Myopia Management Journey - E8
It was another week of learning when it came to myopia management. There 3 areas I will focus on:
When it comes to your Ortho-K patients, Topography is absolutely essential in managing the therapy. Art Optical put on a great webinar Tuesday. It was aimed at the entry level practitioner and I found it very enlightening. I believe the webinar is now on their Youtube Channel. I encourage you to check it out. The 3 pearls I took away were as follows:
The first baseline topographies are the most essential and need to be done correctly. This seems to be quite self explanatory as the initial lenses and subsequent scans are all predicated on this scan. Needless to say, I will be much more involved in these scans.
Reproducibility is essential in the baseline scans. They advised 4-5 initial scans per eye. You want to see reproducibility from one to the next. If you don’t see this, you need to consider the tear film, lash artifacts, or improper fixation.
The patients should be blinking every 4 seconds when doing the scans. I honestly was having them keep their eyes open much longer than this. Lesson learned.
When I do myopia management I use a global fee. Whether you do atropine, Ortho-K, soft contacts or any combination of the above, you pay the same price. This was my saving grace as my first Myopia Management patient just could not continue with my initial treatment with Ortho-K lenses. Just because the child lacked the motivation to go that route didn’t mean that they had to quit the therapy entirely. We had more options!
Thankfully, with the global fee, I merely reiterated our goal of slowing myopic progression and slowing axial lengthening of the eye. In addition, we want the patient's vision to be fully corrected throughout the year. (Remember undercorrection leads to axial lengthening). This refocus made the parent and patient less “embarrassed” to not be successful with ortho-k and kept them motivated to continue therapy. We are going with atropine and will consider alternative therapies in the months to come.
Lastly, I met with my lawyer this week to discuss my plans for growing my office, my myopia management specialty, and the future of the podcast/blog going forward. It was a fun and productive conversation and I share this with you because I encourage you to share your plans, goals, dreams with others. You never know what kind of help or guidance you are going to get. Successful people love to give back and resources such as lawyers, other doctors, or other entrepreneurs are endless vats of knowledge and experience that can make your journey that much easier. That's why I started this to begin with, so reach out and make your dreams happen!
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