In the latest episode of The Chris Wolfe Podcast, Dr. Wolfe participated in a panel discussion focused on myopia management and how to make it simpler for practices and beneficial for patients, specially children.
Managing myopia in children has become a critical focus in optometry, driven by the growing prevalence and potential long-term complications associated with the condition. In a recent panel discussion, leading optometrists Dr. Jordan, Dr. Mann, and Dr. Andrews shared their insights and strategies for effectively integrating myopia management into their practices. This blog post summarizes the key points from their conversation, providing valuable guidance for optometrists looking to enhance their approach to myopia management.
Understanding the Importance of Myopia Management
Dr. Jordan and Dr. Mann emphasized the importance of addressing myopia early to prevent severe complications such as retinal detachments and myopic maculopathy. Dr. Jordan noted, “When you see charts that show children are at risk for retinal detachments and myopic maculopathy, and you can do something about it, it’s crucial to act.”
Both doctors highlighted the significance of patient education and the need to present myopia management as a standard of care. Dr. Andrews added, “We have a responsibility to educate our patients about what’s available to them. If they need time to think about it, that’s fine, but we must ensure they are fully informed about the risks and options.”
Initial Consultation and Education
Dr. Jordan described his approach to initial consultations, where he provides a brief overview of myopia management options and then schedules a free follow-up consultation. This follow-up includes a detailed presentation by his technician, covering treatment options, schedules, and pricing. “We treat it as a program, not a product,” Dr. Jordan explained. “When patients come in for the follow-up, they are better informed and can make a more confident decision.”
Transparent Pricing Models
Both doctors agreed on the importance of transparency in pricing. Dr. Mann shared that his practice breaks down costs into fitting, materials, and visits, ensuring parents understand the comprehensive nature of the program. He said, “We let them know this is the cost for me to take care of you for the entire year. If you want to come in more often, that’s fine. We won’t charge extra.”
Dr. Jordan added that they offer various payment options, including third-party financing and in-office payment plans, to help manage sticker shock. “We tell patients they can split the cost over three, six, or even twelve months. The goal is to start treatment as soon as possible to prevent progression.”
Tailoring Approaches to Individual Practices
Dr. Andrews emphasized that there is no one-size-fits-all approach to myopia management. He encouraged optometrists to adapt strategies that fit their existing practice models. “Think about what you currently do well and make myopia management match that. If you excel at fitting fees and annual supplies, integrate myopia management into that framework.”
Dr. Mann echoed this sentiment, stressing the need to simplify the process and minimize disruption to existing workflows. “New always takes longer and is harder. Any time you can tweak an existing process rather than creating something entirely new, you have a greater chance of success.”
Managing Treatment Options
Combining Treatments
The panel discussed scenarios where combining treatments might be necessary. Dr. Mann shared his experience of transitioning patients from atropine drops to myopia control lenses, gradually reducing the atropine dosage while monitoring the patient’s progress. “We taper them off the drops over six months. So far, I’ve seen no rebound effect and stable progressions.”
Handling Astigmatism
For patients with astigmatism, Dr. Jordan noted that the level of astigmatism influences treatment choices. “If it’s about a minus one or above, we discuss alternative options like ortho-keratology or atropine drops, which can be used alongside corrective lenses for astigmatism.”
Age Considerations
The panel addressed the question of when to stop myopia management, with both doctors advocating for a case-by-case approach. Dr. Jordan recommended maintaining treatment until at least two years of stability in prescription changes. “Typically, we look at around 15 to 17 years of age, but it depends on the patient’s growth and progression.”
Overcoming Sticker Shock
Both doctors provided insights on managing parents’ financial concerns. Dr. Jordan mentioned offering flexible payment plans and emphasizing the long-term benefits of early intervention. “We tell parents there are options, and we can work with them to make treatment affordable.”
Dr. Mann shared a similar approach, offering in-office payment plans and third-party financing. “The most important thing is that the children receive treatment. We are flexible with payments to ensure they get the care they need.”
Team Training
Dr. Jordan highlighted the importance of comprehensive team training to streamline the myopia management process. “We shut down for a day and trained every team member on myopia management. This cuts down chair time and improves efficiency as everyone is informed and can educate parents.”
Insurance and Audits
Dr. Mann shared his experience with insurance and audits, initially submitting myopia control lenses to insurance but later reconsidering due to audit concerns. He advised practices to carefully consider their approach to insurance submissions and ensure compliance with regulations.
Conclusion: Embracing Myopia Management as Standard Care
Dr. Andrews concluded the discussion by reinforcing the idea that myopia management should be considered a standard of care in optometry. He tied this to the professional oath taken by optometrists, which includes commitments to patient well-being, operating within the scope of practice, and continuous education.
“Incorporating myopia management into your practice aligns with our oath as optometrists. It’s about doing the right thing for our patients and using our skills to prevent long-term complications.”
By following these expert insights and strategies, optometrists can effectively integrate myopia management into their practices, providing essential care to their patients and ensuring better long-term visual health outcomes.
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