biometric parameters (axial length, pupil size, etc.), with the help of decision trees, but also according to the context, emphasizing that each case is unique ("one child at a time"). The importance, ideally, of measuring the axial length and its evolution is underlined. Among the many tips given for optimizing myopia control, the authors discuss the value of customizing orthokeratology lenses, especially the treatment zone, as well as multifocal soft lenses. The case studies in the final chapter illustrate different scenarios and the many aspects of managing progressive myopia in practice. This book will be an invaluable tool for vision practitioners concerned with preventing and best controlling progressive myopia (which should be all vision practitioners!).

- Jean-Charles Allary, OD

Formerly in charge of the optometry course at the University of Paris-Sud,

Author of the book Ocular Refraction and Binocular Vision


At a time when childhood myopia progression is raging across the world like a wild fire, this text could not be more important. As an educational and reference tool for the neophyte and experienced practitioner alike, this body of work will serve as a guide for best practices in myopia management. The authors have summarized the pertinent and compelling research as well as provided a unique case study approach to care. This is a highly beneficial tool for any practitioner interested or involved in myopia management.

- Randy Kojima

Adjunct Clinical Professor, Pacific University College of Optometry



This book has such a practical and clinical approach - a real guide to myopia management in daily myopia practice based on the Montreal experience. The latter is crucial: the authors speak from their own research and experience, to provide the best guide possible to their knowledge for one of the most important topics in the field of eye-care today. The subtitle sums it all up I think: 'One Child at the Time'. Myopia Management is so complex - there is no such thing as a 'one-size fits all’ approach for all individuals. This book is a very good attempt to try to deal with all these variables, and categorize these variables where possible. Compliments on this endeavour.

- Eef van der Worp

Ph.D.- Educator and Researcher


Coincidentally on World Book Day 2022, this is to my knowledge the 1st text book version of the clinical need, method, science and theory of myopia management to be produced ..

Myopia, the disease, is now one of the main foci of optometry practice ( and will be in the future that of ophthalmology practice) and as such we are ( should be ) focusing all our efforts in learning and updating our education for use in day to day practice

This book, fully referenced, gives an opportunity to look up the types of myopia, the clinical influences and the options for treatment, all in one place ..

There are may references out there for each aspect of the condition, but other than a few internet sources (superb tho they may be ) this book allows fireside reading, quick reference, and in depth investigation all in one place.

I commend the team behind this comprehensive venture and am sure, like a Kanski, it will become one of the optometry “bibles” on the shelves of our practices.

- Brian Tompkins

Former president British Contact Lens Association (BCLA)

BSc Hons FCOptom FBCLA


If you immerse yourself in this wonderful book “MANAGING MYOPIA – One child at a time”, you will meet Jason. He is very lucky this boy, he had his myopia managed by the team of the clinic of the University of Montreal. Jason is lucky because he was treated as a unique, exceptional case, and with myopia analyzed before being treated. Jason is lucky because he won't become very myopic like his grandfather!

But you will also meet lots of myopic children who benefit from the Montreal Experience. Written by a team of passionate professionals, led by my friend Langis Michaud, who for many years has been interested in this modern-day epidemic.

Passionate about this subject for a long time, this book gave me new leads, new approaches, shared tips and tricks and the desire to further perfect my approach to the subject. This book also gave me the desire not to visit Montreal (because they don't talk about it much!) but the university clinic, meeting the team, touching and seeing a little closer this famous "Experiencing Montreal”. It reads either like a novel, or like a cookbook, it's up to you! It is a magnificent work of references, of case reports, it is inspiring, motivating and last but not least: in French! And being able to read a scientific book of more than 300 pages on this subject represents a real gift for all French-speakers passionate about vision problems, whether they are ophthalmologists, optometrists, opticians or orthoptists, because it is by combining our respective strengths that we will be able to manage myopia!

Thank you Langis and the whole team for sharing your passion, skills and experiences in such a professional and sincere way.

- Philippe Seira

Licensed Optician & Teacher in Contactology

FHNW-Institut d’Optométrie- Switzerland/Suisse


This is a book that will not gather dust on our shelves!

On the contrary, it will be constantly at our side, serving as a reference for our next appointments with children showing signs of myopic evolution!

What eye care professional hasn't dreamed lately of having, at his or her side, a summary of all the tools we have available these days for our children who have one thing in common, myopic evolution, but who each suffer from it differently!

You dreamed it, Langis Michaud and his colleagues did it!

This book, based on the principle that each child to be treated is different, is complete.

It has everything!

An update of scientific knowledge on the subject of progressive myopia in children; what we, as practitioners, can do to manage it in the most appropriate way! How to best treat each case by reminding us of the testing to be carried out and the conclusions to be drawn so that the protocol we put in place is the most judicious!

This book ends with cases presented which, I am sure, will make you think of some of your little patients!

Thank you to Langis Michaud and his colleagues for taking the time to write this book, for sharing their experience with us and for enabling us to be even more attentive to each child we have to treat!

- Pascale Dauthuile

Ancien Maître de Conférences associé à l’Université d’Orsay-Paris Saclay

Présidente AFELC


I read this publication with particular motivation and interest.

The authors have captured and highlighted the clinical aspects, which are part of the daily practice of eyecare providers. They have managed to integrate the evidence-based science, thus simplifying the implementation of a protocol validated by the scientific community.

A great work, with attention to detail, that facilitates scientific consultation for the practitioner in his daily practice.

A book that should represent a fundamental starting point for all professionals who are actively involved in myopia and its evolution in young people.

- Dr Marino Fromenti

O.D., FIAOMC- EurOK President


I learned from every page and the information contained is extremely valuable. Normally books are more scientifically oriented. Here there is a real translation from the scientific to the clinical. I believe this book will be a reference for the clinician wanting to manage myopia.

The book is easy to read, and on each page it describes and introduces additional information to the myopia "mind map". Every clinician needs to internalise this information in order to do effective clinical work. But the real value of this enormous work is the transfer of the "Montreal Experience".

Thank you for the honour of being able to read your magnificent book before publication. 

- Jaume Paune Fabre PHD

ISCLS member

Orthokeratology and Anti-Myopia Lens Designer

Professor Terrassa Optics and Optometry Faculty

European Chairman for Fellowship – International OrthoK Academy


The prevalence of myopia has significantly increased, and in certain countries, it has reached epidemic levels. By 2050, half of the population will be myopic with substantial socio-economic impact and pathological consequences such as myopic maculopathy and high myopia associated optic neuropathy, which are common causes of irreversible blindness. The mechanisms underlying the onset of myopia progression are several and differ between individuals. Therefore, clinicians need to consider several factors when selecting the appropriate management strategy for each, including personal circumstances, geographic regions, and patients’ age, health, and lifestyle. In some cases, a combination of treatments is necessary.

Indeed, the title of this manuscript authored by Langis Michaud, Remy Marcotte, Patrick Simard, Mhamed Ouzzani, “Managing Myopia, One Child at a Time,” reflects this reality and the necessity to treat every child differently. The authors started the book by summarizing and “translating” the findings of both IMI white papers, 2029 and 2021, in a “clinical language,” making it directly relevant to eye care practitioners. To better understand this translation, the authors included several tables explaining the clinical actions required for each scientific concept. The following chapters analyze the basis for myopia management, the different techniques available, and the selection of the appropriate management strategy based on the diagnosis for every patient. The final chapter put the theory into practice by discussing 15 case reports, different from each other’s in diagnosis and management strategies, covering most of the scenarios that clinicians may encounter during their daily routine.

I am impressed by what the authors have accomplished with this book, rendering it an essential textbook in each clinical practice specialized in myopia management.

- Daddi Fadel



In my decades of practice in pediatric eye care, I have experienced the challenge of variable outcomes of myopia management”.   “Managing Myopia One Child at A time” provides a comprehensive and concise review of the literature, myopia control theory and methods.  It presents the precious clinical pearls in a clear and understandable way. “Montreal Experience” introduced in this book will assist clinicians’ decision making and serve as a guideline for optimal myopia management. 

- Helen Changmin Duan, OD, MS, FIAOMC

Assistant Clinical Professor, Emeritus

State University of New York, College of Optometry