Aug. 5, 2020

Myopia Management Journey - E3

Myopia Management Journey - E3

Myopia Management Journey - E3

It was a crazy, but exciting week. I honestly have not been so motivated to learn/master something since I opened the office. I have done a ton of research, did a full consultation, ordered CRT retainers for a patient, and did a dispensing appointment. I started comparing the learning process in optometry school to driving in the snow (can you tell I am a Michigander and went to grad school in Chicago?), it is never easy the first time through. This process has been no exception.

Let's get into it. The knowledge I acquired was essentially more specific details of things I already “knew”. For example, we know the eye grows at a given rate and under myopia management we expect it to grow at a lesser rate. The average growth is expected to be 0.2mm/year which equates to roughly 0.5 D. Under the MiSight clinical study they saw a reduction in growth to 0.1mm/year or about 0.25D. I found research indicating undercorrection can actually cause the eye to grow more, learned that we see myopia at over 23mm and our goal should be to keep the eye less than 26mm, and got a pretty good general understand\ding of what myopic defocus is. All of these things are useful when preparing to present the case of myopia management to a parent. If you have specific questions or are looking for resources, send me an email, I would love to help out.

Now the fun part: I got my hands dirty and made the jump from theory to practitioner. I had a live consultation (albeit with a staff member), but I went through the packet I prepared and gave it a real life trial run. It was interesting seeing how all the details played out in real time. I highly encourage dry runs and having somebody watch and record you. If you are not thin skinned, the honest feedback will expedite your growth. Needless to say, there are a number of things I am modifying in the process.

After the consultation, I got the chance to order CRT retainers. I was thinking I was going to work with GP specialists and use their ISee lens, and I still plan on it at some point, but Art Optical released the MOONLENS and I already have a working relationship with them. I have been to their labs numerous times for training and other activities, order my specialty soft lenses/GP lenses from them, and best of all, they have a “worry free” warranty on their lenses. Being new to the party, this gave me peace of mind going into the process. 

They did not disappoint. I sent my Medmont topography scans to the ordering department and consultation walked me through the scans, plus their online calculator is amazing and answered all my questions. I learned a lot and felt like this is definitely the service and guidance I want going forward. Next week I will have feedback from my Day 1 follow up and subsequent adjustments I made if necessary, so stay tuned.

Lastly, we did a dispensing appointment for the patient. This was a complete cluster… I gave my lead staff a crash course in insertion and removal the day before, and well, it showed. I am definitely going to modify the approach going forward, handling most of it myself initially. Now I know this is very short sighted, and it is imperative that I train my staff and give them the skills to take the easy lifting off my hands. In order to grow and scale, this is an absolute necessity. Like everything, that takes time, effort, and buy in from my staff. Sounds about like everything else on this journey. Nevertheless, I am having a blast and hope you gain a nugget or two of knowledge as you see me going through this process.

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