March 15, 2024
By Sherman Tung, OD, FAAO, FIAOMC, IACMM
Photo Credit: E+, Getty Images
Whether you are a seasoned practitioner or just starting with myopia management, finding the perfect approach in your clinic can take some trial and error. As a practitioner, myopia management quickly became my specialty. Over the years, I have been able to fine-tune my approach to ensure I am providing the highest level of care to my myopic patients. From finances to education, I have compiled a list of the top five ways to enhance efficiency in myopia clinics.
Enhancing Myopia Clinic Efficiency
1. Strategic Consultation Fees
Are you tackling the dilemma of consultation fees? Experiment by utilizing online consultations held by informed myopia ambassadors in your practice. Complimentary online consultations can enlighten parents and secure potential commitments, allowing you to strike a balance between valuable insights and reasonable charges.
For our free consultations, we have a PowerPoint presentation that includes what myopia is, the different treatment options, how we are different from other offices, and the starting prices for the treatments. We also advise our patients to make sure they view the online consultation on a computer screen. Many patients will first attempt to attend on their phones but won’t be able to see the presentation. We recommend they are connected to a stable internet connection and are seated in front of a desktop or laptop screen.
If patients are interested, they can come in for an in-person consultation, including axial length measurement, and a consultation fee will be charged. The doctor can then spend more time focusing on one treatment instead of going through the whole online consultation process.
2. Preventing Orthokeratology Refits
Maximize efficiency by honing your staff’s expertise with topographies. Nearly 95% of fitting issues at my office stem from poor initial topographies. Streamlining this aspect saves considerable time, ensuring smoother consultations and superior outcomes. Consider different options for staff training, as this can help all team members understand what they are looking for when taking topographies.
In my office, I had my primary myopia ambassador watch videos on how to take accurate topographies. Some topographer companies have YouTube videos that better educate staff members on getting precise images. We have gleaned several tips from these videos to use in our practice, some of which include:
- Make sure eyelids are fully open with no lashes in the topography. Sometimes, we have two people taking the topographies. One person opens the lids, and the other person takes the topography.
- Sometimes, a drop of non-preservative tears helps stabilize the tear film and makes the images more reliable.
- Practice, practice, practice. Usually, staff members have to practice on about 50-100 eyes before they master taking topographies. Have other staff members volunteer as guinea pigs during training sessions.
Still, sometimes topographies do not come out well after all that. Occasionally, it is okay to have the patient come back on another day to repeat the topographies.
3. Efficient Lens Cleaning Education
Combat time-consuming explanations about lens care by creating a concise instructional video to complement the training session. By incorporating this video resource into your online presence, you can enhance visibility and engagement, which benefits your current patient base and anyone who may be perusing the internet looking for an ECP who provides myopia management. Platforms such as YouTube can foster better search engine optimization, creating a seamless experience for current and future patients.
4. Strategic Focus on OrthoK Visual Acuity Follow-Ups
When patients do not achieve 20/20 vision post-follow-up, most doctors focus only on improving the visual acuity. Instead, emphasize three main objectives: ensuring corneal health, monitoring axial length, and optimizing functional vision. Our main aim is to ensure that axial length grows at 0.1 mm per year. Understanding that slight deviations in axial length signal myopia progression is crucial — 0.28mm equals a -1.00D change, according to the COMET study.1 Please keep in mind that there is a strong relationship between axial length and the degree of myopia progression in diopters. However, it is neither linear nor consistent across all stages of childhood.2 Axial length will help tune out the refraction noise and allow us to focus on the actual myopia progression. It is a win if they can see 20/happy, and the axial length is stable!
5. Empowering Independence from Helicopter Parents for Lens Insertion/Removal
Effectively manage over-involved parents by gently asserting the child’s growing independence. Remind parents that a vital part of the process is creating a safe environment for their child to learn responsibility. Encourage parents to spend brief moments in the waiting room, significantly boosting efficiency in insertion and removal procedures by fostering the child’s autonomy.
Seeing Improvements Over Time
While these are just five tips that can help boost your myopia clinic efficiency, it is a great place to start seeing positive improvements. There may be some trial and error involved in these methods, but any step you take to improve your practice and streamline your patient care is a win for your practice and your patients. As eye care professionals, we must stay dedicated and committed to our myopia clinics, providing our patients with the highest quality of care.
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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
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References
1 Hyman L, Gwiazda J, Hussein M, Norton TT, Wang Y, Marsh-Tootle W, et al. Relationship of age, sex, and ethnicity with myopia progression and axial elongation in the correction of myopia evaluation trial. Arch Ophthalmol. 2005 Jul;123(7):977–87.
2 Vera-Diaz F. The Importance of Measuring Axial Length. Review of Myopia Management. 2019 Aug
