By David Kading, OD
Dec. 3, 2019
Myopia is more than a simple refractive condition or inconvenience for our patients. It’s a serious, progressive disease that comes with a heightened risk for diseases like glaucoma, cataracts and retinal detachments, even at moderate levels.
Fortunately, there are advances being made every year to stem the growth of this epidemic, and myopia management is becoming more mainstream. Those important advancements include modern Ortho-K contact lens designs.
A Growing Threat to Eye Health
On average, the number of Ortho-K patients in our practice here in the U.S. is growing 50 percent annually. That means many more patients each year whom we can help by slowing the progression of myopia. That’s significant as even a low myope is two times more likely than an emmetrope to develop glaucoma. When myopia progresses to -3 to -5 diopters, the risk of developing macular issues is 10 times greater.
With such risk factors and the knowledge of proven treatments, I believe we would be negligent if we didn’t try to intervene with every young myope we see in our practice.
Easy Fit, Easy Modifications
Over the last couple of years we have been fitting more and more of our Ortho-K patients with contact lenses from Euclid Systems Corporation. The company’s Euclid Emerald and Emerald Toric lenses are a key piece of the equation fueling the substantial growth in our practice’s myopia management services.
One of the things I really like about the Euclid Emerald family of lenses is the ability to select lens parameters so that most patients’ needs can be easily accommodated. Euclid’s consultants are always on hand to help me give patients exactly what they need for an acceptable fit and effective treatment.
Often, fit modifications aren’t even needed. The initial fit for the patient is great because we’re empirically ordering lenses based on Euclid’s Simple 3 Factor Fit data: Refraction, keratometry readings and corneal size (HVID).
The sophisticated design enables me to prescribe the lenses, rather than fit them. More than 80 percent of patients fit with Euclid lenses are successful with the initial lenses ordered, according to The SMART Study, which looked specifically at the empirical fit and effectiveness of Euclid Emerald contact lenses.
That data, and my own experience with this lens design, tell me that Euclid offers an Ortho-K system that can be effectively used by even ODs new to Ortho-K. If more than 80 percent of your patients are successfully fit in an Ortho-K lens with the first fit, an OD will be making a tremendous impact on the lives of many young people, even if that OD doesn’t think of him or herself as an Ortho-K specialist. We would be altering the epidemic of myopia dramatically if we could take that step.
Educating Patients & Keeping It Simple
Our practice’s philosophy is to keep the process as simple as possible for patients and to ensure the focus of parents is on the most important thing – their child’s long-term eye health. We do that by charging just one overall fee for all of our Myopia Management services, rather than charging piecemeal. We never want to put parents in the position of choosing treatments based on cost. Instead, we try to give them a strong professional recommendation and a safety net to cancel or switch treatment plans if needed.
We also enhance the patient experience with thorough education on how to keep the patient’s eyes safe and comfortable during myopia management treatment. We explain to patients and parents the importance of adhering to the recommended wear and care regimen, and we practice application and removal until they are comfortable with each step. We always let them know the signs of a potential problem, such as blurry vision, redness of eyes or eyes feeling pain.
Few of our Ortho-K patients have dry eye, as the majority are 6-12 years in age, however you may see an increase in dryness with the tremendous hormonal changes that come with puberty. A small number of our young patients have ocular allergies, which should be evaluated and treated.
We are careful to screen for anything that might impact the ability of the patient to comfortably wear their Ortho-K lenses for many years. We also stress the regular replacement of the Ortho-K products. Fresh lenses are often all a patient needs to improve decreased comfort and vision decline that comes with soilage and wear.
Expanding Access to Ortho-K
Advances in contact lens design, along with the power of topographical imaging, mean that many patients with corneal elevation differences can now also benefit from Ortho-K treatment where an aligned posterior design may provide improved centration. Designs like the Euclid Emerald Toric, have been instrumental in expanding our Ortho-k patient base.
The ability to modify lens fit to suit the special needs of each patient means more patients than ever can have access to Ortho-K. With so many more experiencing the benefits of this treatment, you will be doing important work lessening the risk to eye health and providing your practice with a strong engine for growth. Finally, we don’t let vision stand in the way of a child’s future. As ODs, we are focused on helping our youngsters fully realize their potential. This is a great reward in itself.
This article may not reflect the opinions or approvals of Euclid Systems Corporation.