The workshop

Introducing myopia management into practice

OT  poses a monthly scenario from a practitioner. This month, we look at introducing myopia management into practice

child eye test
Getty/Bill Oxford

The scenario

Mary, AOP member

“I own a single independent optical practice in the Midlands and we have a large number of children on our database. More frequently we are seeing young patients whom we feel may benefit from myopia management. However, I know from experience that introducing new services can be costly and time consuming. Can you share advice on what the business benefits of introducing myopia management to my practice may be and how I can market the service effectively to current and potential patients”

The advice

Sally Dillehay, expert contributor to the Brien Holden Vision Institute myopia education programme

For many years, most eye care practitioners and patients have viewed myopia as “just” a refractive error – a mismatch in the length of the eye versus its refractive power – that could be easily corrected with glasses, contact lenses or refractive surgery. But over the past 25 years, we have started to realise that myopia is a progressive condition that itself causes vision loss through myopic macular degeneration, staphyloma, retinal detachment and choroidal neovascularisation, etc.

Sally Dillehay
Sally Dillehay

Myopia also increases the underlying risk for cataracts, glaucoma, retinal detachment and macular degeneration. Vision loss from myopia occurs mainly in the middle of a person’s most productive years, and usually impacts 17 years of a person’s life, as compared to something like glaucoma that occurs later in life and generally impacts about 10 years of the productive work years.

The first part of adding myopia management to your practice is to recognise that myopia in and of itself is a disease


Introducing management options

The first part of adding myopia management to your practice is to recognise that myopia in and of itself is a disease, and one in which we as eye care practitioners now have available interventions that are designed to slow down its progression, with the ultimate goal being to reduce the potential risk factors associated with vision loss from myopia. These risks exist for myopia of any level, as publications have detailed that even a -1.00D myope is at increased risk of developing vision loss as compared to an emmetrope.

Once you have accepted that myopia management is something that eye care practitioners need to offer to every myopic patient, then everything in your practice needs to support that goal.

The first step is getting everyone in the practice educated on the data, identifying risks factors and the available interventions. The Brien Holden Vision Institute (BHVI) has an outstanding cost-effective online educational programme for practitioners that will help to get the entire practice quickly up to speed, including how to handle more complex cases, such as those involving binocular vision issues and problem solving orthokeratology cases.

Growing your business

The easiest way to grow this aspect of your practice is internal marketing. Be sure to speak with every patient about myopia, as even hyperopic parents have myopic children. When you see a parent, also be sure to ask about their children. And when you see children, be sure to let their parents or caregivers know that you would be pleased to become their eye care practitioner as well.

Brochures and posters in the examination room can also assist with these efforts, as can phone messages, emails, newsletters and text messages that you send out to patients. Your website needs to introduce and support why the management of myopia is important for patients’ long term ocular health.

The way in which staff answer the phone and patients are greeted in the practice needs to be rethought in terms of what needs to be changed to support the view that myopia is progressive and is more than “just” a refractive error change. Your office flow, scheduling, fees, billing, staff training, follow up schedules and communication tools then all flow from this new commitment.

The BHVI offers a module on The Business of Myopia and how to effectively introduce and market the management of myopia in your practice through both internal and external marketing efforts, such as search engine optimisation.

Procedures and scripts for the practice should be created to make sure that the messages that are being shared with patients by staff are consistent throughout the practice. For example, you wouldn’t want to discuss with a patient how important it is to consider these risks for myopia, only to have someone else in the practice dismiss those concerns as unnecessary. The BHVI will soon be launching a module for practice staff as well that is designed to assist with these efforts.

Be sure to speak with every patient about myopia, as even hyperopic parents have myopic children


Knowledge is power

Less than about 10% of practitioners worldwide are proactively offering myopia management services, often citing concerns over lack of knowledge, lack of available evidence, and increased patient cost as reasons. Ultimately, to have managing myopia become a growing and successful part of your practice, you need to be clear as to why you think it is important to a patient’s long-term ocular health to address myopia for each and every patient in your practice. Your level of commitment and concern will be evident and your practice will grow as a result.