July 15, 2022
By Alba Nazario, OD
At our office, we educate every chance we get. Many parents are surprised about the myopia epidemic and the eye health complications that can arise from high myopia.
As a Doctor of Optometry for over two decades, I began offering myopia management in my practice in 2018, and I couldn’t have started soon enough. That year, I went to the Vision By Design meeting, and I was instantly hooked. I brought myopia management into my practice immediately, and I’ve emphasized the specialty ever since. Being a high myope who has worn glasses for a lifetime, it only makes sense that I would be so passionate about the subject.
After that meeting, I did everything possible to learn as much as possible about myopia management. I attended every webinar available to further my knowledge of all myopia treatment options available in the U.S. I became certified in several different orthokeratology designs and utilized the resources from the American Academy of Orthokeratology and Myopia Control (AAOMC). I also started regularly reading leading myopia management publications, including Review of Myopia Management and Myopia Profile. Treehouse Eyes’ webinars were also helpful in getting educated, as were the educational offerings from the individual orthokeratology manufacturers.
Introducing Treatments to Patients
I currently prescribe both CooperVision’s MiSight 1 day contact lenses and VTI’s NaturalVue Multifocal 1 day contact lenses. In addition, I prescribe several OrthoK options, and I’m certified in Paragon CRT, Euclid, Eyespace, Contex, Moonlens, and iSee lenses. I also prescribe topical low-dose atropine either as monotherapy or combined with OrthoK.
Of these three treatment modalities, OrthoK is the most accepted treatment by my patients because of the added benefit of not using glasses or daytime contact lenses. Patients are wowed by having that glasses-free clear vision for sports and activities. I’ve also seen the greatest success with OrthoK, and when used in conjunction with low-dose atropine, this is an excellent combination for children who are fast progressors.
Every child is different in thinking about which treatment to choose for which patient. Low-dose atropine is my treatment of choice for younger children. Those with higher prescriptions and those without a desire to sleep in retainers prefer dual-focus or multifocal soft lenses. Anyone over age 7 with greater than 1.00D of myopia and who is excited about getting rid of daytime contacts and glasses is a perfect candidate for OrthoK.
At our office, we educate every chance we get. Many parents are surprised about the myopia epidemic and the eye health complications that can arise from high myopia. Resources I mainly use for educating parents are the website My Kids Vision, All About Vision, the BHVI Myopia Progression calculator, and the educational materials provided by the different manufacturers. Having credible information to present in the office is very helpful. Parents love seeing the infographics that show what an elongated myopic eye looks like and what complications are risks when it comes to high myopia. Videos also help place parents at ease.
The biggest challenge has been the lack of consumer information. Parents have been told for years that a new pair of glasses is all that could be done for their child’s myopia. With proven treatments now available, eye care professionals are becoming more proactive about treating juvenile-onset myopia. Sadly, this new information is not always immediately accepted when educating parents in our office. GMAC is doing an excellent job educating the public about the eye health dangers of childhood myopia, and that treatment is now available to slow myopia progression. However, it will take time for most parents to understand and accept this message.
Social media has also been incredibly powerful for us. Everyone is on social media nowadays. It is a must when attempting to educate everyone about the dangers of myopia and the myopia epidemic. We constantly try to educate via social media posts on Facebook, Instagram, LinkedIn, and our Google Business page.
As much work as I put into educating my patients and their parents, I also stay on top of the latest myopia management research for myself — reading, webinars, social media groups, and journals. One never stops learning, as new research and studies are constantly being published. To stay up to date, one has to be willing to learn continuously.
Getting More Practitioners on Board
Myopia management is a specialty that is growing like wildfire. It’s an amazing time in our profession. When I started practicing, there weren’t any options for treating progressive myopia; now, there are multiple options. I hope more colleagues will embrace myopia management and incorporate it into their primary care practices. The fight against the myopia epidemic would be much easier if we educate parents, children, and policymakers that myopia is a disease and must be treated.
Dr. Alba Nazario is a board certified optometric physician and has been practicing in the Central Florida area for over 22 years. She received her Doctorate in Optometry with honors from Nova Southeastern University in 2000 and is co-owner of Eagle Vision Eye Care & Eye Spa located in Lake Mary, Florida. Dr. Nazario is one of the few local certified and experienced doctors in myopia management. She also specializes in specialty fit contact lenses and ocular surface disease.