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December 15, 2023
By Nicholas Despotidis, OD, FAAO, FIAOMC, FCOVD
The Myopia Master®, like the Pentacam®, has been reliable, staff-friendly, and has allowed me to explain to parents what axial length is and whether I have it under control. I’ve invested in OCULUS’ products because I feel that they are the gold standard and that’s the standard I’ve set in my practice.
Photo Credit: Cupertino10, Dreamstime Images
My interest in myopia management started over 20 years ago when my two young children started becoming nearsighted. In that time, I’ve been able to grow my practice in such a way that I now only see myopia management patients — every 20 minutes or so, I have a new myopia patient in my chair.
Going Beyond Topography
While I’ve been taking my patients’ topography readings for over two decades, I only invested in OCULUS’ Pentacam® just over two years ago. This device is more than just a topographer — it’s also a tomographer, which gives me access to all the layers of each patient’s cornea, rather than just the surface. When patients have dry eye or they wear soft contact lenses, there can be a lot of noise on the topography reading. With the Pentacam®, the ability to have both the topographer and tomographer in one gives me a true reading of not just the outer corneal layer but the posterior corneal layer, too, independent of the tear film.
Additionally, tomography allows me to diagnose corneal ectasia. I can now detect early signs of keratoconus prior to fitting a child with a contact lens. Before I had the Pentacam®, I had fit children in orthokeratology lenses and only found out many years later that they had keratoconus. However, with the Pentacam®, I feel confident that I can diagnose a healthy cornea or an unhealthy cornea.
I’ve been excited by it because, unlike most topography devices, it also gives me a better reading of the peripheral cornea as opposed to just the central cornea. That has allowed me to customize contact lens fits much more than I’ve ever been able to because the data is so accurate all the way out to the limbus.
Dependability of the Device
One of the most significant benefits I’ve noticed since having the Pentacam® in my office is how dependable it’s been. It may sound silly to tout how well-made the device is, but in our office, we’ve spent hundreds of thousands of dollars on other devices that require monthly calls with tech support. That has never been the case with the Pentacam®. It’s been dependable, reliable, and so easy for my staff to be trained on and to utilize every day.
My staff was up and running with the Pentacam® within one week. Having your staff trust the technology — and perhaps more importantly, know how to use it effectively — is so critical because the quality of the images we take tells us everything. No matter how good your technology is, the readings are only as good as the picture captured.
When it came to staff training, OCULUS has perfected this system. A company rep came to our office specifically for the training. They went through taking topographies of each other. We tested it out on a few patients, and OCULUS was diligent in showing us good-quality topographies versus poor-quality image captures. By the time the OCULUS rep finished training, we were off and running, confident in the use of the technology. There was never a question or any hesitation from my staff. They knew exactly what they were doing. Then, a week later, OCULUS checked in on us. They held our hand through the whole process, which made everything so much easier.
WAVE NightLens®: My Number One OrthoK Lens
With the Pentacam®, I can fully customize and design the WAVE NightLens® for my patients. The WAVE design is my number one prescribed RGP lens — OrthoK or otherwise. The reason for that is that it’s totally topography-driven and completely customizable. Most FDA-approved lenses give you software data and use a nomogram or calculation to design the lens for you.
With the WAVE Contact Lens System® software, I can design the lens any way I want from start to finish. I can vary the optic zone, the periphery, how much I want to change the cornea, and modify the lens. WAVE lenses have allowed me to offer something unique that other offices may not be able to provide. Other practitioners may be ordering a commonly prescribed FDA-approved lens where you can modify the design, but there are limits to what can be customized. The WAVE NightLens® is a true freeform design.
Parents want the best for their kids. The number one question parents ask me is about the side effects of OrthoK lenses. I always tell them that there is a higher probability of adverse reactions any time a patient is sleeping in a contact lens — soft or hard. However, when the lens optimally fits your child, we’re minimizing those potential risks, and that’s why I fit the WAVE NightLens®.
Prioritizing Accurate Data
After having such success with the Pentacam®, I also invested in OCULUS’ Myopia Master® over a year ago. This instrument allows me to take three measurements: autorefraction, keratometry, and axial length. The reason that is so powerful is because it gives me very accurate baseline measurements compared to other biometers. The Myopia Master® uses optical biometry as opposed to ultrasound biometry, which is more accurate because optical waves have a shorter wavelength.
What I love about the Myopia Master® is that it is easy to use, it gives me a multitude of data, and it is accurate. I get solid data every time a patient comes in. I measure axial length at every visit, and I’m looking for a trend: Is the axial length growing according to what we think growth curves show, or is it growing steeper? The device needs to be accurate and repeatable, which is exactly what the Myopia Master® is.
The Myopia Master® also prints a report for the doctor to help explain whether the myopia is stabilized or not. Parents often ask me how I know their child’s eyes aren’t getting worse, and the answer is: I’ve accurately measured their child’s eye length, and at each visit, I monitor if it’s expanding as expected or not. If it is, we then discuss altering the treatment plan, but if it’s not, we know the treatment is doing what it should.
The Myopia Master®, like the Pentacam®, has been reliable, staff-friendly, and has allowed me to explain to parents what axial length is and whether I have it under control. I’ve invested in OCULUS’ products because I feel that they are the gold standard and that’s the standard I’ve set in my practice.
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Nicholas Despotidis, OD, FAAO, FCOVD, FIAO, has one of the largest practices in the country specializing in myopia management. He’s the lead author of two books, My Children are Nearsighted Too and A Parent’s Guide to Raising Children with Healthy Vision. His workshop SuperChargeYourPractice is the most sought-after practice management course offered at the Vision by Design symposium. His TEDx talk “A Childhood Disease Worth Preventing” educates parents on the growing number of children affected by myopia and possible treatments available to them. |
