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October 3, 2022
As Johnson & Johnson Vision expands its portfolio of myopia management treatments, the international vision care leader is simultaneously building a professional staff to educate eye care professionals about implementing myopia management in their practices.
Review of Myopia Management’s Editor-in-Chief John Sailer recently interviewed two of the members of the Johnson & Johnson Vision myopia care team — Monica Jong, BOptom, PhD, and Chandra Mickles, OD, MS, FAAO, FSLS. Here’s what they had to say about their backgrounds and how they plan to apply their experience to spreading the word about myopia management.
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Monica Jong, BOptom, PhD, (left) and Chandra Mickles, OD, MS, FAAO FSLS
John Sailer, Editor-in-Chief, Review of Myopia Management: Can you both tell us a little bit about yourselves, your background, and what brought you to Johnson & Johnson Vision?
Monica Jong, BOptom, PhD: I’m an Australian-trained optometrist who was inspired to be an optometrist because of my family optometrist. My journey into myopia control research began over ten years ago because I was initially inspired by one of the greats in our profession, Professor Brien Holden, whom I met after my postdoc in Canada. Prior to that, I had practiced all over Australia in various settings, including the Outback. It has been a momentous journey working across all facets of myopia and being part of the development of optical and pharmacological treatments, leading global education and advocacy initiatives at the level of practitioners, scientists, students, and peak health bodies to really move the needle. Speaking to practitioners about their experiences globally has given me a deep understanding of the space and what we need to do to continue to advance the field collaboratively. We have made a lot of progress. It is incredibly exciting to be part of such an important movement that began for me at the Brien Holden Vision Institute and the International Myopia Institute. Joining the industry and making a positive difference in patients’ lives by bringing much needed high quality myopia treatments is what I have dedicated my professional life to.
Chandra Mickles, OD, MS, FAAO, FSLS: My current role is North America Professional Education Lead for Myopia. I lead the myopia professional education initiatives and KOL management for both the U.S. and Canada. Prior to joining Johnson & Johnson Vision, I was in academia and had a key role in contact lens education. I was the instructor of record for contact lens courses and headed successful contact lens and dry eye clinics. I was also involved in research and was a principal investigator for various research projects. I’m extremely passionate about spreading the word about all contact lenses can do to help patients, including myopia management. As such, I lectured and published extensively on contact lenses and was honored to author chapters of contact lens textbooks that are required texts at optometry schools across the United States. I’ve been privileged to be recognized by national organizations and institutions for what I love to do: educate others.
As far as my educational background, I graduated from SUNY State College of Optometry and then went on to complete a contact lens residency, research fellowship, and a Master of Science degree in Vision Science at the University of Alabama at Birmingham School of Optometry. I agree with Monica that it’s an honor to have a key role in such an important mission, changing the trajectory of myopia.
RMM: Very impressive backgrounds. How have you been able to apply your experience to your current role at Johnson & Johnson Vision?
Dr. Jong: My role at Johnson & Johnson Vision is the Global Professional Education Director in Myopia. I’m responsible for leading the strategic direction of education of practitioners in myopia management globally, focusing on bringing science into everything we do. My background in clinical research and developing the first global online myopia management education program for practitioners, as well as lecturing around the world, has given me a global perspective on myopia management and a deep understanding of practitioner needs. This is very important because myopia is a global problem, but the way we manage myopia will need to be adapted regionally and be culturally appropriate. Personalized practitioner education that fits into the busy practitioner lifestyle is key. I co-founded the International Myopia Institute and worked with 150 experts to publish the seminal white papers that guide our profession in myopia. The International Myopia Institute is a working group formed after the first World Health Organization Impact of Myopia and High Myopia meeting in Sydney in 2015. Having been part of these initiatives, collaborating with the leaders in the field, and having a deep understanding means that everything we do at Johnson & Johnson Vision is led by science. Professional education plays a critical role in myopia management, as it is not yet the standard of care, and a global survey reported that single vision spectacles, even in the U.S., remain the most commonly used option in myopia, at around 85%.1 This is where industry can really partner and support associations and conferences in reaching practitioners and the wider medical community in disseminating knowledge to change the trajectory of myopia. There is a huge unmet need2 when it comes to myopia, with the Holden et al. study I was part of reporting that by 2050, half the world will likely have myopia and be at risk of vision impairment.3
To provide this care, we need to reach as many practitioners as possible to address myopia. It’s a pleasure to work with Dr. Mickles with her extensive educational experience supported by a passionate team.
Dr. Mickles: Thank you, Monica. It’s such a pleasure to work with you and your vast knowledge in myopia. As I think about that question, I feel like I’m leveraging a lot of my experience in this current role. The position is well aligned with my experience, knowledge, and skillset. As Monica mentioned, I am heavily involved in professional education. In my prior role, as an industry speaker, academic, and CE educator, I was heavily involved in what I’m doing now, and that is developing and delivering educational programming and content that can increase competencies, confidence, and interest in ODs and future ODs in utilizing contact lenses to treat conditions.
My work as an industry speaker and consultant for various companies provided me with the much-needed knowledge base to navigate some of the regulatory processes in industry. Most importantly, that experience has helped me provide the training, guidance, and ideas to empower ECPs to help patients and to support the success of my speaker team. I was also a very experienced contact lens fitter, and that has helped me be able to impart insights to support cross-functional teams at Johnson & Johnson Vision and enhance the business strategy that was developed by Johnson & Johnson Vision business leaders.
RMM: How important would you say it is to build a strong foundation in myopia care for practitioners?
Dr. Jong: A strong foundation of knowledge and clinical skills is key to building the practitioner confidence in providing myopia management. Despite there being treatments available, single-vision spectacles remain the most commonly used by practitioners in children with myopia.2 There is new research being generated almost on a weekly basis, and keeping up with the latest can be challenging for the busy practitioner. Professional education is central and will ultimately lead to the best patient outcomes.
RMM: What do you think is the critical shift that we need to see in the way clinicians practice myopia management, how long will that take, and could you share some key milestones and successes so far in the efforts of Johnson & Johnson Vision in this space?
Dr. Jong: Awareness about myopia has been building strongly in the last few years, even though the research has been happening for over 20 years. There have been many peer-reviewed reports of randomized controlled trials demonstrating how we can affect eye growth. Now, treatments that have received regulatory approval for myopia management in several countries. The WHO recognition of myopia as a public health issue itself has led to a critical shift. It is clear now that myopia cannot be considered a refractive issue. As an industry, perhaps we need to consider myopia as a disease given that it is generally chronic and progressive and increases risks of vision impairment.3 Practitioners, in general, are waiting to see progression in children before offering myopia management,2 but the evidence points out that once a child develops myopia, they are highly likely to progress. Johnson & Johnson Vision has already had some huge successes in this space, which includes launching a full suite of personalized online education in myopia management in three languages so far, as well as treatment certifications, face-to-face education that includes practitioner and patient communication, and boot camps.
RMM: Can you tell us some more about your North America professional education plans?
Dr. Mickles: I left everyone on a cliffhanger during our last discussion. You know I can’t share all of our secrets, but I will say the cornerstone of our mission is changing the trajectory of myopia. In order to accomplish this goal of getting more doctors on board with myopia management, we must increase ECPs’ competencies, confidence, and urgency to treat myopia. Increasing the urgency to treat is not only important for established ODs, but also for young ODs and future ODs. This requires education tailored to the doctor’s level of expertise, because what an expert in myopia management may need to motivate them is quite different from someone new to this space. As such, we are offering engaging, memorable, and customized professional education based on experience level that will support ECP success. As Monica mentioned, it is not just going to be programs. In addition to the face-to-face and online educational programs Johnson & Johnson Vision has custom-created for practitioners, there will also be downloadable education resources. I strongly encourage doctors to be on the lookout for what is coming. They can reach out to me, or they can reach out to our clinical sales consultant team to learn more.
RMM: Can you tell us more about Johnson & Johnson Vision’s new ACUVUE Abiliti myopia management offering and its benefits?
Dr. Mickles: We are well on our way to developing a full suite of therapeutic products for myopia management, but I’m thrilled that we have now launched the ACUVUE Abiliti portfolio in North America. The portfolio includes a soft contact lens and orthokeratology (OrthoK) lens accompanied by a digital app and website to help support patients in their journey. OrthoK can be immediately life-changing for patients of all ages because it can provide clear, correction-free daytime vision.1* Doctors want to offer those experiences, but some still believe that OrthoK is too complicated or that it takes too much chair time.4 Essentially, for those new to OrthoK, our software may take what is perceived to be a mission impossible to something achievable, and it may save chair time for those who are more experienced. The FitAbiliti software reduces some of the concerns of OrthoK fitting by walking the ECP through the fitting process and recommending a lens, and it has a first fit success rate of approximately 90%.5** ECPs have shared that this is a major benefit of our technology and should hopefully encourage more ECPs to consider OrthoK for their patients. If we truly want to make OrthoK a viable option, we have to remove the complication from the fitting process and reduce chair time. The availability of hyper-oxygen-permeable6 OrthoK lenses helps doctors and parents feel comfortable and confident in their children wearing these lenses.
RMM: Thank you both for all that great information. I just have one last question: What advice would you give eye care professionals wanting to get started in myopia management or OrthoK but may be unsure?
Dr. Mickles: I completely understand being hesitant to get involved in myopia management, especially if it is a new area for a practitioner. It is an area that is growing and can help build patient loyalty.
However, for those who may be uncertain due to lack of experience in myopia management, or those who are looking for high quality professional education and support, Johnson & Johnson Vision can provide a portfolio that includes solutions, resources, and a great network of doctors to help ECPs get started and stay on the journey.
RMM: Excellent. Thank you, Dr. Mickles, and thank you, Dr. Jong.
References
*The lenses are indicated for reducing refractive error up to 6.00D of myopia and up to 1.50D of astigmatism. Results may vary by patient and prescription level.
**Final lens fit is determined by the ECP — software is for decision support only
- Kwan J & Palombi J. Survey: Low use but high interest in myopia control contact lenses. Healio: Optometry. 2020. Available at https://www.healio.com/news/optometry/20200731/survey-low-use-but-high-interest-in-myopia-control-contact-lenses
- Wolffsohn JS, Calossi A, Cho P, et al. Global trends in myopia management attitudes and strategies in clinical practice – 2019 Update. Cont Lens Anterior Eye. 2020;43(1):9-17.
- Holden BA, Fricke TR, Wilson DA et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036-1042.
- Johnson & Johnson. Data on File 2022. ACUVUE Abiliti Overnight Therapeutic Lenses Instruction For Use.
- Lipson MJ, Curcio LR. Fitting of Orthokeratology in the United States: A Survey of the Current State of Orthokeratology. Optom Vis Sci. 2022;99(7):568-579.
- JJV Data on File 2022. ACUVUE Abiliti Overnight Therapeutic Lenses for Myopia Management – Consolidated, Approved Claims List (United States Only Claims).
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