Managing myopia as a dispensing optician

Dispensing opticians and front of practice team members may be the first point of contact for parents and young patients – they may ask for advice, so it is good to know how to respond and inform them. Find out: at your practice, are you able to offer contact lenses, spectacles or any other forms of myopia management? What versions of each management option do you have access to, and what are your practice’s resources for monitoring?

Not all practices actively provide myopia management, but we have a duty to ensure that it is mentioned to all patients who fit the criteria – this may lead to you either receiving or sending referrals from or to other practices. Ensure you have appropriate literature available to give to parents so they can be aware of the facts and reasons for your recommendation, even if you don’t offer a management option yourselves.

When it comes to speaking to patients and their parents, don’t be afraid to start the conversation. If you have noticed a change of prescription, or the prescription and child’s age are within an at-risk category, broach the subject. This will allow patients and their parents to look out for further changes at the next appointment.

If you can, have the conversation in front of the child. You can then mention prevention options such as less screentime and more outside activities – parents will likely appreciate this as it may encourage the child to comply.

If the optometrist has advised management, they may have already begun the recommendation of contact lenses or spectacles in the testing room. You can also talk through the various options as well as, which may be the most appropriate option. Make sure the parents understand the commitment and the success rates, as well as the cost implications associated with the recommendation. For whichever route they select, spectacles or contact lenses, make sure you have all you need to manage their expectations. I would also encourage parents to sign a consent form to say that you have discussed the options and the expectations with them too.

Most spectacle lens manufacturers now offer a myopia management option. Some manufacturers also provide good leaflets and demonstration tools – use them.

Once a treatment has been decided upon, make sure you know and are comfortable with the fitting criteria. For spectacles, pick a well-fitting frame that gives the full use of the treatment zones, the optical centres and heights need to be set monocularly. Plus, make sure the frame fit is secure and allows for some development if the child is of the age where they are likely to have a growth spurt before the next examination.

Don’t forget the importance of the collection visit, this is your chance to ensure the fit is exactly as you wanted. Book a follow-up for a few weeks after the collection so you can see how the child is coping and ensure the fit is still good. Why not ask them to fill in a questionnaire and bring it with them so you can assess the vision and adaptation?

At the follow-up visit, remind the patient, and the parent, how important it is to come back if they notice the frame is slipping, twisted or if their vision just doesn’t feel right. If frames are not fitted correctly, they won’t be as effective.