June 16, 2025
By Caroline Kaufman, OD, IACMM
Photo provided by Dr. Caroline Kaufman
My journey in optometry began over 30 years ago, with the last 20 years dedicated to running my own private practice. About ten years ago, I attended the AAOMC Vision by Design conference, where I discovered the powerful potential of myopia management. While I had been already fitting orthokeratology lenses, I learned that these lenses could also be used to manage myopia. This revelation transformed my approach to patient care and ignited my passion to treat myopia and help children and their parents navigate this process.
Understanding Myopia Management
When I started offering myopia management, I was aware of the benefits of treatments like low-dose atropine, but I found that most parents preferred orthokeratology. This insight prompted me to develop a comprehensive myopia management program tailored to each child’s unique needs.
We offer a variety of treatments, including orthokeratology, atropine, soft multifocal lenses, and I’ll sometimes prescribe scleral lenses with a high plus add. Each treatment plan is customized based on the child’s prescription, risk of progression and lifestyle, ensuring that the chosen treatment seamlessly integrates into their daily routine.
Creating a Personalized Treatment Plan
We tailor treatments for each patient on a case-by-case basis. Sometimes parents arrive already informed about myopia and the importance of treatment. Other times, parents and patients are hearing about myopia management for the first time. In either case, we conduct a thorough myopia consultation where we spend about an hour with the patient. We take Pentacam scans, measure axial length and discuss the child’s history, the parents’ history and what the child does for activities. Having this information, as well as the child’s prescription and their risk of myopia progression, allows me to choose a treatment that best suits their lifestyle and their needs.
Meeting Families Where They Are
I have the same approach when it comes to educating patients and parents on myopia and the available treatments. I recognize that families have varying levels of knowledge about myopia and its implications. For parents who are already informed, the conversation is straightforward. However, for those encountering myopia management for the first time, especially when they thought their child would come in just to get a new pair of glasses, I would modify my approach to address their specific concerns and encourage them to start treatment. For instance, a parent with high myopia may be more receptive to discussing the risks of myopic macular degeneration, while a parent with limited knowledge may require more foundational information.
The Importance of Education
During myopia consultations, it’s important for me to provide families with information they can read at home. We have custom-made brochures that we give to all of our families. We also have quite a bit of information on our website. Between the brochures, the information on the website and the in-depth myopia consultation, most parents usually feel confident in our approach. This combination of resources typically equips families with enough information to feel comfortable moving forward with treatment.
Addressing parents’ concerns is essential for building trust, especially when it involves their child’s health. If a parent is hesitant, I take the time to explore their worries and offer reassurance backed by research. Sometimes parents are worried about the risks associated with their child’s myopia progressing. Other times, parents are worried about the need for thicker glasses, or simply the myopia diagnosis itself. When parents are resistant or skeptical, it’s important to find out what’s causing that. Then I can tailor my conversation to those specific concerns. This personalized approach has been effective in helping families understand the long-term benefits of myopia management.
Working With the Latest Technology
While myopia management has come a long way in the past decade, I have faced challenges along the way. In the early years, the available lens designs for orthokeratology were limited. This made it difficult to address higher levels of corneal astigmatism. However, advancements in customizable lens options have significantly improved the effectiveness of myopia management. I’m excited about how new lens designs and treatment protocols can impact our patients.
Staying informed about the latest research is crucial for my success in treating myopia. I attend the Vision by Design conference annually and serve on the board of the AAOMC. I also regularly explore the Review of Myopia Management website for valuable information and insights from fellow optometrists.
Looking to the Future
I’m optimistic about the advancements in myopia management, and I hope to see the introduction of myopia control spectacles in the United States — which could be a game-changer for many children, and especially young children. I also look forward to further research on all things myopia management – combination treatments, treatment zones of OrthoK lenses, and so much more.
My goal is to ensure that every child has access to effective myopia management. I am deeply committed to serving my community and guiding families through the complexities of myopia.
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Caroline Kaufman, OD, IACMM, earned her Doctor of Optometry degree from the Southern California College of Optometry and completed a residency in Cornea and Specialty Contact Lenses at the Pennsylvania College of Optometry. Since 2020, she has served on the board of the American Academy of Orthokeratology and Myopia Control, holding roles as secretary and currently as treasurer. She is passionate about myopia management and designing custom contact lenses for patients with irregular corneas. |
