May 1, 2025
By Sherman Tung, OD, FAAO, FIAOMC, IACMM
Photo Credit: Getty Images
Throughout my career, I have had the privilege of practicing in various optometric settings, including academia, corporate and private practice. Additionally, I have consulted on establishing corporate myopia clinics.
In my work, I’ve noticed that there is often a misconception that certain practice settings are limited in their scope of care. However, my experience has demonstrated that it is entirely feasible to establish a successful myopia management clinic within a corporate environment, utilizing any and all myopia management modalities.
Understanding the Corporate Setting
Corporate optometry practices often emphasize spectacle sales, and practitioners may feel pressured to adhere to this model. However, some corporations provide flexibility, allowing for the introduction of specialized services like myopia management. Having worked in both the U.S. and Canada, I have observed differences in practice regulations and product availability, which I will highlight along with strategies to enhance patient care in a corporate setting.
Getting Started: A Phased Approach
Implementing myopia management can be approached incrementally, allowing for gradual integration into your practice. It’s essential to be aware of regional regulations, as they can vary by state and province.
Beginner Level
Understanding Myopia as More Than a Refractive Error
High myopia (axial length >26mm) significantly increases the risk of ocular diseases such as myopic maculopathy and retinal detachment.1,5 Educating patients and their families about these risks is a crucial first step. In addition, this is an important time to start discussing lifestyle recommendations, such as increased outdoor time and decreased screen time.
Spectacle Management
Avoid undercorrecting patients, as studies have shown that undercorrection may accelerate myopia progression.3 In Canada, anti-myopia spectacle lenses utilizing technologies such as Defocus Incorporated Multiple Segments (DIMS), Highly Aspherical Lenslets Technology (HALT), Cylindrical Annular Refractive Elements (CARE), and Diffusion Optics Technology (DOT) are available and have demonstrated efficacy in slowing myopia progression.4 Unfortunately, these options are not yet available in the U.S., but it is anticipated that they are anticipated to become available in the near future.
Collaboration and Patient Education
If you lack access to an optical biometer, consider partnering with an optometrist or ophthalmologist who does. Collaborating with fellow ODs or ophthalmologists aren’t “taking your patients away.” Instead, they’re your ally in myopia management care. Providing educational materials to patients about the importance of monitoring axial length can enhance their understanding and engagement in their treatment.
Atropine Therapy
The Low-Concentration Atropine for Myopia Progression (LAMP) study demonstrated that 0.05% atropine is the most dose-effective in controlling myopia progression.7 If you are not yet comfortable with contact lens options, atropine therapy can serve as a viable alternative. Many compounding pharmacies offer atropine formulations suitable for myopia management. However, dose consistency can vary depending on each compounding pharmacy, even for the same clinical dosage.
Intermediate Level
As you become more comfortable with basic interventions, parents may seek additional options, especially for active children.
Daily Disposable Myopia Control Lenses
Dual-focus and multifocal contact lenses have been shown to be effective in managing myopia progression.6,8 These lenses are typically available in spherical designs. For patients with astigmatism or cost concerns, monthly multifocal lenses with a +2.50D add power may be a more accessible option. In Canada, newer daily lenses with smaller diameters with concentric annual zones with a non co-axial relative plus power technology provide additional choices.
Investing in an Optical Biometer
At this stage, acquiring an optical biometer is a significant but worthwhile investment. From a clinical perspective, axial length measurement is a more reliable indicator of myopia progression than refraction alone.5
Advanced Level
At this stage, myopia management becomes truly transformative.
Investing in a Topographer
To successfully implement OrthoK, a corneal topographer is essential. A practical approach is to identify a group of interested families before investing in the technology. Once you have a committed patient base, the demand often increases, justifying the investment. On top of that, manufacturers offer combination devices, so practitioners can get a biometer and topographer in one, which can further justify that investment.
TIPS
Leveraging Support from Contact Lens Companies
Many contact lens companies offer training and support to help practitioners integrate OrthoK into their practice. Utilizing these resources can facilitate a smooth transition into advanced myopia management.
Team Alignment and Consultation Scheduling
Successful implementation into a corporate myopia clinic requires the support and understanding of your entire staff. Ensuring that team members are aligned with your vision and adequately trained will enhance patient care and practice efficiency.
Myopia management consultations often require more time than standard eye exams. Attempting to conduct these consultations within a typical 15-minute slot is impractical. Consider scheduling these appointments similarly to glaucoma workups, allowing sufficient time to thoroughly assess and discuss treatment options with patients and their families.
Adapting to Market Demands
If you observe that families are seeking myopia management services elsewhere, it may be time to adjust your approach. Continuing with the same methods while expecting different results is unproductive. Embracing change can be challenging, but by taking incremental steps, you can build a corporate myopia clinic that meets patient needs and distinguishes your p7ractice.
Conclusion
Establishing a myopia management clinic within a corporate setting is both feasible and rewarding. By progressing from basic interventions to advanced treatments, you can provide comprehensive care while ensuring a sustainable practice model. Whether you are just beginning or looking to expand your services, taking a structured, step-by-step approach will position you for long-term success.
 |
Sherman Tung, OD, FAAO, FIAOMC, IACMM, graduated from Illinois College of Optometry. As a Fourth Year ICO externship preceptor, he is dedicated to mentoring future optometrists. A former president of BC Doctors of Optometry and recipient of the 2019 Optometrist of the Year award, Dr. Tung is celebrated for his contributions to advancing optometric standards. In addition to his role as co-chair for the accreditation team at the AAOMC (American Academy of Orthokeratology and Myopia Control), he owns and operates his private practice, Eyelab, Doctors of Optometry, in Vancouver, BC, Canada, where he continues to provide exceptional eye care services to the community. Find him on Instagram: @helloeyelab
|
References
- Tideman, J. W., Snabel, M. C., Tedja, M. S., et al. (2016). Association of axial length with risk of uncorrectable visual impairment for Europeans with myopia. JAMA Ophthalmology, 134(12), 1355–1363. https://doi.org/10.1001/jamaophthalmol.2016.4009
- Charm, J., & Cho, P. (2013). High myopia–partial reduction orthokeratology (HM-PRO): A 2-year randomized clinical trial. Optometry and Vision Science, 90(6), 530–539. https://doi.org/10.1097/OPX.0b013e318294c291
- Chung, K., Mohidin, N., & O’Leary, D. J. (2002). Undercorrection of myopia enhances rather than inhibits myopia progression. Vision Research, 42(22), 2555–2559. https://doi.org/10.1016/S0042-6989(02)00266-8
- Lam, C. S., Tang, W. C., Tse, D. Y., Tang, Y. Y., To, C. H., & Lee, R. P. (2020). Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: A 2-year randomized clinical trial. British Journal of Ophthalmology, 104(3), 363–368. https://doi.org/10.1136/bjophthalmol-2018-313739
- Bullimore, M. A., & Brennan, N. A. (2019). Myopia control: Why each diopter matters. Optometry and Vision Science, 96(6), 463–465. https://doi.org/10.1097/OPX.0000000000001410
- Walline, J. J., Greiner, K. L., McVey, M. E., & Jones-Jordan, L. A. (2013). Multifocal contact lens myopia control. Optometry and Vision Science, 90(11), 1207–1214. https://doi.org/10.1097/OPX.0000000000000040
- Yam, J. C., et al. (2021). Two-year clinical trial of the low-concentration atropine for myopia progression (LAMP) study: Phase 2 report. Ophthalmology, 128(6), 872–880. https://doi.org/10.1016/j.ophtha.2020.12.012
- Chamberlain, P., et al. (2022). Long-term Effect of Dual-focus Contact Lenses on Myopia Progression in Children: A 6-year Multicenter Clinical Trial. Optometry and Vision Science, 99(3):p 204-212. https://doi.org/10.1097/OPX.0000000000001873
