December 1, 2023
Brianna Rhue, OD, FAAO, hosts Louise Curcio, Brand Director, Myopia Management, and Justin Kwan, OD, FAAO, Senior Manager, Myopia Management, from CooperVision to learn about ongoing efforts to educate the public about the problem of myopia and the solution of myopia control with MiSight 1 day for age-appropriate children. Also, pick up tips on how to continue the conversation CooperVision has started by connecting with parents in your practice in an impactful way.
Read or listen to their discussion here:
Brianna Rhue, OD, FAAO: Welcome to the Review of Myopia Management podcast. I’m going to be your co-host today. I am Dr. Brianna Rhue and I’m excited to be joined by Louise Curcio and Dr. Justin Kwan from CooperVision. I’m going to let them do their own intros, and then we’re going to get into why we are all here, which is to help kids see their best and really change the trajectory of myopia management now and into the future. So, Dr. Justin Kwan, can you give us an intro?
Justin Kwan, OD, FAAO: Sure, I’m glad to be on the show today. Thanks, Dr. Rhue. I am an optometrist. I graduated from Berkeley Optometry in 2009, did a residency, spent some years teaching, then I went to private practice. Now, I’m really privileged to be a part of the myopia team here at CooperVision. I started with them about three and a half years ago.
Dr. Rhue: Amazing. Louise Curcio, tell us a little bit about you.
Louise Curcio: Yes, thanks for having me today. My background is actually not as an optometrist. I come from the business side. I started my career at Mattel, which gives me my interest in myopia management and kids. After my MBA, I went into the specialty contact lens business. So, I’m happy to be here today to really help eye care professionals figure out how to bring more patients and more parents into their practices.
Dr. Rhue: That’s amazing. Well, let’s get started. I’m going to jump into some questions here. We’ll keep it super conversational, as all three of us are parents of little ones that we’re hoping don’t become nearsighted, and how we can really be on the forefront of myopia management. So, as doctors, we’re always asking how our partners are helping us get more patients. Louise, what was the campaign that CooperVision has put together to help meet parents where they are and get them into our practices?
Louise Curcio: Yes, Dr. Rhue. CooperVision just finished a five-month consumer campaign to protect children’s vision and advance myopia control education in the U.S. This was a significant campaign that we’re especially proud of, and it kicked off right before back-to-school, and it continued through the fall, and we really grounded it in the insights on the way parents are looking for information.
Dr. Rhue: So, what was the approach that CooperVision took when you were bringing this campaign to life? Because we know when you’re building these things, a lot goes into it, and we just kind of see the aftermath of all the pretty pamphlets that you guys put together. Walk us through your approach on how it was different than anything else that you’ve worked on in your career.
Louise Curcio: So, really it was about figuring out and being present in places where parents spend their time, and these days that’s a lot more complicated. We took a 360-degree approach and tried to meet parents where they were online. We had a partnership with WebMD. We had ads on Facebook and Google, and we amplified our digital ecosystem, which is MiSight.com and YouTube. Probably the thing that we did differently this time was really break up the messaging between parents that just don’t even know they have an issue with their kids, where there is really no awareness of myopia or nearsightedness, all the way down to the parents that actually knew about nearsightedness, and knew their children were nearsighted and were looking for treatment options. Then, finally, parents that are ready to go in and talk to an eye care professional and receive those treatment options. So, we really changed up the campaign with different messaging for the different pieces of the campaign and tried to meet parents where they were online.
Dr. Rhue: So, how does it fit in to the practitioners when you’re looking at a campaign?
Louise Curcio: What we did was the frontend where we were creating the messaging and encouraging parents to take action and see their eye care professionals, but we can only do so much. So we really rely on the eye care professional to take that awareness once we send them into their practice and to turn it into action. One of the things that we learned from this was really to focus on the actual messaging to parents and use words and use phrases that they understand. So, does your kid have blurry vision? Is your kid nearsighted? And move farther away from words like myopia that we typically use when we’re talking to the trade or to eye care professionals, and use messaging in terms that parents are familiar with. We find that when it moves into the practice setting, if those terms and those messages continue, it only helps to amplify and encourage treatment options.
Dr. Kwan: Yeah, my favorite word from the campaign was protect, because as I talk to more and more people, the word protect is kind of like what we do for our kids when we put them in the right car seat. We use rear-facing for your younger ones, and then front-facing, and then seat belts. We’re protecting kids by holding their hands while we cross the street. So, I think a lot of parents will kind of gravitate around that word protect because it already is something innate that they do as human beings.
Dr. Rhue: I love that, and I also love being a practitioner when patients come in already educated. I think you hit it right there, Louise, when you were talking about terminology. We have to keep it simple because we know 90% of what we say they’re going to forget. So if we continue to simplify those words and not get overburdened or overeducate, which I think a lot of us are doing at this point, because we know so much, and we want them to take action. I love when there’s a piece to this on that education where they’re already educated, and then you’re just getting them over some hurdles that they have to come up with. So, back to CooperVision. What’s the mission? Why is it important for CooperVision to do this, Justin?
Dr. Kwan: Yeah, I feel like we’ve been hit with facts like half of the world will have myopia by the year 2050, which is seemingly kind of distant. You know it’s a large number, but there’s even more urgency than previously thought if we bring it a little closer to home. In less than six years from now, actually half of North America will have myopia, and that’s really where MiSight 1 day comes in for age-appropriate children. We got to use it the sooner the better. The outcomes can only be that much better for quality of life and for eye health risk. But I think a lot of kids skate by without ever getting their first formal comprehensive eye exam, when we know that kids turn -1.00D or -1.25D pretty quickly, and at a younger age than before. I know for me, my first eye exam, I was already a -2.25D. So, not to blame my parents or anything, but this is not an infrequent thing. Would you say, Brianna, you see sometimes like really high prescriptions even at their first eye exam?
Dr. Rhue: Yeah, I was that kid too, Justin, and my parents were both myopes. I was around -2.50D — like no wonder I wasn’t doing well in school. It’s right at our fingertips.
Dr. Kwan: Yeah, and I think what we see on the CooperVision side is the average, or the most prescribed power, of MiSight is about a -2.75D, and it’s a bell curve distribution, and we know that with myopia, and actually all disease states. There’s a lot more mild cases of myopia that are rapidly worsening because, as you know, the younger they are, the faster they get worse. So really, my mantra is, “if better is possible, good is not enough.” How can we continue to identify kids at the earliest signs of myopia?
Dr.Rhue: I love that this is kind of hitting all parents and all caregivers and even the MDs and pediatricians, because you’re targeting obviously people with kids. So, I think that this is going to bring a lot of our communities together in really helping change the trajectory of vision. So, Louise, we all love results, right? And people come in promising our practices the world, and then, let’s be honest, a lot of times things fall short. But you guys are seeing tremendous success in this, and we’re seeing the numbers come into our practices. So, what were the results?
Louise Curcio: The results actually were really exciting because parents want to know information. We’re all parents. We want to do the best possible thing and give our children the best possible opportunities, and so when we put the information out there, parents consume it. And that’s what we saw in the campaign. Parents were actively engaged with our campaign, clicking on MiSight.com, going to YouTube, searching for information, and what this did was they came to the website, they read a lot of the articles in the FAQs on the website, and then they went to the doctor finder to find a doctor to schedule an appointment. The results are there in a very strong way, and they’re there in in a lot of different areas, right? The awareness side as well as the action side of sending patients into practices.
Dr. Rhue: And I think one piece, one tip, to add in here for practitioners is CooperVision can only get you so far. So, when a patient is calling your office, make sure your staff is answering the phone correctly, because that’s where the journey starts. It starts sometimes on CooperVision’s website, then it’ll move over to your own website. So, make sure that everything is there, but really a lot of these conversations happen on the phone, and if you’re just googling ‘who does myopia management,’ and you pop up but somebody calls to make an appointment and you’re either not there or your team says, ‘Oh, what’s myopia management?’ You’re kind of shooting yourself in the foot before you get started. So, just a little practice tip is make sure you have an advocate in your practice that knows everything myopia, because a lot of these questions start on the phone before you convert them into a consult. So, CooperVision can do all these wonderful things, but it ends and starts a lot of the time with you. Justin, is there anything that you’d like to add to that?
Dr. Kwan: Yeah, you know, just preparing the staff. Again, it’s a team effort, and I’ve heard some doctors even say, ‘Is this appointment for glasses, contact lenses, or myopia management?’ And just making that as normalized as possible is another great way to start.
Dr. Rhue: I love that. Louise, anything you want to add?
Louise Curcio: You know, websites are really important. I can’t under emphasize how important that is. When a parent goes to an eye care professional’s website, they need to see information on nearsightedness and myopia. They can see what their treatment options are, so that either before they make the appointment or after they’ve made appointment and then they’re doing more research, the information is there. That one thing alone can make a huge difference to your practice.
Dr. Rhue: I love that. So, this is the third year that CooperVision has supported the industry with advertising to parents and caregivers. What did you do differently this year? What changes are you making as we are all learning together as we go?
Louise Curcio: I think this year was the broadest campaign that we’ve done where we really tried to meet parents where they are, and that included everything from TV advertising that we did in select markets, to journalists covering myopia and nearsightedness in the individual markets, and advertising and sponsorships on websites like WebMD, so it was a very comprehensive campaign. It lasted five months, which is the longest campaign we’ve done to date, and it really did encourage parents to reach out to their eye doctor and learn about not only correcting their vision, but protecting, as Justin mentioned earlier, their vision from getting worse.
Dr. Rhue: So, we all know that this is a multi-prong approach, and it comes down to parents understanding first that there is an issue with their children’s vision, because a lot of times we’ll go to the pediatrician and everything will check out. But then it comes down to getting a yes from the parents once they’re in our office. How did CooperVision approach parents that were looking for treatment options for their kids? Louise?
Louise Curcio: Getting to yes is a long process, and I think we just all need to understand that and accept that, and the first time a parent hears something is probably not going to be the time that they take action. So, our responsibility as leaders in the industry is to create multiple opportunities for parents to hear this messaging. The more they hear the message, the more likely they are to get to yes. And then making sure that we give them the information to help them make that decision.
Dr. Rhue: So, Justin, what advice do you have when talking to parents who are aware their child is nearsighted or myopic and looking at different options?
Dr. Kwan: Yeah, Dr. Rhue, you said it earlier — to keep it simple. I think oftentimes the more we talk, the more confusing we become. So, parents are already looking for a treatment that’s easy, safe, and effective for their age-appropriate child, when it comes to MiSight 1 day. Every time over the years, we’ve talked to like a thousand parents in our big efforts of surveys and research, they usually bring up two things — that they care about an FDA approval, and that they’re impressed and they have trust in the study that’s as long as ours — that’s seven years long. So, you know when doctors communicate to parents, really just magnify the problem without using scare tactics. Describe the problem that with nearsightedness, their child’s eyes are growing too fast, too long, and are getting weaker, but that there is great news that we can solve this problem for them.
Dr. Rhue: And in the campaign, frequently asked questions were the most popular thing that parents clicked on. So, how do you answer to the parent who says, ‘Is my child too young to wear contact lenses?’
Dr. Kwan: Yeah, I think our knee-jerk reaction is to kind of back our point of view with studies. But actually what’s more effective with parents is that if we just use social proof, like saying ‘In my practice,’ or ‘Just last week, a child that was this young’ (and likely younger than the child that you’re talking to right now in the exam room), and once you have this social proof, where you use the YouTube channel, then I think the parents are like, ‘Wow, this is a real patient that’s this young that can be successful with soft contact lenses.’
Dr. Rhue: I use that all the time and it works like a charm. And then also being a young myope, being put in contacts in third grade myself, that’s something that I also use. As we know, most kids will be asking for contacts about two years before their parents will say yes, and I think it’s our duty as the optometrist to get the parents over that hurdle and realize that it is safe. So, Justin, across the country you’ve heard a lot of one-minute elevator conversation starters with parents. What’s the one-minute conversation with parents that we should be having when patients are ready to try?
Dr. Kwan: Yeah, so picture this. We all are going to be in the exam room, and we finished our refraction, and move that phoropter away. I used to start talking about the problem, but you know, learning from Dr. Steve Vargo, you might want to start with a question, because what that does is it causes the child to respond and the mom to pay attention, because mom’s usually on her cell phone in the corner, right? So, it might sound like this. ‘Hey, Jake did you know some eyes are longer than other eyes?’ Then he’ll respond yes or no. Then I explain, ‘The problem of nearsightedness is that your eyes are growing too fast, too long, and getting weaker, and we need to do something about this. We used to have to watch it get worse and worse, but great news, we finally have an FDA approved treatment that’s going to help you see and learn efficiently in third grade. You’re going to enjoy taekwondo and soccer so much more, and we’re really going to protect your vision from getting worse as you grow. How does that sound, Mom?’
Dr. Rhue: Now, the key there is to pause, because I think a lot of us, the pause is uncomfortable for everybody, and you have to wait for the parent, or what I like to say is parents — if you can get them all together, for them to respond and then you can have an open, honest conversation. One thing I love to do is a little exercise that you can do with your team on listening, because we’re ready to kind of jump in as people start talking and not let them finish. So, one thing to try to do with your team is you do a questions game, and you promote questions, and then you have to start your answer to the question with the last letter of the last word that somebody said. And it makes you listen all the way through the conversation, and so if you do that as a resource and as a guide, you’ll really see that patients don’t talk as much as we think they’re going to talk, and then they feel heard and then you can answer the true questions that come up, because sometimes you’re putting questions there that aren’t even there, and then you’re making it a thing. So, an exercise to try — especially with your spouse.
We know some parents are apprehensive about their kids wearing contact lenses. So, how does the campaign support kids wearing contact lenses for the first time, and how has this been beneficial for kids who are asking but their parents are on the fence? Louise?
Louise Curcio: So, one of our number one videos on YouTube during this campaign was the video of 8-year-old twins Olivia and Madeline teaching other children how to use and handle contact lenses. And so, what that tells us is if we can just use case studies and we can show children actively, successfully using contact lenses, it really takes away that fear that my kid can’t do it. What we do is we try to provide resources to help with that conversation and to help make it easier for kids to wear contact lenses. And a lot of it is just communicating with the parents. As we are parents, we know our kids can do things, but sometimes we worry a little bit about you know, maybe it’ll be hard or difficult for them. But we do know kids can do things like wearing contact lenses. We just have to give them the opportunity to do it and give them the right tools to be able to do it successfully.
Dr. Rhue: And Justin, discuss the self-esteem that comes with wearing contact lenses and the confidence that wearing contact lenses instead of glasses can give kids.
Dr. Kwan: A lot of us point back to Jeff Walline’s ACHIEVE study where there were all of these positive self-perceptions in children, young children, that wear contact lenses. They get these boosts in social acceptance, physical appearance, the way they look, and their athletic performance, which probably shouldn’t surprise us. And then going back to that parent conversation, we really need to contextualize how these kids are getting these short-term benefits in their everyday lives, kind of removing them from the exam room, living a day in the life in their shoes. And I think that’s where parents start to get excited about the possibilities, humanize them, like you said earlier, and making the parents and the child be both seen and heard.
Dr. Rhue: And I love that piece because that hits home for me. I was a young dancer and gymnast and my glasses were always broken, and I didn’t like my glasses — especially being an 80s kid, right? Those things were huge. It definitely boosted my self-esteem. And I’m so glad my mom pretty much forced my doctor to fit me in contacts. So, I think we, again it comes down to being an advocate for that kid, and we know most kids can do it, and you’re going to know other kids can’t, and it’s good to give them all of the options and let them choose what’s best for their family as a unit. So, don’t forget where all that falls as well. So, what learnings from the campaign can ECPs use in their office to talk about MiSight and get more patients and parents saying yes? Justin?
Dr. Kwan: Louise and the team have created and improved upon so much material that ECPs can use in their office, whether they have 500 square feet or 5,000 square feet. I think sometimes we get in our heads that we need to make a portion of the office kid-friendly or really deck out a space, but you can just put a couple of stickers on the wall or just have a certain video playing. It doesn’t have to be an all-out thing that’s over complicated. What’s freely available to all of our doctors is the parent education guide, and I think that’s really set up in such a way to make the actual conversation shorter, so that you don’t have to talk through all of the education, which happens to be the seven common questions parents might ask, but to really do your consultation succinctly. And then having the parents go home with their spouse or partner to review what CooperVision has made in that parent education guide. But more importantly, I think just what Louise mentioned about directing them to our online presence. My favorites are still the Instagram page and the YouTube channel, but I think MiSight.com obviously has had wide reach and really led to a lot of results.
Dr. Rhue: One thing that I’ve done in my practice is we’re really good at showing people that we sell glasses, but we’re not good at showing the type of patients that we like to see, right? This all comes down to you loving and wanting to see kids. So, if you don’t like to do that, find somebody that does. But what we’ve done is we take a little polaroid picture of every kid that comes in, obviously with their parent’s approval and we get them to sign a little sheet, but it goes up on our wall that every single parent walks by. And the questions we get are, ‘Oh my gosh, you guys see kids?’ Why, yes we do. So, it’s something so small and so little that can really elevate the types of patients that you want to see, so a little bit goes a long way. You don’t have to, like Justin said, deck out an exam room or all these other things. Just some low hanging fruit goes a long way.
So, what did you learn from the campaign to help eye care practitioners in practice? What did you learn from marketing, Louise?
Louise Curcio: What I learned is that words matter. And as I mentioned earlier, using vocabulary like blurry vision and nearsightedness makes it more understandable for parents and that’s very important. And then taking that learning and moving it onto your website really makes a difference. The traffic that we saw on MiSight.com was incredible. They came onto MiSight.com, they read articles, they watched videos. Parents are major consumers of information when it comes to their children. And the more that information can be provided on an ECP’s website, the better off and the more likely that parent is to ask their doctor or ask about MiSight, and the more likely the first time it’s mentioned to them in the exam lane. It may not be the first time, because what we know is it takes multiple conversations and multiple pieces of information before a parent feels like they can make that decision for their child. So, whether it’s as Justin was talking, about using brochures in the office, or you were talking about putting pictures of kids on the walls, I think the more we can show that there’s something for these children, the better off and the more likely parents are going to be in moving forward with their children’s eyesight.
Dr. Rhue: Yeah, I believe that a no is just a not right now, and I think we have to get comfortable with that, and bringing kids back a little bit more frequently, especially if they aren’t ready yet. So, seeing them back in three months or six months can really really help elevate that patient experience as well, so you don’t feel like you’re forcing anything.
Justin, what’s important when it comes to parent communications? What have you learned?
Dr. Kwan: The learning that I took away was that, like you said, a no can be a not sure, or maybe I don’t understand and I need more time. I was surprised that actually the timeframe was a little bit shorter, that within a month, a lot of parents are ready to act, and it’s one thing to see a survey result of parents, but last week I was talking to a doctor out in Oregon and she was like, ‘I try my best to give all of the parent education materials to every eligible candidate for MiSight, and then usually at the one month mark is when they come back and talk to me.’ And I did not tell her the information before. She relayed that to me, and I was like, wow. It’s just proof in the real world that that one month timeframe is real.
Dr. Rhue: Wow, I’m going to definitely adopt something there. What comes next? As this is an evolving area for both parents, practitioners, and the industry as a whole. Louise, what’s next?
Louise Curcio: Yeah, what we see is that the industry is in agreement that myopia matters and that myopia in children should be treated and ECPs want to treat these patients. What we’re doing next is to help make it easier to move from that treatment into action from that discussion and actual prescribing. The way we’re helping to do that is we’re marketing and we’re communicating to the parents, because if we can build awareness with parents when they come into the practice, they’re much more likely to not need even that one month if they know walking in the door that there’s an option that helps both correct and protect their child’s vision. They’re going to be more likely to be asking for it from their eye care professional, and they’re more likely to say yes right out of the starting gate. So, we’re not stopping as leaders in the industry. We are going to continue to message to parents and to build awareness of myopia and the progression of myopia among parents.
Dr. Rhue: And Justin, it’s been exciting, because I’ve been there since the beginning, and in just three short years, wow, we have learned a lot. What comes next from your point of view?
Dr. Kwan: What I’ve noticed still is that single vision glasses and contacts are still our biggest competitor, if you will, because it’s just so normal. It truly is. It’s like the easy way out. But we’ve learned that MiSight 1 day is so easy, it actually doesn’t take any more time in putting the lenses on the eyes, doing the fit assessment, doing the over-refraction, getting them into training. It’s really not any more time than single vision on that front. So, it’s really about putting the right treatment in place, because I can’t think of any other medical condition that we just give a device that gets worse. But we have so much opportunity ahead of us just with the sheer millions of kids with myopia out there. So, I think what comes next is really just how do we coach and motivate each other to be consistent? Because even if you are not the best at talking to a parent today, let’s just say we do that 10 times this week, and last week we only did it four times in terms of having the parent conversation. We’re not all going to be 0 for 10. I can tell you that much. And like Louise said, we’re seeing the market and all these parents with this much more information. So, I think there’s still that hesitancy we need to overcome, but my job, of course, is to make it as easy as possible for doctors.
Dr. Rhue: So, a bonus question for both of you. Louise, what excites you about this type of work you’re getting to do?
Louise Curcio: This campaign has been so exciting because what we’re doing is we’re creating a category and we’re providing information to parents that many of them have never had before. I was at a party the other night and I was talking to one of the parents, and I started telling them what I do, and parents don’t know that they have this opportunity for their kids, and what I love is the ability to just do a national campaign where we’re literally shouting from the rooftops to parents and moms that there is something out there for your nearsighted child and go see your eye care professional. When I see the results coming out the other end of the kids and the parents that are being prescribed MiSight, and I see the results, that’s just incredible. It’s really incredible.
Dr. Rhue: I love it. Dr. Kwan, what excites you? Because you’re all over the place, man, you’re Mr. Myopia.
Dr. Kwan: Actually, what excites me follows on the heels of what Louise said. I think when you think about your everyday practice where you might be seeing 12 full exams and a couple of red eyes, maybe a PPD, I think when you go home at night, or what you remember from the last week, is really the smiles on the kids’ faces. Who are your most rewarding patients? And nine times out of 10, I would say it’s those that you made an impact on and that you could provide a solution they didn’t have before. And so that really gets me excited about how we can move this profession forward and really accelerate into helping as many kids as possible. Because at the end of the day, that’s our optometric oath that Mile Brujic always brings up. It is really our mission that we should chase after, and it should get us excited to be able to help kids in this way.
Dr. Rhue: And I think what excites me about all of this, and just this industry, creating this category like you said, Louise, is this is such a generational thing. My mom just went under underwent cataract surgery last week and you know that conversation is different in that room. The conversation is different for my grandmother. And now having four generations within my family, you know, with two young kids, I’m not going to be the doctor that’s going to be talking about LASIK or cataract surgery with them when it comes time. So, I think we get to change this trajectory together of not only the generation of kids, but the generations of our colleagues, and that’s really I think what gets me excited about it.
So, thank you for joining us today on the Review of Myopia Management podcast, and for letting me, Dr. Brianna Rhue be your co-host, and make it a great one everybody. Thanks.
Indications: MiSight 1 day (omafilcon A) soft (hydrophilic) contact lenses for daily wear are indicated for the correction of myopic ametropia and for slowing the progression of myopia in children with non-diseased eyes, who at the initiation of treatment are 8-12 years of age and have a refraction of -0.75 to -4.00 diopters (spherical equivalent) with ≤ 0.75 diopters of astigmatism. The lens is to be discarded after each removal.