October 2, 2023
As a child growing up in Ukraine, optometrist Eleonora Orloff recalls wearing spectacles and performing eye exercises and other vision therapy techniques upon the urging of her parents who hoped this approach would stop her myopia from worsening.
“Eye exercises with relaxation were popular there, and at the time, it was the only option to try and slow myopia progression, even though they weren’t effective,” Dr. Orloff says.
Today, Dr. Orloff is a founding partner of Bronx Eye Associates, which focuses on full service eye care, including pediatric myopia control. Here, Dr. Orloff shares her parent communication strategies on how to create short yet impactful myopia speaking points during the consultation.
- Lean into Trust
Since Dr. Orloff opened the doors to Bronx Eye Associates two decades ago, the long-term relationships she’s cultivated with families have in turn created a bond between eye care professional and parent, she says.
“When I recommend that a child start myopia treatment early, parents trust me and my expertise. A doctor’s reputation is priceless,” she continues.
Building on that trust, Dr. Orloff meets every family at their knowledge level and makes sure to translate complex science behind the treatment and related studies into easily understandable terms that resonate with families.
- Point Out Rx Changes
At the onset of the discussion, Dr. Orloff will mention that she’s noticed myopia progression between visits, necessitating a higher prescription for the child just to see clearly again.
Dr. Orloff believes that since the pandemic, parents are much more aware of myopia and the potential of progression since children were online more,1 and this increased parental knowledge makes for an easy segue into the treatment discussion.
“All these factors help me in my conversation, and I’ll lead in with the review of the child’s prescription from the previous year.”
- Remind Parents: Children Keep What They Treat
When it comes to myopia management, Dr. Orloff emphasizes a patient needs to be fully committed, no matter the duration of any intervention.
“For age-appropriate children in MiSight* 1 day, studies have shown there’s no rebound effect.§†2,3 I tell patients, ‘On average, you keep what you treat.’ This point is a significant factor for many families.”
Dr. Orloff also refers to MiSight 1 day as “contact lens therapy” and makes sure to mention that it is the only soft contact lens FDA* approved for slowing the progression of myopia in children aged 8-12 at the initiation of treatment.
“These facts give families even more confidence in pursuing treatment. At this stage, I also tell them, ‘Everything your child saves after treatment matters,’” she adds.
- Use Technology to Continue the Story
At Bronx Eye Associates, children with myopia have their axial length measured at every visit, which provides a vital piece of information for parents, Dr. Orloff says.
“Parents can look at this measurement and realize we’re literally fighting for every millimeter. I explain to families that every fraction of a millimeter counts, since one millimeter is a little over two diopters, and that means a child’s spectacles would be getting thicker every year without the help of myopia control.”
If a practice has the equipment, axial length measurement can be a helpful metric in myopia management. However, it isn’t necessary to fit MiSight 1 day or to do other myopia control management options with children.
- Rely on Staff to Reinforce the Message
Staff at Bronx Eye Associates play a critical role in the practice’s myopia management outreach, Dr. Orloff adds. For example, techs are trained to recognize potential myopia control candidates based on a patient’s age and prescription.
After pretesting, the techs will also plant the myopia management seed by saying, “If you’re interested, ask the doctor about new therapies we have to help control your prescription,” Dr. Orloff explains.
Patient flow is also carefully planned during each step of the myopia visit and designed to catch any potential myopia control candidates who would benefit from treatment. At checkout or during a final stop in the optical department, staff will ask a parent if they want to schedule an appointment for their child or if anyone else in the family needs to come in for an eye examination.
- Close by Accentuating the Value of Investment
Dr. Orloff waits until the end of the examination to discuss myopia management cost, since at this point of the office visit, parents realize the value of intervention and know exactly what they’re paying for, she suggests.
“At this stage of the discussion, families know they are paying for years of research and a sophisticated lens design,” Dr. Orloff says.
Dr. Orloff will then reiterate how MiSight 1 day helps slow the elongation of the eye and myopia progression, while correcting refractive error through the lens’ unique design that includes two treatment zones that create myopic defocus.‡4
“If a parent thinks about myopia control in all these terms, they’ll see the value,” Dr. Orloff says. “The cost translates to about four dollars a day for myopia control treatment and clear vision.”
*Indications for use in the U.S.: MiSight 1 day (omafilcon A) soft (hydrophilic) contact lenses for daily wear are indicated 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 ≤ 0.75 diopters of astigmatism. The lens is to be discarded after each removal.
§Disclaimer: The stability of the myopia reduction effect 1-year post-treatment is being further evaluated in a post-approval study in the U.S. as a condition of FDA approval for MiSight 1 day.
† Preliminary international study data shows that, on average, for children that discontinued treatment at age 14-19 following 3 or 6 years of MiSight 1 day wear, the eye growth reverted to age-expected average myopic progression rates.
‡Compared to a single vision 1 day lens over a three-year period.
- Zhang XJ, Zhang Y, Kam KW, et al. Prevalence of Myopia in Children Before, During, and After COVID-19 Restrictions in Hong Kong. JAMA Netw Open. 2023 Mar; 6(3): e234080.
- Chamberlain P, Arumugam B, et al. Myopia Progression on Cessation of Dual-Focus Contact Lens Wear: MiSight 1 day 7-Year Findings. Optom Vis Sci 2021;98:E-abstract 210049.
- Hammond D, Arumugam B, et al. Myopia Control Treatment Gains are Retained after Termination of Dual-focus Contact Lens Wear with No Evidence of a Rebound Effect. Optom Vis Sci 2021;98:E-abstract 215130.
- Chamberlain P, et al. A 3-Year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optom Vis Sci. 2019;96(8):556-7.
This article was supported by CooperVision.