This website uses cookies to store information on your computer. Some of these cookies are used for visitor analysis, others are essential to making our site function properly and improve the user experience. By using this site, you consent to the placement of these cookies. Click Accept to consent and dismiss this message or Deny to leave this website. Read our Privacy Statement for more.
Print Page | Contact Us | Report Abuse | Sign In | Join
The Corrected View
Blog Home All Blogs
The Corrected View is the official blog of the American Academy of Orthokeratology and Myopia Control. Content includes news, education, and topics in and around Ortho-k & Myopia Control.

 

Search all posts for:   

 

Top tags: Ortho-K  orthokeratology  Corneal Reshaping  VBD  Vision By Design  OAA  Myopia Control  Myopia  IAO  Boot Camp  Nick Despotidis  Practice Management  Paragon Vision Sciences  Bausch & Lomb  Paul Levine  Caroline Guerrero Cauchi  Cxl  Marino Formenti  Fellowship  GSLS  Lasik  Scleral Lens  Atropine  Cary Herzberg  Corneal Crosslinking  GOS  CRT  AAOMC  Jerry Legerton  Pat Caroline 

Introducing Ortho-K into a Primary Eye Care Practice

Posted By Monica Allison, OD, MBA, FIAOMC, FSLS, Wednesday, July 22, 2020

Ortho-k can provide a financial boost to any practice as it requires private pay and it is one of the most rewarding additions one can make to a practice.  With appropriate candidate selection, your patients will become ambassadors for your practice and they will help set your office apart from those who are merely performing eye exams.  It is not difficult to introduce this specialty into an already established practice. 

Most of the things required for ortho-k are already in an optometrist’s office: slit lamp, phoropter, and topographer.  Patients must receive a good refraction and an evaluation of their corneal health. Topography is a must-have for success with ortho-k.  Once regular fittings are achieved, the instrument will pay for itself.

Once the diagnostic tools are in place, proper training must occur for the doctors and the staff.  The staff will be on the frontline fielding questions and promoting OK to patients so they all must understand the process from start to finish.  Many different lens companies will offer training for your entire team, and there are certifications available on their websites.  It is recommended that doctors AND staff complete the training.  The American Academy of Orthokeratology and Myopia Control offers an annual conference, Vision By Design (VBD), that is amazing for hands-on learning opportunities and getting tips from practitioners that are more experienced.  There is a boot camp at VBD every year for newbies and it is one of the best jump starters a practice can do.  Joining the Academy also allows access to google groups and mentor programs where an experienced fitter can help guide the new fitter.

Initially, it would be easiest to start with one lens choice and gain familiarity with fitting that lens.  There will be specific problem-solving solutions with the lens that is chosen and working with their consultants will help discover these.  Fitting sets are recommended with some manufacturers but there are also great options with lens designing software.  When choosing a topographer, if you do not have one yet, consider one that has the capability to create custom OK lens designs.  This will allow you to expand your fitting parameters as you develop confidence in the process.  Choosing the right candidates initially will aid in success and generate excitement in the office as everyone sees the great results.  Low myopes and children are the easiest candidates. Avoid any cylinder above 1.00D initially. When starting out, avoid extremely high demanding, presbyopic, adult engineer patients that expect perfection at all distances.

The best way to start after you are trained is to discuss ortho-k and myopia control with every parent of every myopic child under -4.00.  Adults that are not high demand under -2.50 would also be good to discuss the process with.  It is also important to discuss lifestyle with every patient.  For example, learning that someone is a competitive swimmer and they are using soft contact lenses in the pool would be a good opening for discussing how valuable visual freedom from ortho-k would be.  After you fit one swimmer successfully, the word of mouth from the team will follow.  All happy ortho-k patients promote their doctor to anyone that will listen.  They wonder why no other doctor has mentioned it to them.

As you become more comfortable with higher prescriptions, including Ortho-k as an option for all of your myopic patients will create satisfied patients and create extra revenue for your practice. It is win-win for everyone.

Monica Allison, OD, MBA, FIAOMC, FSLS

This post has not been tagged.

Share |
PermalinkComments (0)
 

MYOPIA CONTROL: An Argument for Axial Length

Posted By Cheryl Chapman, OD, FAAO, Diplomate ABO, Wednesday, July 22, 2020


To measure, or not to measure.  That is the question.

Well here is a hotly debated topic.  In 2016 I asked a question on a facebook forum that went something like this:  ‘What instrument is everyone using to measure axial length?’  I thought I would get a list of A-Scans and their pros and cons.  Wrong.  Instead I had docs asking me why on earth I wanted to spend money on an A-Scan?  After all, if refraction was stable, why did it matter?  I realized then that many people were, at that time, managing myopia without measuring axial length.  

 

The Tide Is Changing

Let’s examine a couple of reasons why I believe axial length is relevant.  

  • Atropine Study Results:  The ATOM 2 study got everyone all hyped up about 0.01% Atropine (myself included).  However, in early 2019, the LAMP Study (which put more emphasis on axial length) was published.  Even though 0.01% seemed to reduce progression of refractive error, it had little to no effect on reducing progression of axial elongation.  

    Hyperopic Shift:  The use of low-concentration atropine can result in a hyperopic shift.  As such, it stands to reason that we cannot depend on measurements of refractive error as our sole means of monitoring progression of myopia.  

    My Own Clinical Observation:  Fortunately I ignored the naysayers,  followed my own counsel, and purchased an A-Scan (I have an IOLMaster).  I noticed that the majority of children I started on atropine 0.01% were progressing in axial length.  I increased their dosage concentrations until I saw stability and I monitor them every 3 months.  The LAMP Study only confirmed what I was seeing clinically.

100% Essential

I believe axial length provides valuable information with all myopia control methodologies.  However, when it comes to managing myopia with low-concentration atropine,  my opinion is that utilization of a high quality, repeatable A-Scan is 100% essential.  

 

Cheryl Chapman, OD, FAAO, Diplomate ABO

This post has not been tagged.

Share |
PermalinkComments (0)
 

Conducting a Myopia Management Evaluation During a Pandemic

Posted By Caroline Kaufman, OD, FIAOMC, Wednesday, July 22, 2020

This article will be generally about providing initial consultation for myopia management with an emphasis on orthokeratology.  Since we are in the midst of a pandemic, I will also share what we have changed for this situation.  

I like to have a comprehensive exam including binocular vision/accommodative testing and cycloplegic refraction prior to a consult.  If the patient is referred by an outside doctor, I will get those records prior to the appointment. 

On the day of the consult we will schedule the patient for an in-person visit with our technician for screening topography.  If all of the other testing has been done prior, I will need to evaluate biomicroscopy and check pupil size.  

  1.  We also take the following history

  1. Age when patient was first prescribed glasses

  2. Current spectacle RX 

  3. History of prior contact lens use

  4. Sports/activities

  5. Number of hours of sleep per night

  6. Parent RX’s

One change for the pandemic is that the patient and parents will have a separate virtual appointment with me to discuss myopia management options. This allows me to connect with patients and parents without wearing a mask.  It also allows the other parent to be present since we are only allowing one parent to accompany the child into the office. Prior to that appointment I review the case to determine the suitability for the various options.  I have the ability to share my screen so that I can discuss graphs and illustrations.  We will discuss the role of vision therapy for that particular child.  We also go over atropine, soft daytime specialty lenses for myopia management as well as orthokeratology.  I find it helpful to use a graph that shows average myopia progression based upon age and demographic.  If the child is a good candidate for either daytime or nighttime lenses, we discuss their willingness to participate.  If they are hesitant to wear any type of contact lens, it can be quite helpful to address their concerns.  I sometimes find it beneficial to let them hold a soft lens as well as an orthokeratology lens.  If they still seem unwilling or too fearful…I usually suggest we postpone contact lens fitting.   For willing candidates, we discuss:

  1. Risk of infection and importance of proper lens care.  

  2. Myopia is still likely to progress, just not as quickly

  3. What to expect during the first few months of lens wear

  1. Comfort for first few days compared to once adapted

  2. Afternoon vision less clear at least initially

  1. If RX is outside of FDA approved range this will also be discussed

  2. Follow up care: 

a. Minimum number and timeframe of follow-up appts.

  1. We need them to be available for the majority of the first 90 days. (i.e. not on vacation for extended period during that time)

  1. Importance of getting at least 8 hours of sleep for best results


If the child seems to be a good candidate for orthokeratology, and the parents and child choose this option-- I will have them back for a fitting appointment.   At the fitting appointment we will take several topographies per eye (although I am just starting to use Pentacam—which may speed up that process).  We take serial topographies until we feel that we have reproducibility and a good baseline.  I am currently designing lenses using software.  I still find it helpful to put a lens on the eyes for 2 reasons:

  1. It gives me an idea of how easy or difficult it will be to train the patient to wear lenses

  2. It gives me an opportunity to evaluate a lens of known diameter on the eye to help choose the diameter of lens to order. ( I find that horizontal white to white measurements on imaging sometimes overestimate the corneal diameter.)


Telehealth can be a useful tool for orthokeratology consultations…especially during this current pandemic.  Software based fitting, rather than relying heavily on diagnostic fitting, can minimize chair time.

Caroline Kaufman, OD, FIAOMC

This post has not been tagged.

Share |
PermalinkComments (0)
 

Orthokeratology with Apprehensive Patients

Posted By Dwight Barnes, O.D., FIAOMC, Wednesday, July 22, 2020

Orthokeratology is a suitable option for vision correction of all ages. However, those of us who primarily focus on myopia control end up seeing mostly children for this service. There are plenty of patients in this age range that are very apprehensive about anything coming near their eyes. These patients present a unique challenge for orthokeratology. We would prefer to start their myopia control treatment as early as reasonably possible to provide the best possible control of their myopic progression. Here are some tips that I have learned along the way to make the initial fitting process as easy as possible for these young patients.

Get the child’s “buy in” 

Very often when presenting myopia control, we get immediate interest from the parents. The patient however is sometimes ambivalent, and on occasion they are afraid. In our practice we take pictures of successful orthokeratology patients and display those pictures in the hallway leading to our exam rooms. This way the patient can see that there are many children about their same age who have been successful with this treatment. When discussing the treatment, it is important to speak directly to the child and specifically encourage questions from him or her, instead of just speaking to the parents. I will typically explain to the patient the benefits we are able to achieve with this treatment (seeing clearly without glasses and slowing down the worsening of their vision). While their parents are usually more interested in the myopia control aspect, the children often care more about seeing without having to wear their glasses.

Explain the process clearly to the patient

Children are smart and they can understand the orthokeratology process quite well. At the evaluation visit, I make it a point to explain to the child exactly what I am going to do and exactly how it will feel. Whether they say it or not, their main concern is usually “will it hurt?”. I am careful to always be honest with them. There will be an awareness and that will feel very unusual to them. However, I also explain to them why it feels that way (mostly the interaction between the orthokeratology lens and the underside of the eyelid). I also explain to them that when they close their eyes gently, as if they were going to sleep, the sensation will be much less. Once I’ve washed my hands, I show them exactly how I will insert the lens, without actually having a lens on my finger. I instruct them to look straight ahead and show them how I will hold their lids open. I tell them that I will bring the lens to right in front of their eye and will ask “Are you ready?”. Then I tell them they will say “YES!” and I will put the lens on their eye. This allows them to feel in charge of the process. If they say they are not ready we will take a brief break and try again. I want them to know I will not force them to do anything. 

The Moment of Truth

Once I put the lens on their eye, I remind the patient of how I told them it would feel. Then I invite them to gently close their eyes for a moment as they start to get used to the comfort. Of course, it is important to give them praise for their part in successfully inserting the lens. Once they see that everything went smoothly and that they can tolerate the sensation, the second eye is usually much easier. Most patients are excited to be successful in doing something they did not think they would be able to do. This success in the exam room typically leads to success in training the child how to do it for themselves. 

While most children are not terribly apprehensive, it is helpful to have a plan for those who are. This way their fear does not create a barrier to providing the most effective treatment for their myopia. I have found that with the right communication and process, most of these nervous patients are still able to be successful.

Dwight Barnes, O.D., FIAOMC

 

Dr. Dwight Barnes practices optometry with his wife, Dr. Kelly Barnes, at Cary Family Eye Care in Cary, NC.  In addition to myopia control he also provides routine comprehensive eye care and fits other specialty contact lenses. He is a fellow of The Academy of Orthokeratology and Myopia Control.


This post has not been tagged.

Share |
Permalink
 

Building A Pediatric Practice (New Episode of TCV Podcast!)

Posted By Matthew Herzberg, Saturday, July 18, 2020

The Corrected View Podcast Episode 4: How To Build A Pediatric Practice

If you want to do myopia control then you need to see kids. So we invited Dr. Nate Bonilla Warford to be our guest to discuss how he built a kid's only optometry practice in the retirement capital of the world.

BECOME A MEMBER: https://aaomc.site-ym.com/page/become-a-member 

AAOMC FUNDRAISER: https://aaomc.site-ym.com/events/EventDetails.aspx?alias=2020fundraiser

PODCAST ARCHIVE: https://aaomc.site-ym.com/news/?id=15260

PODCAST RSS: https://www.orthokacademy.com/the-orthok-podcast?format=rss

SUBSCRIBE ON APPLE PODCASTS: https://podcasts.apple.com/us/podcast/the-corrected-view-an-ortho-k-myopia-control-podcast/id1204529000

AAOMC FB GROUP: https://www.facebook.com/groups/AAOMC/

Tags:  Cary Herzberg  Myopia Control  Nathan Bonilla Warford  Ortho-K  orthokeratology  Paul Levine  Pediatrics  Podcast  The Corrected View Podcast 

Share |
PermalinkComments (0)
 

Is It Time To Get Your Fellowship? (New Episode of TCV Podcast!)

Posted By Matthew Herzberg, Monday, June 1, 2020
Updated: Friday, June 5, 2020

The Corrected View Podcast Episode 3: Get Your Fellowship!

With the current state of the world and the uncertain future of COVID-19. Maybe now is the time for you to pursue your AAOMC fellowship.  Dr. Caroline Cauchi and Dr. Avi Zlatin, our two fellowship co-chairs, guest on the podcast to discuss what fellowship means, why you should become a fellow, and what goes into the process to attain it. 

AAOMC FUNDRAISER: https://aaomc.site-ym.com/events/EventDetails.aspx?alias=2020fundraiser

PODCAST ARCHIVE: https://aaomc.site-ym.com/news/?id=15260

PODCAST RSS: https://www.orthokacademy.com/the-orthok-podcast?format=rss

SUBSCRIBE ON APPLE PODCASTS: https://podcasts.apple.com/us/podcast/the-corrected-view-an-ortho-k-myopia-control-podcast/id1204529000

AAOMC FB GROUP: https://www.facebook.com/groups/AAOMC/

Tags:  Avi Zlatin  Caroline Guerrero Cauchi  Fellowship  FIAOMC  Myopia Control  orthokeratology  Podcast  The Corrected View Podcast 

Share |
PermalinkComments (0)
 

Ten Reasons NOT To Do Ortho-k?????? (New Episode of TCV Podcast!)

Posted By Matthew Herzberg, Wednesday, May 13, 2020
Updated: Friday, June 5, 2020

The Corrected View Podcast Episode 2: Ten Reasons Not To Do Ortho-k

 We originally had plans to release this back in February as a primer for Boot Camp at Vision By Design. Unfortunately, we had to cancel VBD due to the pandemic. However, we still had a great conversation in this episode where Caroline Guerrero Cauchi and I discuss 10 reasons NOT to do Ortho-k. 

AAOMC FUNDRAISER: https://aaomc.site-ym.com/event/2020fundraiser

Podcast Archive: https://aaomc.site-ym.com/news/?id=15260

RSS Feedhttps://www.orthokacademy.com/the-orthok-podcast?format=rss

Subscribe on Apple Podcastshttps://podcasts.apple.com/us/podcast/the-corrected-view-an-ortho-k-myopia-control-podcast/id1204529000

AAOMC FaceBook Grouphttps://www.facebook.com/groups/AAOMC

Tags:  AAOMC  Caroline Guerrero Cauchi  Corneal Reshaping  Ortho-k  orthokeratology  Podcast  The Corrected View Podcast 

Share |
PermalinkComments (0)
 

The AAOMC Needs Your Help!

Posted By Matthew Herzberg, Wednesday, March 25, 2020
Updated: Monday, June 8, 2020

Greetings everyone,
As you know the AAOMC was forced to cancel Vision By Design 2020 in lieu of the spread of COVID-19. Canceling VBD has put the academy in a very difficult position financially, one that we are currently attempting to navigate.

Some of our members have offered to donate to the AAOMC in order to help the AAOMC survive these difficult times. For that gracious gesture, we are very thankful and have put together an official AAOMC 2020 Online Fundraising event to enable these contributions from our membership. We’ve specifically designed the different levels of this fundraiser to give rewards and benefits to those that are able to donate. It’s our way of trying to give you something back in exchange for your support.

For the full details of this event, what your support goes towards, and what benefits are included with each tier, please visit the official page for the fundraising event here: https://aaomc.site-ym.com/event/2020fundraiser

I would like to add that we understand that things are tough for everyone and we live in a difficult and uncertain time. The AAOMC does not want you to donate to us if doing so brings you harm in any way. This fundraiser will be active all year long and provided that things return to a more normalized pace we will always be open to your help if that becomes an option in the future.

I want to say that I hope everyone is safe and healthy and my heart goes out to all of you and your families during this lonely, frustrating, stressful, and anxious time for everyone. The AAOMC has always been like a family to me and you are all in my thoughts right now.


Warm Regards,
Matthew Herzberg
AAOMC Executive Director

Tags:  fundraiser 

Share |
PermalinkComments (0)
 

The AAOMC's Podcast Is Back With A New Name And Direction!

Posted By Matthew Herzberg, Thursday, February 13, 2020
Updated: Friday, June 5, 2020

Welcome to The Corrected View, a podcast about myopia control and the people devoted to its role in specialty care. Each episode we will be discussing news, education, and important topics in and around ortho-k and myopia control. Hosted by Matthew Herzberg, executive director of the AAOMC.

The Corrected View Podcast Episode 1: Misight, Axial Length, Best VBD Yet!

In this episode I talk with Paul Levine OD FIAOMC and Cary Herzberg OD FIAOMC about the recent Misight FDA Approval, The Importance of Axial Length, and why this year’s Vision By Design is going to be the best one yet.

Podcast Archive: https://aaomc.site-ym.com/news/?id=15260

RSS Feedhttps://www.orthokacademy.com/the-orthok-podcast?format=rss

Subscribe on Apple Podcastshttps://podcasts.apple.com/us/podcast/the-corrected-view-an-ortho-k-myopia-control-podcast/id1204529000

More info about Vision By Design 2020https://www.orthokmeeting.com

AAOMC FaceBook Grouphttps://www.facebook.com/groups/AAOMC/

Tags:  AAOMC  Atropine  Axial Length  Cary Herzberg  Misight  Ortho-k  orthokeratology  Paul Levine  Podcast  The Corrected View Podcast  Vision By Design 

Share |
PermalinkComments (0)
 

Vision By Design 2019 Post Meeting Review

Posted By Matthew Herzberg, Wednesday, June 5, 2019
Updated: Saturday, June 6, 2020

Welcome back to the ortho-k podcast! For this episode I thought it would be fun to give our listeners a peek into the post-con wrap up conversation with three of our AAOMC board members and what I consider to be the core of the education committee responsible for Vision By Design. Cary Herzberg, Caroline Cauchi, Paul Levine joined me for a post-con retrospective. VBD2019 was so much fun and there was so many great moments I thought it would be nice for us to share some of the highlights as well as some things we would like to improve upon for next year.

Tags:  Atropine  Boot Camp  Caroline Guerrero Cauchi  Cary Herzberg  Corneal Reshaping  Myopia Control  Ortho-k  orthokeratology  Paul Levine  VBD  Vision By Design 

Share |
PermalinkComments (0)
 
Page 1 of 20
1  |  2  |  3  |  4  |  5  |  6  >   >>   >|