Myopia management

A decade and a half ago, I went on a course to learn how to do ortho-k. Afterwards we started to do more topography. Then, we picked a couple of patients that we thought would be good candidates for ortho-k and got them in. We were quite open about it and said, ‘you are our first two patients, bear with us.’ We gave them a discount to come in and try it. They were both really accepting of the fact that we’re always trying something new. We fitted them with EyeDream lenses, and both responded really well to it.

At that time, myopia management was just beginning. There were people using Proclear multifocal lenses, and ortho-k for myopia management was just emerging. By 2010, we had started to offer ortho-k as a potential for slowing down the progression of myopia in children. We started to use multifocal contact lenses too, for the same purpose.

We had a lot of parents who would take up the offer, but some would say they were going to think about it. Myopia management in those days was fairly new. It wasn’t something that parents had heard about. Slowly but surely, more parents are hearing about it, and we’re getting more parents bringing their children to us, because they’ve heard about myopia management and they’ve heard that we do it.

We’re getting more parents bringing their children to us, because they’ve heard about myopia management and they’ve heard that we do it

The biggest turning point was getting MiSight 1 day in 2017. We kept a database of children who hadn't accepted our offer of myopia management, and once we had MiSight 1 day we rang them and said, ‘we’d like to invite your child in to try a brand new contact lens: a daily disposable that gives really good vision, but can also help to slow down the progression of their myopia.’

Going to parents and saying we’d got a brand new product was really proactive. They liked the fact that we’d phoned them and said that we'd value their feedback on trying it. We do this a lot with other products. If there’s a new product coming out, we will list patients that we think are going to be suitable. If you’re sitting in my chair tomorrow, and you have an issue that I can’t resolve today, I put you in my spreadsheet. My spreadsheet is titled ‘Yet to succeed.’

Parents will talk to other parents, and that draws children into our clinics

We have seen a number of children. The majority slow down the progression of their myopia from where they were, but the other benefit for children wearing contact lenses or ortho-k is that they’re spectacle-free. They are confident at school; they look like their peers. Rather than wearing spectacles for a number of years and then going into contact lenses, they start out in contact lenses and they stay in contact lenses all the way through their school years into university and adult life, which I think is a really positive benefit.

Because we’ve done it for so long and we’ve seen the success of it, our message to parents is that your child is myopic, and our preferred method of correcting your child’s vision now is with contact lenses. We don’t talk about spectacles; we go straight into contact lenses.

It is one of our key services. That, along with contact lenses in general, means that our local community know that we offer these services. Parents will talk to other parents, and that draws children into our clinics.

We’ve seen children start myopia management, who are now graduating from university. We’ve been part of that journey, all the way through

The other thing that we’ve found successful is to do a contact lens trial and send children away for a half day or full day. They talk really positively about their experience, and that brings people in.

Just under 60% of our total contact lens business is related to myopia management. Beforehand, all we could do was prescribe spectacles for children. When myopia management and contact lenses came along, the longer-term outlook for our business became much better, because parents were paying regularly for their child’s treatment. It’s had a positive benefit on the turnover and the profitability of our business, because parents don’t want to spend a huge amount of money on spectacles for their children. But when you offer them contact lenses, and the potential to slow down their myopia, the cost tends to be less of an issue, because they see the added benefit that these two things bring.

But it’s not just about managing a child’s myopia. It’s about building and retaining a relationship with that child and that family, and that relationship grows stronger as that child goes through school. You’re seeing them on a frequent basis. You are part of their growing up. We’ve seen children start myopia management, who are now graduating from university. We’ve been part of that journey, all the way through.