August 1, 2020
By Nadine Humen Forché, OD, MS, FAAO
I practice at Five Points Eye Care in Athens, Georgia, and myopia management is one of our core specialties. We deploy a comprehensive myopia management strategy that involves decision-making based on age, lifestyle, familial risk, progression rate, risk of high myopia, potential side effects, and individual preference. This personalized approach ensures optimal long-term myopia management and helps reduce the risk of visual impairment and blindness later in life.
For a child newly diagnosed with myopia, I will counsel them regarding their lifestyle and recommend either distance-center multifocal contact lenses or orthokeratology to slow the progression of myopia. I am comfortable using orthokeratology because many peer-reviewed studies support its safety and effectiveness.
We are currently undergoing the CooperVision Brilliant Futures training program and are excited about adding the MiSight 1 day option to our practice armamentarium. From a practitioner’s standpoint, prescribing an off-label monthly replacement multifocal contact lens is an option, but it is nice to have the FDA-approved MiSight 1 day lens. In anticipation of being able to prescribe MiSight 1 day, I have been keeping a running list of children who might benefit.
When I talk to parents about myopia management options, a lot of them are also nearsighted, so they understand. For the ones who are not, we explain to them that their child’s eyes are different, and they are at risk for future problems the more myopic they become. Most people have heard of the serious conditions such as retina detachments or glaucoma, and I say, ‘Now we realize that it’s important to provide early treatment.’
I often use my daughter as an example to parents of how early intervention can make a difference. She is 17 now and started in soft lenses when she was 10. We then moved her to orthokeratology about a year later, and her prescription has hardly changed since then.
Our practice has three ODs, including myself, and we see a wide variety of patients. In addition to offering myopia management, we fit scleral lenses, provide vision therapy as well as neuro-optometric rehabilitation, along with delivering a full range of primary-care treatment. We have built an excellent reputation in our community, and people know we can provide a wide range of care or refer them to other ECPs when needed. We have great relationships with other optometrists and ophthalmologists in our area.
Our practice philosophy has helped us get through the COVID-19 closings. We only saw emergencies and urgencies our office for about six weeks until the end of April. Starting in May we implemented an expanded shift schedule to see more patients, including the ones who deferred appointments earlier, in a safe manner. I have had so many people who have told me, ‘I knew I could come here because I knew you would do it right.’ We have been able to instill a sense of safety and confidence…one patient at a time.
Nadine Humen Forché, OD, MS, FAAO, is Diplomate of the American Board of Optometry and a partner at Five Points Eye Care, a group optometric practice located in Athens, Georgia.