Top 10 Tips for Myopia Management

ECPs who specialize in myopia management shared some of their best advice for independent practitioners looking to adopt the specialty.

1.Attain Knowledge
Many educators write and teach about the act itself of attaining knowledge. This may be the single most important step in getting started with myopia management. To reach patients, the chronology of knowledge gathering and dissemination of information flows from clinical and academic researchers to ECPs, to staff, and then finally to the parents or caregivers of patients who would benefit from myopia management. Today, information is readily accessible through credible databases, medical journals, private websites, blogs, re-posted articles, and open-source references. The eye care industry continues to play an invaluable role in driving communication forward through opportunities for continuing education and supporting research and development. Connecting with industry colleagues, myopia journals, and associations allows us to stay on the brink of current knowledge. – Sheila Morrison, OD, MS, FSLS, Mission Eye Care Center for Dry Eye and Corneal Disease

2. Build Trust
Building trust with a very young child is as important as building trust with their parents. The success and the outcome of the treatment depend on the patient’s cooperation. I do this by scheduling a follow-up Zoom call with the parents and the child where they get to see me smiling and encouraging. I try to speak to the child directly and ask them their interests, what they like to do, and how they like wearing glasses. Research shows that being within four feet of someone’s personal space builds trust. In the exam room, where the face mask can interfere with a personal connection, a Zoom or FaceTime call allows me to be artificially close to them. The brain doesn’t know the difference in how that “close” space is created, and in today’s day and age of face masks, this is very pragmatic. Shefali Miglani, OD, Monroe Eye Care

3. Record Your Presentation
To make the process of myopia education easier for myself, my fellow eye care professionals, and parents, I made a YouTube video that breaks down myopia, the risk factors, the available treatment options, and what parents can start doing as soon as possible to improve their children’s vision. I found myself repeating the same things to patients and parents over and over and thought that creating this video would streamline this process in my day-to-day work and for others. The video includes resources such as the CooperVision Myopia SimulatorBHVI’s Myopia Calculator, and articles from Vista Eye CareThe Eye PracticeModern OD, and Eye Bar. – Eric Chow, OD, FAAO, Clarin Eye Care and Coral Gables Eye Care Center

4. Get Buy-In From Parents and Patients
We need to take the parents and the children into consideration when deciding on a treatment plan. If a parent is on board with one treatment method, but a child is more hesitant, we’ll consider something that the parent can be more involved with, either OrthoK or atropine. A big part of this comes down to interviewing the parents and learning about their schedules, what they do for fun, how their children spend their time, and whether or not the parents are willing to contribute. It doesn’t necessarily require a formal screening or questionnaire, but instead, it could be as simple as making casual conversation. You pick up things during the exam when you’re naturally talking and asking about weekend plans or what the parents do in their downtime. – Melanie Frogozo, OD, FAAO, Alamo Eye Care 

5. Plant the Myopia Seed Early
I try to plant the seed early for my existing children and their parents so that when myopia does commence, they are already aware of the available treatment options. Once a child is formally diagnosed with myopia, we discuss the treatment options with patients and their parents more in-depth and express how valuable it is to start a course of treatment. In these conversations, we want parents to understand the risks associated with myopia going untreated — macular degeneration, glaucoma, retinal detachment — without scaring them. We instead shift the focus to how beneficial it can be to choose a treatment plan and get started on it as soon as possible. We reinforce the fact that our primary goal is slowing the progression of myopia. – Vishakha Thakrar, OD, Vaughan Family Vision Care

6. Do Your Homework, On OrthoK and Other Treatments
Being an OrthoK provider is not something you can do successfully without doing many cases and taking the time to learn and stay educated regularly. I had a lot of homework to do before we even had our first OrthoK patient. As an OrthoK practitioner, you want to learn about multiple designs, so I got certified with ParagonContex, and Euclid. Then I found ArtGOV through Vision By Design and spent time understanding that design. I recently went through a weekly online seminar over six weeks through ArtGOV, and I also spend a fair amount of time on the AAOMC email threads and reading updates through resources such as Review of Myopia Management and Myopia Profile. There is so much happening with myopia management from a research perspective, and it very much impacts my clinical approach. The homework never stops these days, but it always benefits my patients and my practice. – Katherine Schuetz, OD, RevolutionEYEs and Little Eyes Pediatric Eye Care

7. Use Social Media
I’ve always tried to utilize social media at my practice to attract new patients and share educational resources. We have always been early adopters of social media, heavily using Facebook and Twitter for many years. More recently, we’ve shifted our attention to TikTok. Using this platform has allowed us to reach lots of people – specifically a younger audience. It is the only method that I know of that will enable us to educate children about myopia directly, and I’ve found that they’re very interested in the topic. TikTok isn’t just for kids, though. Their parents are on it, and serious videos on TikTok make the news regularly. It is a chance to amplify the educational videos that practitioners are putting out there about myopia. – Nathan Bonilla-Warford, OD, FAAO, FCOVD, FIAMOC, Bright Eyes Family Vision Care and Bright Eyes Kids

8. ‘Prescribe’ Myopia Management
When talking with parents, I let them know we now have options to keep their child’s axial length and prescription from getting worse. Most parents are thoroughly intrigued, which leads to great dialogue about myopia management and eventually a commitment to a treatment program. Unfortunately, others are not as receptive and do not see the value. I still send them home with the packet, and I note in their chart to revisit the topic the following year. If the child is at high risk for progression, I will recall them to recheck their prescription in six months. Frequently, when the prescription has worsened at that return visit, the parents will get on board with managing their child’s myopia instead of simply correcting it. I always say that I am prescribing myopia management and not just recommending it. There is a lot of power in that statement. – Ashley Tucker, OD, FAAO, FSLS, ABO Diplomate, Bellaire Family Eye Care

9. Make Your Website Comprehensive
Social media and the internet have played much more prominent roles in my practice than before, as patients and parents can now share their stories. I try to use this to my advantage by making my website as comprehensive as possible. I started by going through all of the questions that parents had asked me in the exam room and wrote content based on them. If one parent asked the question, I believed others would have the same question. This strategy has ultimately been successful in terms of growing my patient base. I get most of my new patients from recommendations and parents who have visited my website. Often, parents who are recommended to me will visit the website for confirmation, which helps educate parents and build trust. – Bhavin Shah, BSc Optom (Hons), MCOptom, MBCLA, Central Vision Opticians

10. Choose the Treatment Option Most Suited to the Patient
I want every patient and parent to know about and understand every treatment option. I let them know what I have the most experience with and what I feel the most comfortable with based on their child’s age and lifestyle, but I talk highly about each option and give each child one strong recommendation. Simply put, not everyone can wear contact lenses 100% of the time. We must have different options suited to various children’s needs and ensure that they’re still getting treatment even if they’re not feeling well or simply don’t want to wear contacts. – David Anderson, OD, Miamisburg Vision Care

This article was written in partnership with BHVI’s 2022 Myopia Awareness Week. This year, the goal is to make your eye moves and spread the word about myopia.

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