March 17, 2025
By Jason Carruthers, RO, FCLS(C)
When I first entered the eye care field in 1994, I recognized my interest in specialty contact lenses. At that time, I mentioned to some classmates that I wanted to specialize in contact lenses. They responded, “You can’t do that. There’s no money in contacts.” So I didn’t pursue it. They weren’t entirely wrong then, but they turned out to have greatly mistaken the situation all these years later.
After a health scare in 2021, I decided to open my new specialty practice, Orbit Contact Lens. Money or not, I wanted to follow my passion.
The Industry Stressed the Importance of Myopia Management
Before running my own practice, I was a specialty sales rep in Canada, selling specialty contact lenses to doctors and teaching them how to fit patients. I saw firsthand how well some practices were doing with myopia management contact lenses.
As an industry insider, you witness the tremendous effort taking place behind the scenes. Doctors are acquiring topographers, and companies are developing new myopia products. There are new lenses, instruments, and fitting software being introduced. Companies are hiring new sales reps, while executives are leaving to start their own ventures. Everything you can imagine is happening, as everyone scrambles to find their place in this myopia gold rush.
Then, at nearly every meeting or conference, you’re confronted with this significant statistic: 50% of the world will be myopic by 2050. There is a critical need for eye care professionals to treat myopic patients. When it was time to open my doors, it was clear to me that incorporating myopia management into my practice was the obvious choice.
Diving into Myopia Management
When I first took the leap into opening my practice and knew that I wanted to focus on myopia management, I started by getting certified in fitting as many lenses as possible. There are so many valuable resources available from industry partners, and I read as much as I could on the topic. The resources from Paragon CRT and Johnson & Johnson Vision were invaluable, as were CooperVision’s educational materials on the MiSight 1 day contact lenses. I also attended Vision By Design and signed up for the American Academy of Orthokeratology and Myopia Control (AAOMC). To get as immersed in the field as possible, I joined all the Facebook groups I could find on myopia management. I picked the brains of some of the high-volume leaders in myopia management such as Dr. David Ng, Dr. Matthew Martin, Jagrut Lallu, and Dr. Anith Pillai.
Paragon CRT lenses were the first ones I started prescribing in my office. One of my first myopia patients was a young lady who was a -4.00D myope when I dispensed the lenses to her. At her first follow-up appointment, she had progressed to -6.00D. Oops!
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Carruthers works closely with his patients to ensure they receive the best myopia management treatment for their needs.
Of course, I eventually got her corrected, but it was a steep learning curve – even for a veteran RGP and scleral fitter. Since then, I’ve successfully corrected countless patients of all ages from 8 to 64 with myopia, astigmatism, hyperopia, and presbyopia. I’ve treated patients at +3.00D to -11.00D with astigmatism up to about -4.00D.
I’m proud to say that I’ve played a role in helping a lot of kids avoid myopia progression. However, I’ve also helped a lot of adults see without glasses or contacts and without needing risky or costly surgery. Everything comes down to having treatments that you believe in. These treatments can be confusing for patients, but being able to share my success stories with previous patients and clearly explain the science and the benefits of them has been beneficial for me.
Get Patients Asking About Myopia Management
Educating patients and their parents about myopia management is an important topic, and I’ve found it to be one of the most significant issues in our industry that hinders the acceptance of these treatments.
Think about the logistics of the conversation that follows. The family is in for a routine exam. Mom is thinking about maybe getting Junior some new glasses while she scrolls on her phone during the exam.
Doctor: “Hey, mom, I’m concerned about Junior’s myopia. It’s gotten worse. Studies show that higher myopia can contribute to several visual health risks later in life. We should fit him in special contacts that cost $2,000. Depending on which treatment we choose, he may have to wear them while sleeping, and you’ll have to buy new ones regularly. Here’s a picture of his eyeball getting longer.”
Mom: “Oh, wow. Can’t he just get stronger glasses?”
Doctor: “Well, sure, but his myopia is likely going to continue to progress.”
Mom: “I see. Let me talk to my husband and get back to you.”
And then, you never hear from her again. Plus, you just killed the eyeglass sale.
I find it’s best to reverse this order. Get patients to ask you first about myopia management. Then, instead of telling them why they should pursue it, ask them what their concerns are.
Instead of saying, “I’m concerned about Junior’s vision getting worse,” I will ask, “Are you worried about Junior’s vision worsening?” This subtle change makes a significant difference in conversion rates. Informing parents that there’s a problem won’t be as convincing as having them express the problem. If the parents don’t feel there is an issue, it’s challenging to sell the solution.
Simplifying Myopia Management
When I first opened my practice, one of the biggest challenges was finding patients. Anyone can buy a topographer and get certified, but then you wait for patients to find you. Patients aren’t searching for us. They aren’t Googling “myopia control near me, and they don’t know it’s a problem.
Myopia management is the most critical specialty in eye care that I’ve seen in the last three decades. However, if we wait for the public to inquire about it, we’ll have missed the boat. Public education campaigns exist, but they often aren’t sufficient, and the message overly complicates the issue. It needs simplification.
Anti-smoking campaigns were effective, but they took decades to persuade people to act on a straightforward message — one they already believed in. In contrast, anti-myopia campaigns are complex and often meet skepticism. There are myopes in every city in America who don’t realize or believe that myopia is a problem.
As Dr. Dwight Akerman stated at THE Myopia Meeting in Vancouver in 2023, “Myopia is a disease that, if left unchecked, will result in massive amounts of eye pathology and vision loss.”
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Jason Carruthers, RO, FCLS(C) is a dual licensed Optician and Orthokeratologist with a special interest in myopia control and irregular cornea. He has traveled extensively, training and advising doctors across Canada on prescribing and fitting specialty contact lenses. Jason studied Ophthalmic Optics and Ocular Pathology at The School of Opticianry at Georgian College where he was awarded an honors diploma. He has extensive post-graduate training in Lasik co-management, ocular surface disease, dry eye, and orthokeratology for the treatment and prevention of myopia. Jason is also a recognized expert in the field of cosmetic eyelash extension. |
Some products covered in Review of Myopia Management are prescribed off-label in the United States because they are not FDA-approved for slowing the progression of myopia in children.
MiSight 1 Day soft contact lenses are FDA-approved 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 less than or equal to 0.75 diopters of astigmatism.
