AAOMC Newsletter Issue 1 May 2023

ItiswithgreatpleasurethatIwelcomeyoutotheinaugural editionofTheCorrectedViewe-TeaAnAAOMCPublication Thise-publicationisdesignedwithyouinmind.Wewillbe deliveringstoriesofinterestandinspiration,clinicallyrelevant articles,AAOMCnewsandupdatesandmuchmore We welcomeyourfeedbackasweperfecttheprocesstodeliver thecontentthatyoufindmostintriguingandhelpful

Furthermore,Iwouldliketoinviteyoutoutilizethis e-publicationasameanstoengageyourstaffandpatients I thinkyouwillfindvalueindiscussingspecificcontentatstaff meetings,usingitasalearningtoolwithyourhighlytrained paraoptometrics,andevenlinking someofthecontenttoyoursocial

Thesky'sthelimit.TheAAOMCisgrowingandwewantyouto growwithus Comealongonthisjourneyandenjoytheride

CherylChapman OD,FAAO,IACMM,FIAOMC, DiplomateABO

President,AmericanAcademy ofOrthokeratologyandMyopiaControl

VisionbyDesign2023

WhenTheAAOMCwasborn23yearsago,itwasapipedream,cobbled togetherwithasingulargoal:todeliverunparallelededucationtodoctors thatwantedtolearnorthokeratologyandtodosoinanunbiasedforumthat promotedsharingofideasandcollaboration.Overtheyears,thispipedream morphedintorealitythankstohardworkandunbridledcourageand determinationofourfounderswhofacedmanynaysayersandmuch skepticism.TheVisionByDesignconferencehasgrownwiththetimes,always includingnewresearchandadaptingtoencompassthevariousmyopia managementtherapiesbeyondorthokeratology

If only ARBO knew the amount of learning that happens during the coffee breaks, they would surely start giving us CE for it!

Throughalloftheadaptationsand growthVBDhasalwaysmanagedto maintainitsuniquelyspecialvibe Thepassion andenergyispalpable.IfonlyARBOknewthe amountoflearningthathappensduringthe coffeebreaks,theywouldsurelystartgivingusCEforit!Oneofthemostuniqueandpopular

offeringsisthe2dayBootCampthatprecedesthemainconferenceeveryyear Itisdeliveredinawell-paced,non-intimidatingenvironmenttocatapultdoctorsintohoningtheirorthokeratologyskillsandcomfort levels Many-a-doctorwilltellyouthatVisionByDesignwastheirspringboardintomyopiamanagement Anticipationishighforthe pinnaclemyopiamanagementmeetingthisSeptember6-9thattheRenaissanceSchaumburgConventionCenternearChicago, Illinois.Wecannotwaittoseeyouthere!

Education

TheCorrectedViewPodcast

TheCorrectedViewistheofficialpodcastoftheAAOMCwithourhostsDr AnithPillaiandDr DwightBarnes Jointhemastheyhearfromgueststhatarepassionateaboutmyopia control/ managementandorthokeratology ViewournewestTheCorrectedViewpodcastepisode withguestDr DavidKadinghere

InternationalAcademyofOrthokeratologyand MyopiaControlAccreditation

FIAOMC|IACMM|CMN

TheIAOMCoffersseveralopportunitiesforaccreditation Eachrequiresseriouspreparation,a masteryofthesubjectandtestingconductedbyapanelofaccreditedpeers.

InternationalAcademyCertificationinMyopiaManagementIACMM

TheIACMMwasestablishedtodemonstratetoyourpatients,thepublicandyourcolleagues,that youhaveundergonepeer-reviewedtestingandcertifiedyouradvancedcompetenceinthefield ofmyopiamanagement

BenefitsofCertification?

Providesvalidationofcompetencytoyourpatients,thepublicandyourcolleagues SpecialdesignationinAAOMCPatientSearchtool

UseofdesignationIACMM

Prominentcertificateupdatedannually SomedoctorswishtoattaintheFIAOMCbutarenotableduetolackoftime,noaccessto patientsorinsufficientexperience.Thisisamoreattainablealternative.

Guaranteedtoincreaseyourknowledgeofmyopiamanagementtechniques PrioritygivenwhenapplyingfortheFIAOMC

WhoisEligible?

Eyecareprofessionalspracticingmyopia management NonOD/MDarewelcome toapply

CertificationProcess: Preparationoptions:

Requirements:

MembershipintheAAOMCingood standing

Testing:

Writtentest:Passcertificationtestwith 85%orhigher

OralExam:submitonecasereport andsitforapeer-ledoralexam

FellowoftheInternationalAcademyof OrthokeratologyandMyopiaControlFIAOMC

Include photographers nameinthecaption

TheFIAOMCisthehighestlevelofaccreditationwithintheAcademy.FIAOMCshavebeenpeer-evaluatedandhavedemonstrated theirskillsnotonlyinmyopiamanagementbutalsoinadvancedcomplexorthoKdesigns

Whyshouldyouconsidertakingthisjourney?

Itwillprovideyouwithmanypersonalandprofessional benefits

Practicebuilder:youareviewedasanauthoritybyyour patientsandcolleagues.

Whenitcomestoatransferofcaretoanothercity, memberswilloftenchooseanFIAOMCoverother members.

Attainingthefellowshipisveryusefulwhencreating contentforyourwebsite,newsletterorpressrelease HelpfulwhenapproachingTVstationsasyouarea certifiedauthority

Youwillreceiveacertificatetodisplayyourstatusinyour officeandwebsite.

Youwillbe“tagged”onthedoctorfinderasanFIAOMC Personalgrowthisajoyinitself

Whatmustyoupossesstobeginthejourney?

Prerequisites….

PossesstheIACMM

MustfittwodifferentorthoKmanufacturersorusea customdesign

Beamasterinpreandposttopographyanalysis

MustbeabletodesignanorthoKmoldforhighly advancedcases

Mustpossess“guru”levelskillswhentroubleshooting Ownatopographer

Havefitaminimumof50orthoKcases

AttendedMyopiaManagementbootcamp(orhavefit100 orthoKcases)

HavebeenamemberoftheAcademyfor2years

HaveattendedatleastoneAcademymeetingwithinthe last3years

Whatarethesteps?

Completetheprerequisites

Submitapplicationandincludeanabstractof1 advancedcase

Passthewrittentestwith85%

Submit3casereports

Sitfortheoralexam

AAOMC’sCertifiedMyopiaNavigatorCMN

Myopiamanagementisarapidlyevolvingarea,andAAOMCiscommittedtoensuringthatoptometriststhatoffermyopia managementprogramshavethehighestlevelofeducation.ThisimplementationneedsmorethanaClinician;youneedtoinvolve yourteaminthisjourneytobesuccessful Yourteammembersshouldlearnaboutmyopiamanagementtoproperlyeducate parentsabouttheimportanceofpreventingeyedisordersandthetreatmentoptions availablefortheirchildren Theyshouldbeabletorespondtofrequentlyaskedquestions andengagewithparentstolaythefoundationforthevariousclinicaltreatments.Itis essentialtoalertparentstoanypossiblerisksassociatedwitheyedropsorsymptoms broughtonbycontactlensusagethatnecessitateanimmediateappointment Thiscollaborationnecessitatesthateveryoneinthepracticespeaksthesame clinicallanguage

Your team membersshould learn about myopia management, to properly educate parents about the importance of preventing eye disorders and the treatment options available fortheir children

CertifiedMyopianavigator(CMN)isaone-of-a-kindcertificationdesignedspecifically fortechnicianswhohavedemonstratedthehighestlevelofknowledgeandclinicalabilities inthefieldofmyopiamanagement AAOMCoffersastafftrainingprogramandmembership forthoseadvancedteammembersthatplayacrucialroleinthisprocess Thisaccoladeincreasesrespectfrompatients, coworkers,andemployers.ToobtaintheCMNcertification,ECPsmustattendstaffbootcampinpersonorelectronically,passthe certificationtest,andbeingoodstandingwiththeirAAOMCmemberships

Hereare7reasonstohaveaCMNinyourpractice.

2 Certificationvalidatesknowledgeandcapabilities

Certificationconfirmsthatastaffmemberhasthemyopiamanagement knowledgeandskillsrequiredtoexecutethejob.

1. Offeroutstandingmyopiamanagementtreatmenttothepatientaswellas administrativeandclinicalassistancetotheoptometrist TheseSpecialSkillsenable evenentry-leveloptometrictechnicianstomakeasignificantcontributionto excellentpatientcare.

3 Certificationindicatesthoroughtraining

Certificationcanserveasevidenceofhigh-qualitytraining Applicantsfor theCMNmusthavecompletedBootCampandpassedthecertificationtest. Theprocessofaccreditationhasanimpactontrainingandeducation standards YourtrainingwillbeofthegreatestcaliberifyoupursueCMN

4 CMNreceivesgreatercompensation

CompensationisincreasedforCMNswithgreaterexpertiseinmanagingmyopia

5. Certificationvalidatesclinicaljudgment.

Asaproductiveteammember,yourclinicaljudgmentimproveswithexperience, whichallowsyoutobuildbestpracticeproceduresandapproachesforyourclinic

6 AccesstoAAOMCresources

ViaAAOMC,youwillhaveaccesstoup-to-dateinformationforthisfield'srapidly evolvingresearch

7 Gainmorerespect

Yourqualificationmakesyouaccountableforhigherstandards,earningyouthe respectofpatients,colleagues,andcoworkers.

Whoiseligible?

Anyparaprofessionalinvolvedinmyopiamanagement

Requirements: StaffMembershipintheAAOMCingoodstanding MusthaveattendedStaffBootCamp(in-personorvirtual)

Purchasethenewcomprehensivemyopiamanagementbook,ManagingMyopia:OneChildataTime (LangisMichaud,RemyMarcotte-Collard,PatrickSimard https://managing-myopia.com

Haveyoueverconsideredthevalueitwouldbringourprofessionto haveinsightintohowpatientsfeelaboutmyopiamanagement?Not justthequestionsthattheybringtoyouandyourstaff,butthe concernstheyvoicetoeachotherwhentheystandonthesidelines ofasoccergame Ohtobeaflyonthewall!

Gaininsightintopatientopinionsinanovelnewway.Joinour patient-doctor-industrycommunityintheFacebookGroup:Myopia ManagementforEveryone

ScantheQRCodebelowtogetstarted Shareitwithyourpatients viayoursocialsandemail

Doyouhaveanadvertisementyouwantfeaturedinthe AAOMCNewsletter?

ContactMeganatmegan@aminc.orgtodiscussdetails!

CaseReport"Anna"

PaulLevine,OD,FIAOMC,IACMM,FAAO

IfirstmetAnnainSeptember,2019

Shewasreferredtomeforan OrthoKevaluationbyalocalOD andpresentedwithhermother,a 5’11”Caucasianwoman,andAnna herselfwasalready5’5”at12years old Shealsohadarefractionof -700ineacheye!ThoughAnna wasasmallerdoppelgängerofher Mom,therewasnosignificant familyhistoryofhighmyopia

ThereferringdoctorsawanincreaseinAnna’smyopiafrom -5.75to-7.00intheprioryear.Shehadbeenfitintobifocal contactlenses,butwasunabletotoleratedistanceblurso wasrefittoBiofinityEnergys Isuspectthebifocallenswas BiofinityMultifocal,buttheinfowasnotsharedwithme.She alsohadblueblocking“anti-fatigue”glasses(brand unknown)tousewhennotwearingcontactlenses

Ifoundthefollowingduringmyexamination: MR:OD-700-075x180=20/20;OS-700-050x155=20/20-1 CR(1%tropicamide):OD-7.00-0.50x180;OS-6.75-0.25x165

NRA/PRA:+3.50/-2.50

CT:OrthoD/N;NPCTTN

Pupils:4mm-6mm

Axiallength:OD27.35mm;OS27.44mm!!

Here’swherethecasegetsreallyinteresting

Symmetrical,toriccorneas.

Sphericaltreatmentbasecurveswerechosenastheamount ofrefractiveandcornealcylinderswereequivalent Duetothe presumedpseudomyopiaofapproximately1Dandflat corneas,Itargetedapowerof-6.50OUacceptingthefact thatwemaynotachievefullcorrection Lensdiametersused were117mm(HVID123x95%)

Lensdesigns:

Liftedalignmentcurvesinflatmeridianduetohighevaluesto avoidtoosteep/tightalignment.

Caseanalysis:

Pros:normalcornea,similarrefractiveandcornealcylinder, highevalues(H>V),motivated

Cons:highmyopiaprogressingatarapidrate,flatcorneas, NRA/PRAindicated1Dovercorrection(perhapscyclopentolate mayhavejustifiedthisfinding,butonlytropicamidewasused for“damp”refraction),largeHVID123mm

Plan:

ProceedwithOrthoKfittingwiththewarningthatfullcorrection maynotbepossibleduetohighmyopiaandflatbaseline keratometry.Patientandparentwillingtousespectacle correctionforresidualmyopiaorsoftcontactlensesforsports

Lensdesign(Wave):

Whendesigninglenses,Ilookattheelevationmapstodecide thetypeofperipheralcurvesneeded(sphere,toric,quadrant specific) Inthiscase,toricalignmentcurveswerechosen

Day1:

OD-475-050x180;OS-350-075x155

Week1:

VAsc:OD20/60OS20/30-2;OD-150DS,OS-050DS

PaulLevine

OD,FIAOMC,IACMM,FAAO

VAsc:OD/OS20/20;ODPlanoDS,OS-025DS

Finalresult:

Mostrecentvisit10/8/2022:

VAscOD20/20-2OS20/25;ODPL-050x5,OSPL-050x165 ALOD2754mm(baseline2735mm,OS2758mm(baseline2744mm)

Patientnow17yearsoldand6’tall!

Todate,theonlytreatmentmodificationshavebeenduplicatereplacementofretainerlenseswithnoneedtorefit oradjusttargetpower

Finalthoughts:

ThispatienthadmanythingspotentiallyworkingagainsthercandidacyforOrthoK.Shehadhigh,rapidlyprogressingmyopia,wasin amajorgrowthspurt,hadveryflatcorneasandfailedwithsoftbifocalcontactlenses(thoughshemayhavebeenmoresuccessful withotherdesigns) Mostimportantly,shehadnormalshapedcorneas,minimalastigmatism,motivationandwaswillingtoaccept lessthanfulltreatment Fortunately,shewasabletoenjoyfullcorrectionandhashadacompletearrestinprogressivemyopia despitesignificantbodygrowth.Thiscasepresentationfurthervalidatestheedict“underpromiseandoverdeliver”.Adashofgood luckneverhurtseither

GraphshowingAnna’sALprogressionincomparisontonormalemmetropeandnon-MMmyopicprogression

MemberSpotlight

Dr NickDeespotidis,OD,FCOVD,FAAO,FIAOMC

Dr DespotidisisinprivatepracticeinHamilton,NewJersey Hetooksometimeoutofhisdaytogiveussomeinsightintohis journeyasoneoftheleadersinourprofession.

Howdidyougetintooptometry?

Iworkedthroughouthighschoolandcollegeatahardwarestore.Theowner’ssonwas anoptometrist,havingalwaysbeeninterestedinthehealthcarefield,thisintriguedme Oneday,thehardwarestorewassoldandIwasfired!Itooktheopportunitytogetajob atanopticalchainandtherestwashistory.

Howhasyourcareerjourneybeenovertheyears?Wasitsmoothsailingmainly?

AftercompletingaresidencyinVisionTherapyandPediatricVisionatSUNY,Ijoinedapracticeandwassubsequentlyfiredaftermy 4thweek!Thatmotivatedmetoopenmyownpractice In1998Iopenedourofficecoldwithmycurrentpartner,BarryTannen,who happenedtobemysupervisorduringmyresidency everythinghappensforareason

Pleasetellusaboutyourpractice?Whatmakesituniqueordifferent?

Weestablishedourpracticewithtraditionaloptometricserviceslikeeyeexams,eyeglassesandsoftcontactlenses andlotsof hardwork Aswegrew,wecametotherealizationthatinordertofulfillourpersonalgoalsinlife,family,autonomy,respectand appreciationwe’dhavetofocusonsubspecialtiesthatwereuniquetooptometry,likevisiontherapyandmyopiamanagement. After12yearsinpractice,wemadethedecisiontofocusonthesespecialtiesinlieuofgrowingourpracticebytraditionalmeans Lookingback,thatwasoneofthebestdecisionswemadealongourjourney

Whatarethemostrewardingaspectsofyourcareerandwhataresomeofthechallengesyoufaceinyourpractice?

ThemostrewardingaspectofmycareeristheappreciationIreceivefrompatientsandparentsalmostdaily We’vedesignedan officewherewesincerelyhelpeachfamilyuniquely,bymakingthetimetolisten….it’sthatsimpleandthatchallenging.Wemade thetimebyeliminatinginsurancesthatarebasedonvolumeinexchangeforservicesthatareworthyofdiscussionamongpatients andtheirfamilies

Thechallengehasbeenmaintainingourfaithinourdecisionsto eliminateourdependencyoninsuranceplansandtraditional commoditieslikeeyeglassesandsoftcontactlenses

Howdoyoumanagetobalanceyourcareerandyour personallife/family?

I’velearnedtruebalanceisamyth.Everytimeyousayyesto somethingorsomeone,you’resayingnotosomeoneelse So I’velearnedtotrulyembodywhatIvaluemostinlifeandmake mydecisionsaccordingly.It’saconstantandneverendingprocess, butmyinternalcompassalwayssteersmeinthedirectionthat fulfillsmyvaluesinlife

Doyouhaveanominationfora MemberSpotlightyouwould liketoseehighlighted?

Pleasesendyournomination(s)to megan@amincorg

Doyouhaveanadvertisementyouwantfeaturedinthe AAOMCNewsletter?

ContactMeganatmegan@amincorgtodiscussdetails!

Dr NickDeespotidis OD,FCOVD,FAAO,FIAOMC

ParaoptometricSpotlight

CrystalSwahn,CMN,CPO

CrystalSwahn,CMN,CPO,isthefirstParaoptometrictocompletetheCertifiedMyopia NavigatorDesignationsetforthbytheAAOMC SheworkscloselywithDr CherylChapman inGretna,Nebraska.SheisalsoworkingcloselywiththeAccreditationCommitteeto developnewStaffBootCampresourcesforfutureCertifiedMyopiaNavigators

Tellusalittlebitaboutyourroleinyourpractice?

IworkasaTechnicianSpecialist,meaningIworkverycloselywithallofthefollowingspecialty services:MyopiaManagement,SpecialityContacts,andDryEyeServices(IPL&Lipiflow) Mydayto daydutiesinclude,butarenotlimitedto,pre-testingpatients,takingcareofthescheduleflow, andpreparingthescheduleforthedoctor Orderingcontacts,patient,andstaffeducation

Howdidyougetinterestedinworkinginthefieldofoptometry?

Ihavealwaysbeeninterestedinhealthcare MygrandmotherwasanRN IthoughtIwantedtofollowinherfootsteps Thisfield honestlyjustfellintomylap Onedaywhileinmyyoung20’sIfoundmyselfworkingataneyeclinicinthemall Istartedoffworking ontheclinicsideforawhile Ithenmovedtosellingglassesandeventuallybecamethelabmanager Iknewthiswouldbethe careerforme.KnowingIwasabletohelppatientsseewassorewardingforme.

Arethereanychallengesthatyouhavehadtoovercomeinyourcareerjourney?

MybiggestchallengeIwouldsayismydyslexia.Inthebeginningitwasthehardesthurdletoovercome.Tryingtorememberthe words,howtospellthem,andontopofthattryingtofigureoutwhatthewordsmeant Iwouldspendhoursresearchingand studyingthewordsandmeanings AyearlaterIsatfor,andpassed,theCertifiedParaoptometric(CPO)exam Thatgavemethe confidencetotalktopatientsandstaff.NowIseedyslexiaasanunforeseenstrength.

Whatdoyoubelieveisthemostimportantthingyoudotosupportyourdoctorandyourpractice?

Istayuptodateonallthelateststudiesandcertifications.Iamabletoanswernearlyanyquestionpatientsorparentsmayask.I alsoworkhardtomaintaingreatcustomerserviceskills

Whatinspiresyouthemostinyourfieldofwork?

ALLaspectsofMyopiaManagementinspireme.Beingabletoseethechangewecanmakeinapatient'svisionistrulymagical.I enjoybeingabletopassmyknowledgeontopatients,parents,andstaff AndnowbeingabletohelpwithVBDandtheAAOMCis trulyadreamcometrue

WhatisonepieceofadvicethatyouwouldgivetoaparaoptometricthatisinterestedinworkingtowardsCertifiedMyopia NavigatorDesignation?

ToallthefutureCMN’soutthere,someadviceIwouldlovetogivetoyou:Ifyouarelookingforacareerchange,somethingtohave passionfor,lookatMyopiaManagement Itwilltakededication,alotofhardwork,loyalty,andgreatcommunication However,if youhavethedrivetobethebest,thenIwantyoutoremember;youareoneoftheMOSTimportantpartsofMyopiaManagement Yourpatientsanddoctorneedyou.Andmostimportantlytherewardisamazing.

Howdoyoumanagetobalanceyourcareerandyourpersonallife/family?

OnethingIliketodoisscheduletimeforeverythinginmycalendar.Ifeelthathelpsmebesttostayontask.

StudentMemberUpdates

Theyear2023bringsexcitingopportunitiesforoptometry studentsandresidents,andtheAmericanAcademyof OrthokeratologyandMyopiaControl(AAOMC)isheretohelp

AAOMCiscommittedtopromotingcollaborationandeducation inmyopiamanagementatalllevels,andstrivestobeavaluable educationalandpracticeresourceforoptometryschools, educators,andstudents

AAOMCputsontheVisionbyDesignconference,takingplace fromSeptember6–10th,2023inChicago,Illinois Thisconference willprovideaplatformforexpertsfromaroundtheworldtoshare theirknowledgeandexperiencesinmyopiamanagement, makingitanexcellentopportunityforoptometrystudentsand residentstolearnandgrow.AAOMCisalsoexcitedtoannounce the“Corks&Contacts”MixeratVisionbyDesign,wheremembers canconnectwithcolleaguesandlearnfromexpertsinarelaxed andenjoyableenvironment

Inaddition,AAOMCoffersaspecialdiscountedrateforstudent members,providingaccesstoanactiveinternationaldiscussion group,wherememberscanlearnfromexpertsaroundtheworld AAOMCalsooffersco-writingandspeakingopportunitiesfor residents,virtualorin-personmyopiaworkshops,andpractice managementlecturesforstudents

TocollaboratewithAAOMCortolearnmoreaboutthese opportunities,reachouttoMeganSchoenfelderat megan@aaomcorg

Don’tmissoutonthesevaluableopportunitiestoenhanceyour knowledgeandskillsinmyopiamanagement JoinAAOMCand registerforVisionbyDesigntoday!

CrystalSwahn CMN,CPO

RecentPublications

Therearehundredsofarticlespublishedeverymonthaboutmyopia. Hereareafewthatdeserveyourattention

1. Usageoflow-doseatropineonnonmyopicyoungkids.

Canalowdoseofatropinepreventtheonsetofmyopiainchildren?Itappearsthatitcan TheLAMP2studyshowedthatthe administrationofatropine0.05%couldbeeffectiveinapopulationof6-8yearoldswhoweremildlyhyperopic(-0.00to+1.00).Thus, only1/3ofthechildrenbecamemyopicafter2yearsoftreatment,comparedto1/2whenthe001%concentrationoraplacebowas used However,beforeprescribingAtropine005%becomesthenorm,otherstudiesneedtoconfirmtheseresults

REF:EffectofLow-ConcentrationAtropineEyedropsvsPlaceboonMyopiaIncidenceinChildren: TheLAMP2RandomizedClinicalTrial|Ophthalmology|JAMA|JAMANetwork

2 Isthereamagicalcookbookmethodtomanagemyopia?

Theauthorsofthisarticleproposea3-yearretrospectiveanalysisofatreatmentalgorithmdevelopedusingtheDelphimethod (expertconsensus) Thisalgorithmconsistsof3steps First,thestratificationofthechild,ie itsevaluationaccordingtoriskfactors forprogression(3ormore=highrisk),thentheprescriptionofatreatmentdeterminedbythephysicianinconsensuswiththe parents,andfinallyaphaseofevaluation/modificationofthetreatment,whichimpliesthatthestrategyismodifiedifthechild progressesmorethan025Dor01mmin6months Theauthorsconcludethattheirapproachiseffectivesince60%ofthechildren progressedonly03mmorlessin3years Thisunderscorestheimportanceofindividualizedtreatmentandregularfollow-up RetrospectiveAnalysisofaClinicalAlgorithmforManaging...:OptometryandVisionScience(lww.com)

3. Whatisinthekid’splatemayinfluencehisrefractiveerror.

Littleisknownabouttherelationshipbetweendietandthedevelopmentofmyopia,althoughsomearticlesinrecentyearshave suggestedthatadiethighincarbohydratesorahighbodymassindexcouldbeconsideredasmyopia-promotingfactors.

Now,wholegrainintakehasbeenstudiedinthissense ItwasconductedinChinawithchildrenaged6to12years,documenting theirintakeofwholewheat,vegetablesandfruits Theauthorsdemonstratedthatchildrenwithahighintake(>50%ofthedry weightofthefoodconsumed)ofwholewheat-basedfoods(cereals,rice,bread)progressedlessrapidlythanothers Nutritional aspectswillundoubtedlyhavetobepartofmyopiamanagementinthefuture. Associationbetweenwhole-grainintakeandmyopiainchinesechildren:across-sectionalepidemiologicalstudy|BMC Ophthalmology|FullText(biomedcentral.com)

4 Greenlighttoredlight?

Exposurefor3minutes,twiceaday,toredlightdeliveredbyalaserwith anirradianceof035±002mW/cm2,awavelengthof650nm±10nm,and anaverageilluminationofapproximately400luxhasbeenshowntobe effectiveinthepast,althoughsomeshortcomingshavebeenraised regardingthedesignofthestudiesinvolved

Thisstudywasconductedfor1yearinapopulationofyoungmyopes(10 yearsoldand-2.50Donaverage).Theresultsareastonishingandconfirm thatexposuretoredlight,asadministered,completelyslowsdown myopicprogressionandevenslightlyreversesit(-002mmofaxiallength and+0.25Dofrefractiveerror).Thedifferencewiththecontrolgroupis 050mmand112D Ofcourse,furtherlong-termstudiesareneededto confirmtheseresultsand,inparticular,todeterminewhetherretinal healthisnotaffectedbysuchexposureovertime.

Photobiomodulationtherapyretardedaxiallengthgrowthinchildren withmyopia:evidencefroma12-monthrandomizedcontrolledtrial evidence|ScientificReports(nature.com)

AdvertiseHere!

Doyouhaveanadvertisementyouwantfeaturedinthe AAOMCNewsletter?

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TheWorldSocietyofPediatricOphthalmology& StrabismusMyopiaConsensusStatement2023

Myopia(commonlytermednearsightednessorshortsightedness)has increasedinprevalencearoundtheworld Inadditiontogenetic factors,therenowexistsevidenceofnumerousenvironmentalfactors thatcontributetomyopiadevelopment Itiswell-knownthatthe commonformsofchildhoodmyopiaareduetoaxialelongation(ie,a longereyeball).Asaresultofrenewedresearchactivityonmyopia,itis clearthatsomeformsofearlyinterventionslowtheaxialelongation processandthusthepotentialamountofmyopia Inasmall percentageofmyopes,theelongationprocessbecomes“pathologic”

andisassociatedwithanincreasedriskofcataract,glaucoma,retinaldetachment,strabismus(heavyeyesyndrome)andmyopic maculopathy1 Additionally,functionaldeficitswhenmyopiaisuncorrectedalongwithimpactedcareerchoicescanoccur Itisnot clearatthistimeifthenewinterventionscanpreventorreducethesecomplications,although,therearesoundhypotheticalreasons tobelievetheydo.InthisConsensusStatementalltheinterventionswehavedescribedarebasedonstudiesthathaveshown statisticalandclinicalsignificance

TeaTimewiththeResidents

Ortho-KfortheWholeFamily EmilyGottschalk,OD MichiganCollegeofOptometryCorneaandContactLensResident

EmilyGottschalk

OD

Orthokeratologyprovidesspectacleandcontactlensfreedaytimecorrectionwiththeaddedbenefitof myopiamanagementforthedevelopingeye Duringmyresidency,IhavefitpatientsofallageswithOrtho-K lenses Often,theinitialconversationaboutorthokeratologyisasamyopiacontroloptionforapediatric patient,promptingparents,impressedwiththetechnology,toaskiftheytooarecandidates As orthokeratologycontinuestobeused,patientswillbecomepresbyopicandrequirenearcorrection.Rather thanhavingtowearreadersovertheirOrtho-Ktreatment,Ortho-Kmaybeabletoofferthecontinued benefitsofcleardaytimeunaidedvisionformyopicpresbyopes

Contactlensoptionsforpresbyopicpatientsinterestedinnon-surgicalspectaclefreecorrectionincludemonovisionorsimultaneous multifocalopticsinsoftandgaspermeablecontactlenses,translatingcornealGPs,andcombinedsimultaneousandtranslating cornealGPs.Orthokeratologyhasthepotentialtofilltheneedforpatientsinsearchoffreedomfromdaytimecontactlensweardue tosoftcontactlensintoleranceorcornealGPlensawareness AlsoincludedareexistingOrtho-Kwearerswhohavenearcomplaints asemergingpresbyopes

Monovisioncanbeachievedwithorthokeratologywhenthepatientismyopicenoughtoundercorrectthenon-dominanteyeto providetheappropriatenearpower Limitationsofmonovisioncorrectioninanymodalityincludecompromisedbinocularity,limited intermediatevision,anddecreasedsuccesswithincreasingaddpower.

SimultaneousmultifocalopticsinsoftandGPcontactlensesareachievedthroughconcentriccircularzonesofpowerorasphericity thatprovidesagradientpowerchangefromthecenteroracombinationofbothcontainingeitheracenterdistanceorcenternear refractivepower1Orthokeratologyinducescentralcornealflatteningwithamidperipheralringofsteepeningtoachievefocusatthe foveaandmyopicdefocusoftheperipheralretinatodecreasetherateofaxialelongation2Centerdistancemultifocalsoftcontact lensesarealsousedformyopiacontrolastheyinduceopticaleffectssimilartothoseinducedbyorthokeratology.3

Theconcentriccornealreshapingoforthokeratologymaybeconsideredformyopicpresbyopiccorrectionbyprovidingcenter distancemultifocalopticstothecornealsurfacethroughvaryingopticzonediameters Smallopticzonesizesareusedformyopia controlforgreateraxiallengthretardation.4Foradultpatientswhowillnolongerbenefitfromthemyopiacontroleffectsof orthokeratology,thelargestavailablebackopticzonediameter,usually60mm,istypicallyselected Thisprovidesalargetreatment zonetoavoidvisualdistortionsincludingglareandhalos Decreasingtheopticzonesizeallowsgreatermyopicdefocusornear opticswithinthepupil.Differingopticzonesizescanbeusedforamodifiedmonovisionwithlargeropticzonesizeinthedominant eyeforpredominantlydistancecorrectionandsmalleropticzonesizeinthenon-dominanteyeforenhancednearcorrection Patient complaintscanbeaddressedbyalteringopticzonesizeincludingdecreasingtheopticzonefornearblurandincreasingtheoptic zoneforbetterdistancevision.Furtherresearchcandeterminepatientoutcomesandtheeffectofpupilsizeandaddpoweronoptic zonediameterselection Developmentofastepwiseapproachforfittingorthokeratologyformyopicpresbyopeswillallowclinicians tofitthewholefamilyinOrtho-K

Announcements

Withchangeandgrowthcomeshardwork Withallof theexcitingnewthingshappeningatAAOMC,it becameclearthatwewouldbenefitbyaskingforhelp fromourgreatestasset:ourmembers Fourteen doctorshavesteppeduptotheplatetovolunteertheir time,passionandexpertise.OurAdvisoryBoard encompassesawiderangeofperspectives, geographyandpracticemode

Notonlydotheyhelpgiveinputandideas,theyare alsoactivelyinvolvedinourcommitteesproviding extrasupporttoourBoardofDirectors.Theyhave beencontributingwithcontentcreation,ournew studentoutreachprogram,andvendorrelations,to nameafew

PracticePearls

Understandthelimitationsofeachlensdesignyouuse,noonelensisperfect. Lensselectionneedstobepickedwithforeseenchallengesaheadtoallow easiertroubleshootingifneeded -Dr JonathanSkoner

Thankyourstaff Everyday Wethankourpatientsastheyleavetheoffice everytime,butdowethankourstaff?-Dr PaulLevine

Ifsomeonecomesinhungryandtiredtheygetcrankyveryquickly.Wehave snacksandsoftdrinksforbothparentsandchildrenintheoffice Childrenlove it,andparentsreallyappreciateit -Dr GlendaMoheeputh

Haveapracticepearlyouwouldliketoshare? Sendyourpearlstomegan@aaomcorg

OrthoKFollow-UpBestPractices:

FromtheEyesoftheSupportStaff

SubmittedbyCrystalSwahn,CMN,CPO

WhatdoIdoatanOrthoKfollowup?Theinterviewisasimportant(ifnotmoreimportantthan)any ancillarytestingdoneatfollowupvisits.Havinganaccurateaccountofwhatthepatientiswearing andwhattheirhabitsarecanhelpavoidmistakesinreorderingandcanaidintroubleshooting

Iliketostartwithgatheringaminimumofinformation;andusethefollowingpneumonictoremember somepertinentquestions:‘ABCCOIL’

AGEofthecurrentOrthoKmolds(whentheystartedwearingthem,notwhentheywereordered)

BRANDofOrthoKmoldsthepatienthasbeenwearingineacheye

COLORSofcurrentOrthoKmolds

CONCERNS(ifany)regardingvisionorcomfort

IN:WhattimedidtheyputtheirOrthoKmoldsINthepreviousnight

OUT:WhattimedidtheytaketheirOrthoKmoldsOUTinthemorning

LENSsolutionsanddropstheyusefordisinfectingandforinsertion

Thenexttimeyouseeoneof thesemembers,pleasetell them‘thankyou’!

CrystalSwahn CMN,CPO

Importantdiscoveriesareoftenunveiledduringtheinterviewthatchangeyourdoctor’sapproachtotheexam.Forexample,ifyou havedeterminedthatthepatienthasmixedtheirmoldsupandhasbeenwearingtheminthewrongeyes,itmaysaveyourdoctor fromchasingtheirtailwithtryingtotroubleshootandordernewlenseswhensimplyswitchingthembacktothecorrecteyewillget thepatientbackontrack.AnexampleofhowIwillsuccinctlydocument‘ABCCOIL’inthepatientchartcanbeseenbelow:

OU:08/16/2022-NightLens

Color:redandyellow

Novisionorcomfortconcerns

Ptputmoldsinat10:30pm

Pttookmoldsoutat8:30am

Aquaclearandrefresh

Inadditiontotheinterview,asthetechnician,Iperformvisualacuity, axiallength,autorefraction,pentacamandmedmont Ihavealso beentrainedtoinsertthemoldswithsodiumfluorescein(NaFl)dye

andperformanteriorsegmentphotographyandvideographytocapturearecordofthefitoftheOrthoKmolds.Patientswilloften bescheduledfora‘techonly’visitattheir3and9monthfollowupvisits MydoctorwillreviewtheresultsandIwilldiscussthemwith thepatients/parentsviaourtextingapporaphonecall Thepatientwillseethedoctoratthe6and12monthvisits This‘leapfrog approach’reducestheamountoftotaldoctorchairtimeneededperpatientwhilestillgivingusthefrequentdatachecksthatwe believeallowsustomanagemyopiasuccessfully.

ClosingRemarks

Ubuntu-TheSenseofCommunity

byDr LangisMichaud

byDr LangisMichaud

Familyandfriendsoftentendto cometogethertocelebrate joyfulmoments,butalsoto comforteachotherwhenlife bringsunfortunatesurprisesor tragedy,aswehaveseen recently Thistypeofbehavioris normalbecauseitappealsto thedeephumanneedto regroup Ubuntu-theoldAfrican

concept-meaninghumanitytowardsothers Forthousands ofyears,thishasbeenthemosteffectivewaywehavefound, asaspecies,tosurviveandthrive Fromsmallcommunities, totowns,tovillages,thebondswerewovenbetweenthose whoagreedtoshareacommonspaceandthesamereality, givingrisetomutualaidandthesharingofknowledge Nowadays,thisrealitycontinuestonourishthelifeofour neighborhoods,ourstreets,andencouragesustohelpeach other Whataboutattheprofessionallevel?

Thegroupingofmembersofthesamecommunityofpractice hasproventimeandtimeagainthatitisessentialtothe developmentofeachofitsmembers,throughthesolidarityof thegroupandthesharingofknowledgethatitgenerates.As eyecareprofessionals,weareproudtobemembersofour

SpreadtheLove

CollegesandProfessionalAssociationsatthestateand nationallevels.Manyadvancesinourfieldsofpracticewould nothavebeenpossiblewithouttheconcertedactionofits members Speakingwithonevoice,establishingstandardsof practiceandcommonethicalguidelinesareguaranteesof theindividualandcollectivedevelopmentofprofessionals

TheAmericanAcademyofOptometryandMyopiaControl (AAOMC)isonesuchgroupthatbringstogetheracommunity ofpractitioners,whosegoalsarethedevelopmentand sharingofthesciencesurroundingorthokeratologyand myopiamanagement Thisscienceisevolvingrapidlyandas agroup,theAAOMChasbecomeareferenceinthefield Itis thereforeimperativethateveryeyecareprofessional interestedintheseaspectsofpracticejointhegroupand becomeamemberoftheorganization Adheringtothe Ubuntuphilosophy-

Membershipmeansbecominginformed,participating, exchangingideasandattendingAAOMCevents The exchangesandlinksthatareestablishedinthisway,between professionalsfromallbackgroundsandcountries,enrichour clinicalactivityandcontributetothedevelopmentofaunique clinicalknowledge BecomingamemberoftheAAOMCandparticipatinginits activitiesshouldbepartofyourprioritylist.Itwillbeoneofthe easiesttoachieve!

KnowaDoctororParaoptometricthatyouthinkwouldenjoythecamaraderieandbenefitsofTheAAOMC?

Invitethemtojoinusingthislink:https://aaomc.site-ym.com/page/become-a-member

"I am because we are "