December 1, 2023
By Hetel Bhakta, OD
I have no doubt in my mind that delivering the important message on myopia is one of the biggest hurdles that we as eye care providers face when communicating with our patients. We are generally good at diagnosing myopia and explaining how this nearsighted condition is the reason behind blurry distance vision. We explain in great detail the myriad of treatment options, and by the end of the exam, the patient and the parent become so overwhelmed that they default to what they know best: purchasing an updated pair of eyeglasses!
What went wrong? We overwhelmed the patient with too many options and caused confusion.
Lucky for us we have a number of resources from our industry partners in the myopia management space that allow us to provide a more concise menu of myopia treatment options. In my office, we prefer to use marketing materials that are clear and concise, which I find the literature for the Abiliti Overnight Therapeutic Lenses for Myopia Management to be. We display Abiliti banners and posters in visible areas throughout the office and keep a good supply of brochures in the exam rooms. The Abiliti brochures, posters, and banners all have one thing in common — fewer words, more images, and a QR code link which takes the patient to the SeeYourAbiliti.com website, opening up a world of knowledge, describing how the Abiliti Overnight lens works to manage myopia. Imagine that the patient and the parent have already learned about myopia and OrthoK all before you set foot in the exam room. Genius!
Dr. Bhakta’s Myopia Menu
The myopia menu that I present to my patients involves a simple and relatable conversation of this progressive condition and categorizes this discussion into what, why, how, and when.
What is myopia? The patient (or parent) chose to come to you for your expertise and knowledge. You, the optometric physician, must describe myopia for what it is: a medical condition that causes the eye to grow longer than natural development, leading to blurry vision at far distance. I will typically point to the “Let’s Talk About Myopia”1 infographic by Johnson & Johnson Vision as I discuss these points. Additionally, I inform the patient and parent that there are alternatives to wearing eyeglasses and regular contact lenses for myopia management that may suffice.
Why do I have myopia? The parent may or may not be aware of why it is happening and would like you to confirm their suspicions! Myopia is progressing in part due to children spending more time with up close activities — like copious hours spent on a tablet, phone, computer, or reading books — and less time with outdoor activities.2-3 It is important to incorporate advice on good visual habits as part of your treatment plan early in this conversation. Parents will become completely engaged upon hearing you lecture their child, reinforcing what they are already nagging their children to do at home.
How can we treat myopia? Both the patient and the parent want to know how to manage this condition. Keep the options simple. During your exam you will have gauged if the patient is a good contact lens candidate. I always give the patient a choice of two options. I begin with the idea of orthokeratology. OrthoK lenses correct myopia overnight while sleeping, so that there is no need for eyeglasses the next day!*4 I also discuss the daytime soft myopia management contact lens options. I then ask the patient which works best for their lifestyle, if they play sports, and ask how they feel about contact lens wear. I go over pros and cons, narrow down the options, and settle on one. I typically hand out literature, such as the Abiliti Overnight lens brochure, if OrthoK is decided on, explaining that this is an FDA approved lens for myopia management5 for children and adults.
When should we begin treatment? We want to begin treatment right away, so I discuss the next steps with the patient and the parent. Not once do I discuss fees. Not once do I discuss eyeglasses. I simply transfer the patient to an optical staff member who is well versed in myopia management discussions to complete the monetary transaction and schedule the next appointment. My staff will schedule an appropriate time to take additional measurements and allow enough time for follow up questions that either the parent or patient may have.
At the first lens dispensing visit, it is essential to provide supportive literature to reaffirm the treatment plan. In my office I have informative insertion and removal training materials that help the patient with tips and tricks demonstrating different techniques. I also encourage both the patient and the parent to download mobile apps, such as SeeAbiliti, where they can access online training and educational videos, as well as track their child’s outdoor time and much more. This allows me to engage in open discussions with patients during follow up visits as they share their visual habits.
As myopia management continues to evolve, it is important to provide patients access to the latest information available, offering both tangible and digital options. In this technology era, patients appreciate not only the professional opinion of their optometrist, but also literature from credible sources that outline the available treatment options for their diagnosis — and I’d much rather they receive this information from their optometrist instead of searching general information from the internet.
|Dr. Hetel Bhakta is a board-certified optometric physician and is certified in orthokeratology and MiSight lenses for the treatment of myopia progression in children and young adults. Dr. Bhakta’s focus is on the prevention of sight threatening diseases associated with high levels of myopia and as such has implemented a robust myopia management program in her practice. Dr. Bhakta completed her Optometry degree at Manchester University in 2002 and her Doctorate in Optometry at the New England College of Optometry in 2008. She has additional residency training in ocular diseases accredited by NOVA Southeastern University, and she has extensive experience working in medical optometry and providing treatment and management of eye diseases such as keratoconus, glaucoma, cataracts, diabetic retinopathy, and macular degeneration.
*Results may vary by patient and prescription level.
- Ramdass S. Myopia Management: A 10-Step Plan for Success. Review of Optometry. September 2023. Available from https://www.reviewofoptometry.com/article/myopia-management-a-10step-plan-for-success
- Wu PC, Chen CT, Chang LC, Niu YZ, Chen ML, Liao LL, Rose K, Morgan IG. Increased Time Outdoors Is Followed by Reversal of the Long-Term Trend to Reduced Visual Acuity in Taiwan Primary School Students. Ophthalmology. 2020 Nov;127(11):1462-1469. doi: 10.1016/j.ophtha.2020.01.054
- Huang HM, Chang DS, Wu PC. The Association between Near Work Activities and Myopia in Children-A Systematic Review and Meta-Analysis. PLoS One. 2015 Oct 20;10(10):e0140419.
- Vincent SJ, Cho P, Chan KY, et al. CLEAR – Orthokeratology. Cont Lens Anterior Eye. 2021;44(2):240-269.
- Data on File 2023. Instructions for Use (PMA P990018/S008)
Important safety information:
ACUVUE Abiliti Overnight Therapeutic (tisilfocon A) Contact Lenses are indicated for use in the management of myopia. They are indicated for overnight wear for the temporary reduction of myopia and should only be disinfected using a chemical disinfection system. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. These lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness, other eye problems, or if patients have any allergy to any ingredient in a solution which is to be used to care for these lenses. Complete information is also available from Johnson & Johnson Vision Care, Inc. by calling 1-877-334-3937, or by visiting www.seeyourabiliti.com.