Thank you to CooperVision for supporting the Defocus Media Podcast and connecting us with our expert guests for this conversation.
With 41.6% of Americans affected by myopia and evidence of rapidly increasing rates of myopic progression experienced by kids during the COVID pandemic, optometrists are being called upon to help slow down this global epidemic. Surveys show that the majority of US based optometrists (87% in a 2019 poll) are interested in offering myopia management in their practices, but very few are actually doing so. Fitting rates of myopia management contact lenses for children is under 5% in the USA currently. So how do we make the shift from being interested as a profession to actually providing myopia management to our patients?
Joining us on this episode are Dr. Aamena Kazmi of Bellaire Family Eye Care, and Dr. Gabriela Olivares of The Eye Center of Pembroke Pines, Florida. Both of these doctors have prioritized integrating myopia management into their private practices, and each of their practices have successfully fit nearly 50 patients in MiSight 1-Day disposable contact lenses for myopia control.
Dr. Olivares shared that COVID closures for their office was when they decided to make myopia management a core focus. “We had that time to sit down and think about how we could come back stronger.” Both she and another doctor in her practice got MiSight certified during that time and once their offices were back open, they immediately launched myopia management as a core part of their practice. Dr. Kazmi developed a passion for myopia control during her optometry school experience at University of Houston College of Optometry. The school now has a myopia management clinical rotation for students as well! But while new graduate optometrists are getting hands-on experience with myopia control in clinic now, all doctors are learning how to integrate this specialty into their practice management.
“Myopia control is a win-win,” Dr. Olivares states when asked about the practice management aspect of adding myopia control as a specialty. “It’s great for the practice and it’s great for the patients.” Their practice achieved success by focusing on internal referrals from the other doctors in their large group practice for any myopic children under 18 or those with rapid prescription progression. They also created specific branding and a new website for their myopia management clinic called Nearsighted Solutions. In Dr. Kazmi’s office she states that a key to success has been talking about myopia management to every eligible patient at every patient encounter. They made packets to send home with parents to give them more information since that initial day of the comprehensive exam it can sometimes be overwhelming for a parent to digest.
Both Dr. Olivares and Dr. Kazmi agree a key to success is to schedule eligible patients for a follow-up visit to focus on myopia management options in more detail. If a parent is not interested at the time of the initial visit, instead of waiting to discuss things again next year at their annual exam where prescriptions may have skyrocketed, they schedule follow-up visits sooner – between 3 and 6 months. In their experience, many kids are already progressing within 6 months from their last visit, and seeing that change is happening so fast can help highlight to the parent the importance of intervening. Other tips that they advise to help better educate parents:
- Demonstrate to parents how difficult it is for their myopic children to see by using plus lenses in the child’s Rx and letting them look across the room. You can also show them changes in prescription this way. For example if the child changed from -1.50 to -3.00, you can hold up a +1.50 and then a +3.00 to the parent to show them what those numbers truly mean.
- Utilize the Brien Holden Vision Institute Myopia Calculator to show parents predicted outcomes if their prescription continues to change.
- Define success so that parents understand that myopia management cannot reverse a prescription, and that it cannot stop all further changes from happening. In a three-year clinical trial, patients prescribed MiSight 1 Day lenses for myopia control achieved 59% less change in prescription and 52% less change in axial length than the control group.
What can you do when parents push back that they have never heard of this treatment option? Dr. Kazmi explains to parents that many doctors in her area are not offering myopia management to their patients at this time because it does require additional certification, which she has completed. The MiSight 1 Day contact lenses for myopia management received FDA approval in 2019, so many doctors’ office have just now started to adopt this new technology. With this option being so new, she assures parents that they will be hearing more and more about it from school nurses, pediatricians, and through social media campaigns as the word gets out! When she does have push back, she is careful to listen and understand where her patients and their parents are coming from. “I understand that this isn’t the option you’d like to move forward with right now, so let’s meet back up and see how your child’s eyes are changing in 6 months.”
Check out more great tips and advice by tuning in to the episode for how to build and grow your myopia management practice. And head to https://coopervision.com/practitioner/myopia-management to learn more about adding myopia management to your practice and to get certified to fit MiSight 1 Day.