AAOMC Newsletter | Issue 1 | 2024 Edition

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American Academy of Orthokeratology & Myopia Control

Issue No. 1 | 2024 Edition

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President's Address As we step into the promising horizon of 2024, I am thrilled to extend a warm welcome to each and every one of you, both longstanding members and those joining our esteemed academy for the first time. Your presence and dedication form the bedrock of our community, and I am honored to address you as we embark on another year of progress and innovation in the field of orthokeratology and myopia control.

To our new members, I extend a heartfelt welcome.

Your decision to join our academy signifies your commitment to advancing excellence in optometry and eye care. We are thrilled to have your expertise and passion enriching our collective knowledge base.

As we reflect on the successes and growth of 2023, I extend my deepest gratitude to our members. Your unwavering support, engagement, and contributions have been instrumental in propelling the AAOMC to new heights. Together, we've fostered an environment of collaboration and shared learning that continues to define our academy.

Looking ahead, I invite each of you to play a pivotal role in the expansion of our annual Vision By Design conference. Our conference serves as a nexus for knowledge exchange and professional development in the realm of orthokeratology and myopia control. I urge you to take action by leveraging the power of social media. Let's amplify our reach and impact by sharing information about our upcoming conference on platforms like LinkedIn and Facebook. Your voice and advocacy can make a significant difference.

I encourage you to visit the AAOMC LinkedIn page or our Facebook page and actively engage with our posts. Share our updates, discussions, and insights with your networks. Better yet, craft your own posts, highlighting the value of our conference, and include the registration link to encourage participation. Together, we can broaden our community and empower more professionals to join us on this journey toward advancing eye health.

Remember, our strength lies in unity. Let's continue to stand together, support one another, and propel the field of orthokeratology and myopia control to new heights.

Thank you for your unwavering commitment and dedication to our shared mission. Here's to a year filled with collaboration, growth, and transformative advancements!

Warm regards,

Cheryl Chapman OD, FAAO, IACMM, FIAOMC, Diplomate ABO President, American Academy of Orthokeratology and Myopia Control

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In This Issue

Page 1

President's Address

Page 4

Cover Story Part One | Expressing Gratitude to Outgoing Board of Directors Members Part Two | Welcoming New Faces to the AAOMC Executive Committee Part Three | Meet Your New Vice President

Page 8

Regional Meeting Update

Page 9

Toronto Regional Meeting

Page 10 Navigating the Digital Frontier: Balancing Screen Time for Healthy Vision Page 11

Vision by Design 2024

Page 12 Case Report Page 15 Paraoptometric Spotlight Page 17 Recent Publications and Assessment with Dr. Langis Michaud and Dr. Patrick Simard Page 22 Tea Time with the Residents Page 22 Practice Pearls Page 24 Paraoptometric Tea Page 25 Closing Remarks Page 25 Spread the Love

Missed A Previous Issue?

Catch Up on the Previous Issues Today!

Issue 1 | May 2023 Issue 2 | July 2023 Issue 3 | October 2023

Cover Story Part One | Expressing Gratitude to Outgoing Board of Directors Members Part Two | Welcoming New Faces to the AAOMC Executive Committee Part Three | Meet Your New Vice President

Part One | Expressing Gratitude to Outgoing Board of Directors Members As we bid farewell to a chapter in our journey, it is with a mix of gratitude and appreciation that we extend our heartfelt thanks to the distinguished Board of Directors members who have recently completed their terms and are stepping down.

Dr. Paul Levine, Dr. Sami El Hage, Dr. Caroline Guerrero-Cauchi, and Dr. Bruce Koffler have each played pivotal roles in guiding the American Academy of Orthokeratology and Myopia Control (AAOMC) towards excellence.

A Legacy of Leadership Dr. Paul Levine (Past-President): Dr. Levine's unwavering commitment to advancing orthokeratology and myopia control has left an indelible mark on our organization.

His leadership and expertise have been instrumental in shaping the direction of AAOMC, and we express our deepest gratitude for his dedicated service.

Dr. Sami El Hage (Scientific Session Chair): Dr. El Hage’s passion for myopia control research and innovation has greatly contributed to our mission.

His vision and strategic insights have guided AAOMC and the field of orthokeratology to new heights.

We are immensely thankful for the wisdom and guidance he brought to the board.

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Dr. Caroline Guerrero-Cauchi (Co-Creator of BootCamp & Accreditation Chair): Dr. Guerrero-Cauchi's commitment to education and her advocacy for professional development have been invaluable. Her contributions to fostering a culture of continuous learning within AAOMC have inspired many. We extend our sincere appreciation for her dedication to our community.

Dr. Bruce Koffler (OMD Liaison): Dr. Koffler's dedication to pushing the boundaries of orthokeratology has been nothing short of inspiring. His leadership in bridging relationships and providing perspective with the ophthalmological community has left an enduring impact. We express our deepest gratitude for his tireless efforts.

A Great Community The AAOMC community has flourished under the guidance of these exceptional individuals. Their collective wisdom, innovative ideas, and passion for our shared mission have propelled us forward.

As we bid farewell to these esteemed members, we reflect on the countless ways they have enriched our organization and the lives of those we serve.

Looking Forward While we bid farewell to these board members, we are excited about the new opportunities that lie ahead. The foundation they have helped build provides a strong platform for the continued success of AAOMC. We welcome new perspectives and ideas that will contribute to our ongoing mission. Thank You, Dr. Paul Levine, Dr. Sami El Hage, Dr. Caroline Guerrero-Cauchi, and Dr. Bruce Koffler: On behalf of the entire AAOMC community, we extend our deepest gratitude to Dr. Paul Levine, Dr. Sami El Hage, Dr. Caroline Guerrero-Cauchi, and Dr. Bruce Koffler for their outstanding contributions and leadership. The impact of their service will resonate for years to come.

Part Two | Welcoming New Faces to the AAOMC Executive Committee We are delighted to announce and extend a warm welcome to the newest additions to our esteemed Executive Committee at the American Academy of Orthokeratology and Myopia Control (AAOMC).

These dedicated individuals bring a wealth of expertise and passion to their roles, further strengthening our commitment to advancing the field of orthokeratology and myopia control.

Meet the New Executive Committee: Dr. Jonathan Skoner - Vice President We are thrilled to introduce Dr. Jonathan Skoner, who has assumed the role of Vice President. Dr. Skoner, an accomplished optometrist, has an impressive background in orthokeratology and myopia control. His dedication to the field and vision for the future align seamlessly with the goals of AAOMC. Dr. Skoner's leadership promises to inspire and guide us toward new horizons.

Dr. Caroline Kaufman - Treasurer Dr. Caroline Kaufman will remain on the Executive Committee, Transitioning from the role of Secretary to the role of Treasurer.

Her knowledge of the board’s background and personal experience will allow her to continue to grow the organization into a financially stable one.

Dr. Marie Homa-Palladino Secretary Dr. Marie Homa-Palladino joins the Executive Committee as Secretary, bringing a wealth of experience and expertise to this vital role. Her commitment to fostering communication and collaboration will be undoubtedly enhance the effectiveness of our committee and benefit our entire membership.

Current Executive Committee Members: Dr. Cheryl Chapman - President Dr. Cheryl Chapman continues to lead the way as our dedicated President. Her vision and guidance have been instrumental in shaping the trajectory of AAOMC, and we are fortunate to have her at the helm.

Megan Schoenfelder Executive Director Megan Schoenfelder, our invaluable Executive Director, plays a pivotal role in ensuring the smooth operation of AAOMC. Her unwavering commitment to the organization and its members is truly commendable.

Exciting Times Ahead As we welcome these new members to the Executive Committee, we look forward to a dynamic period of growth and progress for AAOMC. Their collective expertise will undoubtedly contribute to the continued success and advancement of orthokeratology and myopia control. We encourage our members to connect with our Executive Committee, attend events, and actively participate in the vibrant community that is AAOMC. Together, we will continue to make significant strides in the field, fostering innovation and excellence.

Please join us in extending a heartfelt welcome to Dr. Jonathan Skoner, our new Vice President, and Dr. Marie Homa-Palladino, our new Secretary.

Thank you for your continued support and dedication to the American Academy of Orthokeratology and Myopia Control.

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Part Three | Meet Your New Vice President

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THE CORRECTED VIEW The Corrected View Podcast The Corrected View is the official podcast of the AAOMC with our hosts Dr. Anith Pillai and Dr. Dwight Barnes Catch Up On Recordings Today!

Dr. Jonathan Skoner, a distinguished member with a wealth of experience in the field, has been elected as our new Vice President. To gain insight for our members and help you learn more about your new VP, we asked Jonathan to answer a few questions as follows: Can you share with our members a bit about your journey in optometry and how you became involved in orthokeratology and myopia control?

During my early school years at Juniata College I had the opportunity to study all types of rural health care providers, optometry being one of them. Soon after my optometry experience, I ended up reading a New York Times article about a young girl with convergence insufficiency who was failing school.

Despite about 15 different doctor visits with various specialists (4 of them were ECP’s), an eye doc finally found out why she struggled so much in school, she had a severe CI! This article inspired me to help kids and become an eye doctor advocating for pediatric patients who can’t speak for themselves and have no idea what they’re experiencing wasn’t normal.

Orthokeratology and Myopia Control came into my focus about 11 years ago. The intrigue and challenges I encountered in fitting Orthokeratology and custom lenses struck my inner calculation driven mind….I attended my first Vision By Design meeting and the rest is history!

How do you balance your professional responsibilities with your professional life and hobbies?

This is really difficult. I practice long hours daily, and balancing this with my academy involvement definitely pulls from my many personal interests. I have a strong passion for OrthoK and Myopia Control, so I feel it’s my obligation to put extra efforts in now to allow these areas of practice to continue to thrive with the generations to come. We must all do our small part to demonstrate a big collective effort to show everyone that the AAOMC is the leading source of knowledge and evidence based practice in regards to OrthoK and Myopia Control. Outside of the AAOMC and practice, I am absolutely looking for any opportunity to spend time with my wife, family and friends. Generally, I try to disconnect from my email and phone in the evening hours to ensure I get personal time that’s genuine. In the clinic, to promote better balance of my time, I instituted block scheduling.

This has allowed me to be much more efficient, specifically to my MC patients.

As the Vice President, what goals or initiatives do you hope to focus on during your term to benefit AAOMC members in the field at large?

I want Orthokeratology and MC to be viewed with respect in the medical and optometric communities. As myopia explodes

explodes globally, AAOMC is in a prime position to foster industry relationships for a greater overall goal, changing the way myopia is viewed and treated. My goals are too many to list, but here’s a few I’ll be focused on: 1. Continue to establish AAOMC (in North America) and IAOMC (worldwide) as trusted and unbiased sources for clinicians in America and worldwide.

2. Work towards creating a new standard of care for myopes everywhere, making MC the new standard when warranted.

3. Promote a welcoming and pressure free environment for anyone interested in our craft and message.

4. Generate respect of established AAOMC members as leaders in their local community advancing the standard of care responsibly.

5. Create convenient and approachable resources on a local level that will engage all docs and motivate them to either provide MC with AAOMC training or refer to AAOMC’s network of experts.

6. Help myopia control become part of school curriculums.

7. Grow the AAOMC to a position of unquestionable sustainability to achieve long term goals in MC. What do you see at the primary challenges currently faced by optometrists in the field of myopia control, and how do you plan to address them?

I think the long standing mindset of prescribing “stronger glasses” for progressing myopes is slowly being eroded away, but too slowly. There is a preponderance of evidence that supports the association between ocular pathology and axial length changes associated with progressive myopia. Many members of the AAOMC understand this well thanks to our outstanding education. I hope to address the larger optometric community through education campaigns on a local level via regional chapter meetings. We must empower ECP’s with tidbits of knowledge that leave them inquisitive and self driven to find out more. In addition, we will actively engage more with current students of optometry to help shape the mindset of future OD’s.

How can individual members actively contribute to the mission and success of the AAOMC?w can individual members actively contribute to the mission and success of the AAOMC? Some thoughts that come to mind: Join the AAOMC, if not already a member Follow our very active google group with input from ECP’s worldwide, it’s an outstanding resource.

Attend Vision By Design annual Meetings Consider applying for AAOMC advisory board member Let us know if you have interest in being involved with regional AAOMC chapter meetings or even starting one in your region Talk with other docs in your office, spread the word on importance of MC and dispel myths that linger Are there opportunities for members to volunteer or participate in committees to shape the direction of the organization?

Absolutely, please reach out to myself, our president Dr. Cheryl Chapman or our executive director Megan Shoenfelder to inquire. We’re always looking for members to contribute.

If you could have any superpower related to optometry, what would it be and how would you use it?

I would magnetize peoples corneas and OrthoK lenses, so the lenses would always “snap” into perfect positioning. No more decentration issues! Imagine the possibilities…

If you were to create an eye-related slogan for your term as Vice President, what would it be?

“Reshaping The Myopia Mindset” Is there anything else you would like to share with AAOMC members and the broader optometry community as you step into this role?

Please help the AAOMC establish a new standard of care for myopia. We are a non-profit organization solely dedicated to this objective. Embracing this objective as a unified profession will have impacts beyond our lifetime.

We encourage all AAOMC members to extend a warm welcome to Dr. Jonathan Skoner as he assumes his role as Vice President. His passion for optometry and commitment to the AAOMC's mission make him an invaluable asset, and we are excited about the positive impact his leadership will have on our academy.

Regional Meeting Update We are excited to announce the launch of AAOMC Regional Chapters. These chapters will provide a valuable opportunity for members to network with each other and industry sponsors, learn about the Dr. Jonathan Skoner latest myopia management techniques, and get involved in advocacy efforts.

In addition, we hope they will provide a comfortable setting to share ideas and learn from each other's experiences.

AAOMC Chapters will be organized by geographic region, and will meet on a regular basis twice a year.

We will look for each chapter to hold a meeting around January and June of each calendar year. For the year of 2024, the first set of regions include: South Florida Chicago New York Toronto Northern California Please see our website for updates of all AAOMC chapters including the chapter leaders and upcoming scheduled meeting dates & topics.

Our goal is to expand to more regions across the country in the upcoming years. If you feel that your region has a strong foundation of myopia management doctors and untapped potential, please contact us to put your region at the top of our list for upcoming chapters.

We are currently accepting inquiries for chapter leaders. Chapter leaders will be responsible for organizing and running chapter meetings, as well as communicating with the AAOMC national team. If you are interested in leading a chapter, please contact our executive director Megan Schoenfelder (megan@aaomc.org).

We look forward to seeing you at a chapter meeting!

P.S. We encourage you to spread the word about the new Local AAOMC Chapters to your colleagues friends.

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Check Out Some Photos from Our Regional AAOMC Meetings.

Become a Chapter Leader Today!

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Toronto Regional Meeting Toronto Meeting Summary from Dr. David Ng

Connect with us to make sure you never miss an announcement. Check us out on our following social sites.

Myopia Management for Everyone Join this unbiased patient doctor group to see what patients are saying about myopia management

AAOMC

THE LIGNMENT ZONE The Alignment Zone A new segment brought to you by host, Dr. Paul Levine. Join him for insight on some of your most burning questions.

Dr. Paul Levine

Thomas Aller

The Alignment Zone

Dr. David Ng

The first American Academy of Orthokeratology Myopia Control (AAOMC) Toronto chapter meeting, was a resounding success despite the extreme cold weather. The atmosphere inside was warm as over 30 optometrists gathered to listen to a diverse range of talks.

The evening started with "The escalating epidemic of Dr. Fiona Soong discussing myopia, especially among the urgent need for all children and young adults doctors to make myopia is now a major public management a part of their health issue. " practice. The escalating epidemic of myopia, especially among children and young adults is now a major public health issue. Dr. David Ng continued with an introduction to the AAOMC and the benefits of membership, while highlighting the value of attending Vision By Design in October 2024. “If you only attend one out of town CE conference a year this is the one!” Dr. Vick Chan took the stage to share his expertise, presenting the "10 most important points to know before beginning your OK journey."

This was particularly valuable for the one-third of attendees who had not yet done their first OK fit. Following Dr. Chan, Elsa Lee, the local representative from Johnson and Johnson Myopia Management, introduced the Abiliti platform, showcasing its educational resources and online support.

Perhaps the “best” of the evening was an inspiring talk by Dr. Gary Lau, who illustrated the power of custom OK designs by fitting cases that most doctors would avoid. To finish Drs. David Ng and Fiona Soong provided insights on how the information presented by Vick, Elsa, and Gary could be integrated into practice. Dr. Ng shared his experiences and challenges with a busy myopia management practice with pearls of “what works and what doesn’t work”, highlighting the transformative impact his two Certified Myopia Navigators (CMN) have had in his practice. The meeting concluded with links for online educational resources and ended with a lively Q&A session, leaving the audience eager for more. The event successfully brought together optometrists of varying experience levels, providing valuable insights and fostering a sense of community within the field of orthokeratology and myopia control.

Check Out Some Photos from Toronto Regional AAOMC Meeting.

Navigating the Digital Frontier: Balancing Screen Time for Healthy Vision Cheryl Chapman, OD, FAAO, IACMM, FIAOMC, Diplomate ABO As we traverse the ever-evolving landscape of technology, it's imperative for us, as vision care professionals, to address the impact of increased screen time on our patients, especially the younger generation. Driven by the ongoing surge in digital device usage, myopia progression has become a significant concern. Allow me to share insights on this matter and offer practical tips for promoting visual health.

Cheryl Chapman OD, FAAO, IACMM, FIAOMC, Diplomate ABO

The Myopia Challenge: Research consistently shows a strong association between screen time and the progression of myopia in children and adolescents[1]. Prolonged hours spent staring at digital screens not only strain the eyes but also contribute to the elongation of the eyeball, increasing the risk of myopia progression.

Beyond Myopia: Other Negative Effects: Excessive screen time is linked to a host of negative effects on eye health. Digital eye strain, characterized by symptoms like headaches, dry eyes, and blurred vision, is prevalent among those immersed in prolonged screen use[2]. Moreover, disrupted sleep patterns, increased sedentary behavior, and potential retinal damage are concerns that cannot be overlooked.

Positive Aspects of Screen Time: While the drawbacks are evident, let's not ignore the positive aspects. Educational apps, virtual learning platforms, and digital resources provide invaluable tools for learning and skill development. It's crucial for us to help patients strike a balance between utilizing these resources for constructive purposes and safeguarding their visual health.

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Strategies to Reduce Screen Time: Empower families with practical tips to minimize screen time without sacrificing the benefits of technology: 1. Create Tech-Free Zones: Designate specific areas in the home where screens are off-limits.

2. Establish Screen Time Limits: Encourage parents to set daily screen time limits based on their child's age[3].

3. Prioritize Outdoor Activities: Engage in outdoor activities, proven to mitigate myopia progression[4].

Visual Hygiene Recommendations: 1. Harmon Distance: Educate patients on maintaining a harmonious working distance during near work to reduce *Photo created and recognized from the eye strain[5].

American Academy of Child and 2. 20/20/20 Rule: Encourage the 20/20/20 rule - every 20 Adolescent Psychiatry (2022) minutes, look at something 20 feet away for at least 20 seconds, aiding in reducing digital eye strain[6].

3. Age-Appropriate Screen Time Recommendations: Recommend adherence to guidelines like those from American Academy of Child and Adolescent Psychiatry.

By integrating these recommendations into our discussions with patients and their families, we can empower them to foster healthy screen habits, striking a balance between the benefits and potential risks of digital devices.

[1]: Gwiazda, J., Deng, L., Manny, R., Norton, T. T., & COMET Study Group. (2014). Accommodation and related risk factors associated with myopia progression and their interaction with treatment in COMET children. Investigative Ophthalmology & Visual Science, 55(7), 4921–4930.

[2]: Sheppard, A. L., Wolffsohn, J. S., & Digital Eye Strain Symptom Conversion Study (2018). Digital eye strain: Prevalence, measurement and amelioration. BMJ Open Ophthalmology, 3(1), e000146.

[3]: American Academy of Pediatrics. (2016). Media use in school-aged children and adolescents. Pediatrics, 138(5), e20162592.

[4]: Wu, P. C., Tsai, C. L., Wu, H. L., Yang, Y. H., Kuo, H. K., & Outdoor Activity and Myopia Prevention Study Group. (2013). Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology, 120(5), 1080–1085.

[5]: American Optometric Association. (2019). Computer Vision Syndrome. Retrieved from https://www.aoa.org/patients-and-public/caring-for-yourvision/protecting-your-vision/computer-vision-syndrome [6]: Rosenfield, M. (2016). Computer Vision Syndrome (aka Digital Eye Strain). Optometry in Practice, 17(1), 1–10.

VISION BY DESIGN VBD2024 October 2nd - 5th, 2024 | Dallas, Texas

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Post Lasik Case Report In 2021 I received a call from a patient who lived 400km away.

He was referred by a colleague, was a post-lasik patient and now wanted to try ortho-k. He Juan Bolívar, was 25 years old.

OOD, FIAOMC, IACMM He was trying to pass the entry exam to get into the fire brigade, but he needed to overcome a 20/30 visual acuity without glasses. He had had lasik to remove his myopia 3 years previously, but the myopia had reappeared, after a period of time. At that moment, he had two options, refractive surgery with phakic IOL or ortho-k, another lasik procedure was not an option because he didn't have enough corneal thickness.

He discarded surgery due to his previous bad experience, he didn´t trust any surgery.

He had asked ophthalmologists and optometrists about ortho-k in post lasik patients, but neither advised him to do it. Ophthalmologists said that it was dangerous, optometrists said that it didn’t work in post lasik cases.

Finally, a former student of mine recommended he should consult with me.

Initial Assessment

Topographies show centered surgery, regular and with a 6.50mm ablation area (tangential maps). Elevation maps didn't show any irregularity.

These topos are perfect to start with ortho-k

It is possible to fit ortho-k in thin corneas, after surgery.

There was enough epithelial thickness to do orthok. As usual, epithelial thickness after lasik is thicker than normal in the central area, which helps us to do ortho-k in a safe way.

-Biomicroscopy shows a homogeneous and regular flap junction, it also shows typical patterns after surgery, black lines that appear when a patient hasn’t blinked for some seconds. This is not a negative factor against doing ortho-k, but I also found blepharitis which is a negative factor against doing ortho-k.

Prior to starting ortho-k it is always necessary to improve the blepharitis condition to minimize problems when any contact lenses are used (especially in ortho-k and also scleral lenses). In this case I recommended blepharitis treatment before starting with ortho-k.

Is important to note that dry eye condition is very frequent in post-lasik patients, and this must be treated to avoid problems with the ortho-k result over time.

Look at how the epithelial thickness decreases from the center to the mid periphery area (near to the ablation edge).

INITIAL PRESCRIPTION OD: -1,25 VA: 25/20 OS: -1.75 VA: 25/20 INITIAL FITTING In Post-lasik cases it is important to take into account BOZD, in this case we used larger than normal diameters (6,50 and 7mm).

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Normally we can´t use the central data to select the periphery, because the periphery is steepen when more diopters are removed by lasik. Elevation maps could help us to understand the prognosis of the case. A large area topography is more useful due the importance of the periphery (normally narrow cone topographers give us more information about the periphery) We used DRL lenses, but customized them: BOZD (larger than normal) Central sagittal height (lower than normal) Periphery (steeper than topographies data stated) Power target (in this design, power target is relative to central sagittal design, and we need to know how to work this design to calculate the power target (M)) OD: K7.65 M3.25 P7.45 TD10.80 BOZD 6.50

I decided to do 2 small changes: 1. Increase BOZD to 7mm. I wanted to improve the stabilization of the lens, looking for more definition in the red ring.

2. Increase -0.25 target power, because of miscalculations in the first lens.

OS:

OS: K7.60 M4.25 P7.45 TD10.80 BOZD 7.0 VISIT AFTER 15 DAYS OD:

VA: 25/20 - Patient is very happy with the result.

OD: SECOND LENS (AFTER 15 DAYS) OD: K7.65 M3.50 P7.45 TD10.80 BOZD 7.00

VA 20/25 - Patient noticed haloes at night.

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VA: 25/20 - Patient is very happy, visual acuity is perfect, haloes improved, repeatability of vision was also perfect.

Finally my patient passed his exam, nowadays he’s a firefighter. He continues using Ortho-k and his visual acuity is perfect even when he does 24-hour work shifts.

To diminish the blepharitis, he continues with cleaning his eyelids.

The key in this case was to achieve a great repeatability of vision by the stabilization of the lens which was achieved, when customizing the relationship between ablation diameters and BOZD.

Paraoptometric Spotlight An Interview with Rochelle Tang, a Paraoptometric for Bayview Vision Care in Toronto, Ontario Who is the doctor you work for?

Dr. David Ng. Tell us a little bit about your role in your practice.

As the Myopia Management Coordinator, my role is patient engagement and education. Working closely with our doctors and staff, I coordinate the designing, implementing, and maintenance of the custom myopia management programs for each child. One important aspect of my role is educating patients and their Rochelle Tang families about myopia, its progression, and the available treatment options.

I also help with determining each patient's myopia risk profile.

"Communication is key Communication is key for myopia management success. After the for myopia management patients and parents have finished with their sessions with the doctors success. " I am present to answer any additional questions or concerns that may arise.

Our goal is to raise awareness about the myopia epidemic and emphasize the need for early intervention.

How did you get interested in working in the field of optometry?

I developed an interest in optometry because of personal experiences and a fascination with healthcare. As a myope who started wearing glasses at age 8, I wondered if anything could be done to stop my prescription from getting worse. I was always intrigued by human vision and I enjoyed working with people. The field of optometry allows me to continue learning about the human eye while applying that knowledge to helping patients in the office.

Are there any challenges that you have had to overcome in your career journey?

A challenge I’ve had to overcome in my career journey is deciding on a specific subspecialty in healthcare.

Initially, I was pursuing a career in physiotherapy. However as I spent more time working at the eye clinic, I found optometry interesting and when pairing it with a background in neuroanatomy, I knew that a career in the optometric field was a fit for me.

What do you believe is the most important thing you do to support your doctor and your practice?

The most important thing I do to support my doctor and practice is providing exceptional service. I make it a priority to ensure patients feel welcomed and comfortable. I believe that a positive patient experience is the key building blocks for successful myopia management.

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What inspires you the most in your field of work?

The impact we have on improving quality of life is what inspires me the most in this field of work.

What is one piece of advice that you would give to a paraoptometric that is working in a practice that offers myopia management services?

A piece of advice I would give is to ensure that you have a firm knowledge of myopia and treatment options.

This will give you the confidence needed when dealing with patients and parents. Take the time to address every concern parents have about their child's myopia and the proposed management program (sorry that was two pieces of advice).

How do you manage to balance your career and your personal life/family?

I am fortunate that the flexibility and support at my workplace allows me to balance my work life and personal life. During my academic career, one of the most significant challenges was mastering time management while being a double varsity athlete. I take pride in my active lifestyle and prioritize self-care, which is essential for my physical and mental well-being.

Have A Member You Would Like to See Highlighted?

Please send your nomination to megan@aaomc.org.

Comprehensive Myopia Management Managing Myopia One Child At A Time describes the most recent scientific advances and translates them into a unique clinical approach we call The Montreal Experience. With more than 15 years of experience in controlling myopia and treating several hundred children and young adults, the authors have developed a practical and successful approach.

Using specific cases that explains their Myopia and Myopia management, taking some of the mystery out of the topic authors are providing the reader with insight and confidence to help their patients.

Purchase the Book Today!

Recent Publications

AAOMC Doctor Finder

Have you updated your information on the AAOMC Doctor Finder since the new website was launched?

Doctor Finder Dr Langis Michaud OD M.Sc. FAAO (Dipl) FBCLA FSLS FEAOO FIACMM

Dr Patrick Simard, OD, MSc, MBA, FAAO, FBCLA, FIACLE, IACMM

Article One | Topical Atropine for Childhood Myopia Control, The Atropine Treatment Long-Term Assessment Study Y Li, M Yip, Y Ning, J Chung, C Leow et al - JAMA Ophtalmology, 2023

Our new Doctor Finder even allows practitioners to denote which lenses they are comfortable fitting to make transfer of care a smoother, easier process.

Purpose: To report the long-term safety and outcomes of topical atropine for childhood myopia control.

Methods: This prospective, double-masked observational study of the Atropine for the Treatment of Myopia (ATOM) 1 and ATOM2 randomized clinical trials took place at 2 single centers and included adults reviewed in 2021 through 2022 from the ATOM1 study (atropine 1% vs placebo; 1999 through 2003) and the ATOM2 study (atropine 0.01% vs 0.1% vs 0.5%; 2006 through 2012).

Results: Among the original 400 participants in each original cohort, the study team evaluated 71 of 400 ATOM1, adult participants (17.8% of original cohort; study age, mean [SD] 30.5 [1.2] years; 40.6% female and 158 of 400 ATOM2 adult participants (39.5% of original cohort; study age, mean [SD], 24.5 [1.5] years; 42.9% female) whose baseline characteristics (SE and AL) were representative of the original cohort. In this study, evaluating ATOM1 participants, the mean (SD) SE and AL were −5.20 (2.46) diopters (D), 25.87 (1.23) mm and –6.00 (1.63) D, 25.90 (1.21) mm in the 1% atropine-treated and placebo groups, respectively (difference of SE, 0.80 D; 95% CI, −0.25 to 1.85 D; P = .13; difference of AL, −0.03 mm; 95% CI, −0.65 to 0.58 mm; P = .92). In ATOM2 participants, the mean (SD) SE and AL was −6.40 (2.21) D; 26.25 (1.34) mm; −6.81 (1.92) D, 26.28 (0.99) mm; and −7.19 (2.87) D, 26.31 (1.31) Conclusion: Among approximately one-quarter of the original participants, use of short-term topical atropine eye drops ranging from 0.01% to 1.0% for a duration of 2 to 4 years during childhood was not associated with differences in final refractive errors 10 to 20 years after treatment. There was no increased incidence of treatment or myopia-related ocular complications in the 1% atropine-treated group vs the placebo group.

These findings may affect the design of future clinical trials, as further studies are required to Page 17 investigate the duration and concentration of atropine for childhood myopia control.

Langis and Patrick’s Clinical Translation: Although it was not possible to review all the data from the original cohort of ATOM1 and ATOM2, this article reminds us to keep in mind that short-term results within 2 to 4 years of treatment may be different from long-term results after discontinuation 10 to 20 years later.

It should also be considered that many of the analyses in this article are flawed, since the treatment and control groups differ in age, refraction and period of treatment received.

The conclusion (if we can consider it, despite the many biases of the article) was predictable. If you treat young myopes between the ages of 8 and 12 for 2 years and then stop, they will resume their age-related myopic growth and progress relatively quickly. The same is true if you treat a 40-year-old with glaucoma for 2 years, stop all interventions, and then 20 years later assess his visual fields and compare them with those of a person of the same age (now 60) who has never been treated. In both cases, the glaucoma will have progressed and there will be few useful visual fields left.

However, points to remember: No difference was found in the rate of ocular complications such as MMD, cataract and glaucoma.

It does not prove nor eliminate the presence of a potential rebound effect.

Results may suggest that using atropine as a single therapy on a short period is probably the best approach to control and limit myopia progression. Over time, optimal results may be achieved by keeping our patient on a myopia control strategy throughout adulthood.

Article Two | Peripheral Defocus, Pupil Size, and Axial Eye Growth in Children Wearing Soft Multifocal Contact Lenses in the BLINK Study DA Berntsen, A Ticak, LT Sinnott, MA Chandler, JH Jones, A Morrison, LA Jones-Jordan, JJ Walline and DO Mutti - IOVS, 2023 Purpose: The purpose of this study was to evaluate the relationship between peripheral defocus and pupil size on axial growth in children randomly assigned to wear either single vision contact lenses, +1.50

diopter (D), or +2.50 D addition multifocal contact lenses (MFCLs).

Methods: Children 7 to 11 years old with myopia (−0.75 to −5.00 D; spherical component) and ≤1.00 D astigmatism were enrolled. Autorefraction (horizontal meridian; right eye) was measured annually wearing contact lenses centrally and ±20 degrees, ±30 degrees, and ±40 degrees from the line of sight at near and distance. Photopic and mesopic pupil size were measured. The effects of peripheral defocus, treatment group, and pupil size on the 3-year change in axial length were modeled using multiple variables that evaluated defocus across the retina.

Results: Although several peripheral defocus variables were associated with slower axial growth with MFCLs, they were either no longer significant or not meaningfully associated with eye growth after the treatment group was included in the model. The treatment group assignment better explained the slower eye growth with +2.50 MFCLs than peripheral defocus. Photopic and mesopic pupil size did not modify eye growth with the +2.50 MFCL (all P ≥ 0.37).

Conclusion: The optical signal causing slower axial elongation with +2.50 MFCLs is better explained by the lens type worn than by peripheral defocus. The signal might be something other than peripheral defocus, or there is not a linear dose-response relationship within treatment groups. We found no evidence to support pupil size as a criterion when deciding which myopic children to treat with MFCLs. Langis and Patrick’s Clinical Translation: The BLINK study showed that using a centerdistance bifocal lens, a higher addition (+2.50D) was more effective in slowing myopia than a lower one (+1.50D). In an attempt to explain the mechanism responsible for the efficacy of this design, the authors evaluated the peripheral defocus component as a possible mechanism of action. After modeling the different variables, the author found that the peripheral defocus is not the only factor explaining the impact of the bifocal lens

used in the study. They suggest that other mechanisms can be in play. Optical aberrations were not measured but authors suggest that they are players to consider in future studies. The mechanism of the myopia control strategy most likely varies with the device used, and explaining the effects with a single mechanism, such as the peripheral defocus theory, seems unlikely.

This study reminds us also that humans do not behave and react like most of the animals our studies are based on. A lot of things are still to discover.

Article Three | Seasonal and Annual Change in Physiological Ocular Growth of 7- to 11-Year-Old Norwegian Children NG Nilsen, SJ Gilson, H Lingren, M Kjaerland, HR Pedersen and RC Barraas - IOVS, 2023 Purpose: To investigate seasonal and annual change in physiological eye growth in Norwegian school children.

Methods: Measurements of ocular biometry, non-cycloplegic spherical equivalent autorefraction (SER), and choroidal thickness (ChT) were obtained for 92 children (44 females) aged 7 to 11 years at four time points over a year (November 2019–November 2020). Seasons (3- and 5-month intervals) were classified as winter (November–January), winter– spring ( January–June), and summer–autumn ( June–November). Cycloplegic SER was obtained in January and used to group children. The seasonal and annual changes were tested with a linear mixed-effects model (P values were adjusted for multiple comparisons from 2006 through 2012).

Results: All the children experienced annual ocular growth, irrespective of SER, but less so during the summer– autumn. The baseline SER was lower (P < 0.001), axial length (AL) was longer (P < 0.038), and choroids were thicker in 10- to 11-year-old than 7to 8-year-old mild hyperopes (P = 0.002).

Assuming mild hyperopes (n = 65) experience only physiological eye growth, modeling revealed seasonal and annual increases in AL across sex and age (P < 0.018), with less change during the summer–autumn than winter– spring. The 7- to 8year-olds had a larger decrease annually and over winter–spring in SER (P ≤ 0.036) and in ChT over winter–spring than the 10- to 11-year-olds (P = 0.006).

Conclusion: There were significant seasonal and annual changes in AL in children who had physiological eye growth irrespective of age within this cohort.

Annual changes in SER and seasonal choroidal thinning were only observed in 7- to 8-year-old children. This indicates continued emmetropization in 7- to 8-year-olds and a transition to maintaining emmetropia in 10- to 11-year-olds.

Langis and Patrick’s Clinical Translation: Depending on the latitude, Norway in this article, daylight may vary significantly throughout the year and have an impact on the seasonal progression of myopia. In addition, daylight during the walk to school and until bedtime can be considered an important factor in estimating the child's exposure to natural daylight.

Points to remember: Both 7-8 year olds and 10-11 year olds show higher rates of progression in winter, Subfoveal choroidal thickness (SFChT) is thinner in winter, The seasonal effect on axial length and SFChT follows the same pattern in mild hyperopes and significant hyperopes.

The seasonal effects of daylight on choroidal thickness, even in hyperopes, may explain the preventive effects of more time outdoors on myopia.

Article Four | Six-year cumulative treatment effect and treatment efficacy of a dual focus myopia control contact lens P Chamberlain, DS Hammond, B Arumugam, A Bradley- OPO, 2023

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Purpose: Accumulated axial growth observed during a 6-year clinical trial of a dual focus myopia control contact lens was used to explore different approaches to assess treatment efficacy

Langis and Patrick’s Clinical Translation: Without any control group for the last 3 years of this cohort, the authors have compared the dual focus cohort to the historical non-treated cohort of myopic and emmetropic groups.

Methods: Axial length measurements from 170 eyes in a 6year clinical trial of a dual focus myopia control lens (MiSight 1day, CooperVision) were analysed.

Treatment groups comprised one having undergone 6 years of treatment and the other (the initial control group) having 3 years of treatment after 3 years of wearing a single vision control lens.

Efficacy was assessed by comparing accumulated ocular growth during treatment to that expected of untreated myopic and emmetropic eyes. The impact of treatment on delaying axial growth was quantified by comparing the increased time required to reach criterion growths for treated eyes and survivor analysis approaches.

Points to remember: Using a predicted shows a reduced growth by 0.52 mm after 6 years, Ethical concerns limit the classic randomized control trial with two-arms, Delaying the time to reach a certain level of axial length is also a way to measure efficacy.

Results: When compared to the predicted accumulated growth of untreated eyes, 6 years of treatment reduced growth by 0.52mm, while 3 years of treatment initiated 3 years later reduced growth by 0.19mm. Accumulated differences between the growth of treated and untreated myopic eyes ranged between 67% and 52% of the untreated myopic growth, and between 112% and 86% of the predicted difference in growth between untreated myopic and age-matched emmetropic eyes.

Treated eyes took almost 4years longer to reach their final accumulated growth than untreated eyes. Treatment increased the time to reach criterion growths by 2.3–2.7 times.

Article Five | Assessment of the Clinical Effectiveness of DRL Orthokeratology Lenses vs.

Single-Vision Spectacles in Controlling the Progression of Myopia in Children and Teenagers: 2 Year Retrospective Study

Conclusion: Estimated growth of age-matched emmetropic and untreated myopic eyes provided evidence of an accumulated slowing in axial elongation of 0.52mm over 6 years, and the treated growth remained close to that expected of emmetropic eyes. Six years of dual focus myopia control delayed the time to reach the final growth level by almost 4 years.

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With the proliferation of myopia control methods, it is unlikely that the control group will remain uncontaminated by other methods, and a dual focus group as a comparative group might be a better alternative for future treatment.

Purpose: The purpose of this study was to assess the effect of orthokeratology treatment with DRL lenses on the control of myopia progression compared with single vision glasses users (monofocal glasses). It was also possible to analyze the clinical efficacy of orthokeratology treatment with DRL lenses for myopia correction in children and adolescents.

Methods: This is a 2 year retrospective, multicenter study, performed in eight different ophthalmology centers in France. A total of 360 data records of children and adolescents with myopia between -0.50 D and -7.00 D at baseline visit, who completed treatment and had a centered outcome, were selected for the study from a database of 1271. The final sample included subjects undergoing orthokeratology treatment with DRL lenses (n = 211 eyes) and spectacle wearers (n = 149 eyes).

Results: After one year of treatment, the data analysis shows that the DRL lens has a refractive myopia progression control rate of 78.5% compared with the spectacle wearers (DRL M change = -0.10 ± 0.25 D, p < 0.001 Wilcoxon test and Glasses M change = -0.44 ± 0.38 D, p < 0.001 Wilcoxon test). Similar results were found after 2 years of treatment (80% with 310 eyes).

Conclusion: This study showed the clinical efficacy of orthokeratology DRL lenses compared to monofocal spectacle wearers in controlling myopia progression in children and adolescents in a 2 year retrospective study.

Langis and Patrick’s Clinical Translation: This article reminds us of the importance of OK lens design. The lens reviewed here is optimized for myopia control by limiting the central treatment zone and optimizing reservoir pressure by adding a second reservoir. This second reservoir also helps to center the lens. What's really interesting is that the effect of the lens on myopic progression holds up in older clinical populations. So we shouldn't hesitate to fit older myopes who are still progressing.

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Tea Time with the Residents Leveling Up Myopia Management with Combination Therepy

Sharon Qiu

The availability of clinically effective myopia management treatment options, such as orthokeratology, low-dose atropine, multifocal soft contact lenses (MFSCLs) and myopia management glasses, have drastically changed the landscape of myopia management. However, despite demonstrated clinical results of these individual therapies, not every child will respond to a chosen treatment. When a clinician observes fast myopia progression despite myopia management at six-month or one-year follow-up, a natural next step would be to add a second treatment, thus using a combination therapy approach.

There are a few questions to consider before initiating combination therapy – Is combination therapy effective? When should combination therapy be initiated? What concentration of low-dose atropine should be chosen? In this article, I will review the current evidence on combination therapy and present a simplified approach to prescribing combination therapy.

Is combination therapy effective?

The optical myopia management strategies, such as orthokeratology, MFSCLs and myopia management glasses are thought to work by the peripheral defocus theory. Low-dose atropine is a pharmacological myopia management strategy whose mechanism is still unknown1. Because the optical and pharmacological myopia management strategies work by different mechanisms, one can hypothesize that combination therapy may work synergistically and yield additive myopia management effects.In the literature, combination therapy with orthokeratology and low-dose atropine was the most widely studied. At the time of this article, seven studies were conducted on the effect of orthokeratology and low-dose atropine combination therapy, where the subjects were followed between 1-2 years1-7. Out of the seven studies, all but one study6 demonstrated the superior effectiveness of combination therapy. Together, the six studies showed that combination therapy was on average 42.85% more effective than orthokeratology monotherapy when comparing the mean axial length progression over the study period.

In comparison, fewer studies investigated the effectiveness of MFSCL and low-dose atropine combination therapy. In the BLINK study, Jones et al. reported that over 3 years, the combination therapy of low-dose atropine and MFSCL with +2.50 Add did not produce a statistically significant axial length slowing effect compared with MFSCL monotherapy8. A retrospective chart review produced similar results9.

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Practice Pearls Almost no patient really wants to be washed out of orthok to be refit, but if you don't do it, you caIn just wind up chasing your tail. Find a way to get it done without too much disruption to their lives.

Nathan Bonilla-Warford, OD, FAAO, FCOVD, FIAOMC

Inheriting an orthok patient (for example, previous doc retired or patient moved to your area) is almost always a bigger headache than it seems. Patients usually come in 1) thinking everything is fine (when it isn't quite) or 2) wait until they are having real problems and 3) with different habits/care instructions. Unless you can get complete records and lens designs from the previous doc and you think that it is completely straightforward, consider washing out and refitting them completely, or at least charging extra for the work needed.

Nathan Bonilla-Warford, OD, FAAO, FCOVD, FIAOMC Have A Practice Pearl You Would like to Share?

Send your pearls to megan@aaomc.org

Myopia management glasses are a relatively new treatment option, and they are not yet available in the United States. To date, only two studies focus on combination therapy of low-dose atropine and Defocus Incorporated Multiple Segments (DIMS) myopia management glasses10-11. Both studies were conducted over one year. One study involving Asian subjects reported that combination therapy was 31.7% more effective than DIMS monotherapy when comparing the mean axial length progression over the study period11, whereas the other study involving European subjects showed that combination therapy had no statistically significant benefits.

In conclusion, more studies are needed to better understand the effect of combination therapy, especially for the newer treatments. More data is also needed on the long-term and rebound effect of each combination therapy option.

When to initiate combination therapy?

Typically, an optical myopia management treatment is recommended rather than low-dose atropine monotherapy, as these treatments can provide both myopia management and myopia correction.Research shows that each optical myopia management treatment would yield about 50% reduction in axial length and refractive error progression10. It has also been shown that axial length and refractive error progression are age and ethnicity-dependent10. A simplified approach to track myopia progression involves using published data on the mean axial length and refractive error progression without myopia management, and an example is provided below13. If a child’s axial length and/or refractive error progression does not meet the 50% reduction goal based on age-ethnicity norms, the clinician may consider initiating combination therapy.

What concentration of low-dose atropine should be prescribed?

The LAMP study recommended using 0.01%, 0.025% and 0.05% low-dose atropine for myopia management, as they slowed axial length and refractive error progression in a dosagedependent manner with minimal side effects14.

Once the decision of combination therapy has been made, we recommend starting with the

middle concentration (0.025%) and re-evaluating the patient for side effects of light sensitivity and near blur in one month. If the child experiences significant side effects at the next follow-up, the concentration can be decreased to 0.01%. If the child still shows fast progression in axial length and/or refractive error six months or one year after initiating combination therapy, the concentration can be increased to 0.05%.When managing myopia, every diopter and every millimeter matter.

Although more studies are needed to support the efficacy of combination therapy, practitioners should consider combination therapy when monotherapy fails to adequately control myopia.

References 1. Zhao Q, Hao Q. Clinical efficacy of 0.01% atropine in retarding the progression of myopia in children. International Ophthalmology.

2020;41(3):1011–7. doi:10.1007/s10792-020-01658-0.

2. Kinoshita N, Konno Y, Hamada N, et al. Efficacy of combined orthokeratology and 0.01% atropine solution for slowing axial elongation in children with myopia: a 2-year randomised trial. Sci Rep. 2020;10(1):12750. doi:10.1038/s41598-020-69710-8.

3. Hao Q, Zhao Q. Changes in subfoveal choroidal thickness in myopic children with 0.01% atropine, orthokeratology, or their combination. Int Ophthalmol. 2021;41(9):29632971. doi:10.1007/s10792-021-01855-5.

4. Xu S, Li Z, Zhao W, et al. Effect of atropine, orthokeratology and combined treatments for myopia control: a 2-year stratified randomised clinical trial. Br J Ophthalmol.

2022;bjophthalmol-2022-321272. doi:10.1136/bjo-2022-321272.

5. Yu S, Du L, Ji N, et al. Combination of orthokeratology lens with 0.01% atropine in slowing axial elongation in children with myopia: a randomized double-blinded clinical trial. BMC Ophthalmol. 2022;22(1):438. doi:10.1186/s12886-022-02635-0.

6. Chen Z, Zhou J, Xue F, Qu X, Zhou X. Two-year add-on effect of using low concentration atropine in poor responders of orthokeratology in myopic children. Br J Ophthalmol.

2022;106(8):1069-1072. doi:10.1136/bjophthalmol-2020-317980.

7. Tan Q, Ng AL, Cheng GP, Woo VC, Cho P. Combined 0.01% atropine with orthokeratology in childhood myopia control (AOK) study: a 2-year randomized clinical trial. Cont Lens Anterior Eye. 2023;46(1):101723. doi:10.1016/j.clae.2022.101723.

8. Jones JH, Mutti DO, Jones-Jordan LA, Walline JJ. Effect of combining 0.01% atropine with soft multifocal contact lenses on myopia progression in children. Optom Vis Sci. 2022;99(5):434-442. doi:10.1097/OPX.0000000000001884.

9. Erdinest N, London N, Lavy I, et al. Low-concentration atropine monotherapy vs. combined with MiSight 1 day contact lenses for myopia management.

Vision (Basel). 2022;6(4):73. doi:10.3390/vision6040073.

10. Nucci P, Lembo A, Schiavetti I, Shah R, Edgar DF, Evans BJW. A comparison of myopia control in European children and adolescents with defocus incorporated multiple segments (DIMS) spectacles, atropine, and combined DIMS/atropine. PLoS One. 2023;18(2):e0281816. doi:10.1371/journal.pone.0281816.

11. Huang Z, Chen XF, He T, Tang Y, Du CX. Synergistic effects of defocus-incorporated multiple segments and atropine in slowing the progression of myopia. Sci Rep. 2022;12(1):22311. doi:10.1038/s41598-022-25599-z.

12. Walline J. Myopia Control: A Review. Eye & Contact Lens. 2016; 42(1):3-8.

Doi:10.1097/ICL.0000000000000207. 13. Nixon A, Noel B. Managing myopia: A clinical response to the growing epidemic [Internet]. 2021 [cited 2023 Sept 23]. Available from: https://www.jnjvisionpro.com/education-center/resourcelibrary/managing-myopia-clinical-response-growing-epidemic.

14.

Yam JC, Jiang Y, Tang SM, Law AKP, Chan JJ, Wong E, Ko ST, Young AL, Tham CC, Chen LJ, Pang CP. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, PlaceboControlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology. 2019 Jan;126(1):113-124. doi: 10.1016/j.ophtha.2018.05.029. Epub 2018 Jul 6. PMID: 30514630.

Paraoptometric Tea Talking to Kids about their Myopia: Engaging Both Children and Parents for Effective Myopia Management Myopia is a widespread vision challenge that affects children on a global scale. As a respected member of your optometry team, the effective management of myopia in young patients demands not only clinical expertise but also the art of communication. Engaging both the child and their parents in conversations about myopia presents an exciting opportunity to boost compliance, ignite motivation, and empower them to play an active role in safeguarding their visual health.

Nicole Heal, CMN

To effectively engage with young patients simply begin by adjusting your physical posture to meet the child at eye level. This simple act, combined with addressing them by their name, instantly forges trust and rapport, setting the stage for a productive dialogue.

Now, let's talk about language. The key to explaining myopia to children is simplifying technical terms and concepts. Using relatable metaphors, we are able to effectively communicate with our paediatric patients. We talk about myopia as a camera requiring focus assistance or employing imaginative analogies, such as "eye superheroes" relying on specialized lenses to perceive the world clearly.

"The key to explaining myopia to children is simplifying technical terms and concepts."

Children are visual learners, so let's captivate their imagination. Models of the eye, colourful cartoon-like diagrams, and animations can bring the complexities of myopia to a level that is easily understood by children. Show them how eyeglasses or contact lenses step in as trusted allies, countering the effects of myopia. While parents undoubtedly play a pivotal role in decision-making, remember that the young patients are heroes in their own right. Engage them directly, inquire about their experiences with corrective lenses, and seek their thoughts on improving their vision. This participation instills a sense of ownership and bolsters their commitment to the prescribed treatment plan.

Open lines of communication will welcome questions and concerns from both parents and children.

Occasionally a child may be apprehensive or confused about their myopia treatment options - this is easily addressed by carefully listening to their concerns and providing the information they need.

Similarly, parents may seek reassurance regarding the safety and efficacy of the myopia management modalities, providing the answers in a concise accurate manner is the most effective approach in these situations.

One of the most effective “tools” we use to strengthen compliance is the myopia program contract.

Picture it as a mutual commitment where both parent and child actively engage and take responsibility for their myopia management journey. Having both child and parents sign the contract will provide a sense of dedication and accountability with the program.

Successful myopia management is the cumulation of clear communication, concise conversation and colourful cinematics. You need to impress upon the families that myopia management is a team effort where everyone has a role to ensure success. By fostering a sense of responsibility and emphasizing the long-term health benefits, we are able to help our young patients preserve their vision.

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Closing Remarks The History of AAOMC The American Academy of Orthokeratology and Myopia Control exists to provide an open forum that allows our members to learn and interact with other members and find a safe environment absent of the interests or Paul Levine, O.D., FAAO, agendas of any one person, IACMM, FIAOMC group, or company. Our roots go back to the very beginnings of Orthokeratology and as such our board and membership represent not only the pioneers of Ortho-K but also those dedicated to pushing this field to new heights. The AAOMC, through our workshops, courses and accreditation programs, allows our members to grow in competence and demonstrate this ability to their peers and the public. Through our innovations, the AAOMC advances the science and practice of Orthokeratology and myopia management.

The AAOMC as it is known today was founded as the Orthokeratology Academy of America in 2002

by Dr. Cary Herzberg along with his inaugural board consisting of Drs. David Davidson, John Rinehart, Jim Day, Stuart Grant, Joe Collins and Norman Leach. Through incredible personal sacrifices of time and expense, this group forged on to create the first educational academy dedicated to the art and science of Orthokeratology.

Our first stand-alone conference, Reshaping the World took place at the University of Houston in 2004. In 2007 we went back to Houston for our second conference led by Drs. Sami El Hage and Norman Leach. We continued annual meetings and in 2009 Vision by Design was born, a name given by Dr. John Abdella. Our annual meetings continued

CORRECTED VIEW E-TEA an AAOMC Publication

Our annual meetings continued up to 2019 as attendance grew each year. VBD became one of the most influential specialty meetings in the world and some of our international partners even used our model and name for their annual meetings.

Without former executive director Matthew Herzberg, our board of directors and the most loyal membership in eyecare, none of this would have been possible. The run was ended as we saw the global pandemic attack our lives in ways we never saw coming. However, we persevered as we always do and resumed VBD in 2022 and will continue to do so each and every year!

The Academy at its conception represented eye care professionals in the US and Canada. In 2010, Dr. Herzberg saw the wisdom of embracing myopia control and proposed a new name, the American Academy of Orthokeratology and Myopia Control.

As the Academy became more visible, it was clear that there were other enclaves of like-minded individuals worldwide. In 2011 Dr. Cary Herzberg (AAOMC), Dr. Marino Formenti (EurOK) and Professor Pieying Xie (IAOA) founded the IAOMC (International Academy of Orthokeratology and Myopia Control). We are now one of six sections covering the world, including Europe, China, Australia, New Zealand, Latin America, India, Pakistan and south east Asia. Today the international eye care community and public are reaping the benefits of our open forum and educational opportunities advocated by our founders.

Spread the Love Know a Doctor or Paraoptometric that you think would enjoy the camaraderie and benefits of The AAOMC? Invite Them to Join!

Issue No. 1 | 2024 Edition

American Academy of Orthokeratology & Myopia Control Page 25