Dr. Oliver WOO
Lead of AOC-Academy of Orthokeratology and Myopia Control
1 December 2019
Myopia management is a lifelong journey that requires your commitment. It is a journey that you will never forget and one that you will become incredibly proud of.
Your decision to establish a myopia management clinic will see you learn new skills, develop new professional relationships and most importantly, change the lives of your patients.
Over the past 24 months I have increasingly received phone calls from patients asking to make a myopia management appointment. This request is quite distinct from the former calls requesting an orthokeratology (OK) appointment. The shift reflects the increasing awareness among patients, referrers and practitioners of the many approaches we can now take to manage myopia.
However, there is more that we can do, and much more we need to know, and so we should continue to develop our knowledge on the available options and pursue further research. Furthermore, we should become more proactive in discussing myopia management with our patients, even before they ask us about it.
This, I believe is critical, because when it comes to myopia, doing something is better than doing nothing.
GETTING STARTED IN YOUR CLINIC
It is definitely not hard to start a myopia management clinic. All the latest and most appropriate equipment is only one phone call away.
The biggest challenge is knowing how to keep the passion burning and how to maintain a consistent commitment to this area in the practice. I know it is hard because I have failed before. It is very difficult to focus all your energy in one direction all the time.
Another challenge is making the public aware of what you are doing. It can be hard for them to appreciate the value of your service, especially in the short-term.
To succeed, we need good mentors and coaches to support us as we move forward and become better practitioners. We need to constantly update our skills and knowledge to keep up with market trends. And, we need front of house staff that share our passion for myopia management and are adept at identifying potential patients. Ensuring they know the myopia management options available will help them start the conversation with patients before they come into the consultation room. To succeed, everyone in the practice must work as a team with the same mission and goal.
HOW DOES MY PRACTICE DIFFER FROM OTHERS?
At my practice, comprehensive eye examinations (including binocular vision) and aftercare appointments and services are our main focus. We book a series of consultations in advance when the treatment programme commences and send text message reminders. This crucial procedure is integrated into our plan to ensure that our patients’ prescription and myopia is under proper management. No parent rejects the extra love and care we give to their kids.
I also differentiate my practice with my clinical care. I know a simple set of numbers and a patient’s refractive error are not enough to identify the current state of their myopic progression. For this reason, I consider biometry to be essential. I started measuring axial length 15 years ago and it quickly became a standard procedure of my practice. By measuring axial length we can identify when and how to change our management programme, and give our patients a clear picture of what we’re doing and the direction we are heading towards. This is why and how we can offer the highest quality treatment for our patients and differentiate ourselves in this growing field.
Finally, the most important aspect of any myopia management plan is to achieve patient compliance with the recommended intervention, be it spectacles, contact lenses and/or pharmacology. To do this, we are careful to document and explain the advantages and disadvantages of the treatment approaches we use, particularly when using pharmacological intervention. We are also careful to make patient safety the priority. If patients are using myopia control specific spectacle lenses, we have to make sure the frame is in the optimal position according to the manufacturer’s recommendation. A simple adjustment of the nose pad could make a big difference to their vision and myopia progression, and create a big impact on their life.
This extra level of care, along with our consistent after care service, differentiates us from others and allows us to connect more personally with our patients and achieve optimal outcomes. It also justifies the necessary fees associated with our myopia management expertise and programme.
ENTRÉE COMES BEFORE THE MAIN
One of the most important aspects of myopia management is patient communication, right from the beginning. I would liken initial discussions of myopia management with patients to the ‘entrée’ before they immerse themselves in the ‘main course’ of their myopic treatment journey – it sets the tone for the course to follow. We need our patients and their parents to be confident in our care, our professionalism, and our capacity to change their lives by giving them a taste of what is to come.
However, it is important to limit the discussion, especially in the first instance, because it is very hard for our patients to take in all the technical and scientific information and recommendations we give them at once.
This advice comes from experience. I used to spend at least an hour trying to convince parents of my suggested treatment strategy for their child. Many times I failed, faced rejection and felt frustration. So my best advice is to be wise with your approach and your time. Give your patients the opportunity to consider the options and follow them up if you don’t hear from them over the next week or so. Be patient and show them you really care about their child’s vision and ocular health. This is how you can be a very different eye care professional and how you can create a strong professional relationship – you may be seeing this child for the next two, three or even ten years!
TECHNOLOGY AND PASSION
I have found that a thriving and successful myopic management clinic is not bound by equipment and technology, but defined by the passion and commitment of practitioners and the way they use these technologies to facilitate the quality of their service.
From my experience, too many practitioners are too focused on using OK alone for myopia control. Although it takes time and effort to develop the skills to use this modality, I encourage you to view OK as a practice builder, and to consider using other options that may also be effective. Embrace and make use of other technologies, such as ophthalmic lenses with a myopia management function, which are a great option for early myopes and those who aren’t suited for contact lenses. If you’re prescribing spectacle lenses for myopia management, don’t feel bad about doing so, but do be vigilant about routine eye examinations and aftercare – these steps are crucial for achieving the best result due to the unique fitting of the frame for each patient.
One thing I never expected was that practising myopia management would give me financial freedom. It has allowed me to travel the world, running workshops, presenting lectures and sharing my passion for myopia management to help many practitioners in this area. It has also allowed me to change people’s lives from a young age.
Another surprise has been the increasing pride I have in the impact of my work and the way in which my love of practicing has grown more each day.
If, like me, you start treating patients who are at the young age of eight, you’re going to be their good friend for at least 10 years. Your patients will see you as more than just an optometrist – they will see you as a friend and respected healthcare professional. I have had quite a number of wedding invitations and engagement notices from our patients in the past year alone! This is a priceless reward, and one of the reasons why I am so proud of being an optometrist. I believe you can also have this experience in your future.
A LIFELONG SERVICE
Regardless of your approach to myopia management, there’s one very important thing to remember: Myopia management is not a ‘buy and bye’ type of business model. We are not selling products, but rather providing an ongoing and lifelong eye care service. We need to see the value of our work in order for our patients to appreciate the significance of our service. When we approach it as such, our patients will understand that an appropriate management fee is necessary and should be expected.