With the rise of myopia worldwide in recent years, there is no shortage of patients who need to be treated. Myopia prevalence estimates using the 2020 U.S. Census show that the country requires 39,025,416 eye exams for every child with myopia each year, with two exams per year. one
Of the approximately 70,000 optometrists and ophthalmologists nationwide, each eye care specialist (ECP) must attend to 278 children every six months to meet current eye care requirements for children with myopia in the United States. 1 That’s an average of over 1 childhood myopia diagnosed and managed per day. How is your practice different?
As an ECP, our goal is to reduce the burden of progressive myopia and help prevent long-term visual impairment in all patients with myopia. But what do our patients think of their own corrections and results?
When it comes to orthokeratology (Ortho-k), patient feedback on their vision-related quality of life is loud.
A study by Lipson et al., using the National Institute of Eye Diseases with Refractive Error Quality of Life Questionnaire, compared adults wearing single vision soft contact lenses with adults wearing orthokeratology lenses. They concluded that overall satisfaction and vision were comparable, however approximately 68% of participants preferred Ortho-k and chose to continue using it at the end of the study. 2 Subjects reported a preference for daytime uncorrected vision.
While adults may prefer Ortho-k, what about nearsightedness in children? Zhao et al. evaluated children before and after 3 months of orthodontic wear.
Children using Ortho-k showed higher quality of life and benefits in their daily activities, were more likely to try new things, were more self-confident, more active, and more likely to play sports, which ultimately resulted in more overall time spent on treatment. on the street. 3
It is possible that a holistic approach to the treatment of myopia could help to continue to engage patients and adequately help manage long-term adherence to the treatment regimen required for the treatment of myopia.
Ortho-k has made significant advances in lens and material design since the first FDA approval of ortho-k contact lenses in 2002. Two topics stand out in clinical practice today: Ortho-k lenses with a meridional depth difference and the ability to adjust the diameter of the rear vision zone.
While meridian orthokeratology lenses are typically prescribed for patients with myopia and astigmatism, the options for fitting them far exceed those for correcting myopia and astigmatism.
For example, in accordance with the manufacturer’s recommendations, empirically for patients with a corneal toricity of 0.50 diopters (D), one return zone depth difference can be empirically assigned.
However, a small amount of a toric lens on the cornea, combined with an Ortho-k lens that takes into account the meridional depth difference, will ensure proper tear drainage and optimal centering under the lens. Thus, some patients may benefit from the stability and excellent fit provided by this design.
In a recent clinical trial, orthokeratology 5 mm rear vision zone diameter (BOZD) lenses brought many benefits to patients with myopia. The results showed that the 5 mm VOZD increased myopia correction by 0.43 diopters at the 1-day visit compared to the 6 mm VOZD design (control lens), providing rapid correction and improvement in visual acuity (Figures 1 and 2). 4, 5
Jung et al. also found that the use of a 5 mm BOZD Ortho-k lens resulted in a significant reduction in the diameter of the topographic treatment area. Thus, for ECPs aiming to achieve smaller treatment volumes for their patients, the 5 mm BOZD proved to be beneficial.
While many ECPs are familiar with fitting contact lenses to patients, either diagnostically or empirically, there are now innovative ways to increase accessibility and simplify the clinical fitting process.
Launched in October 2021, the Paragon CRT Calculator mobile app (Figure 3) allows emergency physicians to define parameters for patients with Paragon CRT and CRT Biaxial (CooperVision Professional Eye Care) orthokeratology systems and download them with just a few clicks. Order. Quick access troubleshooting guides provide useful clinical tools anytime, anywhere.
In 2022, the prevalence of myopia will undoubtedly increase. However, the ophthalmic profession has advanced treatment options and tools and resources to help make a difference in the lives of pediatric patients with myopia.