AAOpt 2023: Integrating orthokeratology for myopia management

Daniel G. Fuller, OD, FAAO Dipl., FSLS, sat down with Optometry Times®' assistant managing editor Emily Kaiser Maharjan to talk about his presentation, "Orthokeratology for Myopia Control Workshop," which he co-presented during the 2023 American Academy of Optometry meeting in New Orleans.

Editor's note: This transcript has been lightly edited for clarity.

Emily Kaiser Maharjan:

Hi, everyone. I'm Emily Kaiser Maharjan with Optometry Times. And I'm sitting down with Dr. Daniel Fuller, who co-presented a workshop on orthokeratology for myopia control at the American Academy of Optometry Meeting in New Orleans. Welcome, Dr. Fuller, I'm so glad you could join me.

Daniel G. Fuller, OD, FAAO Dipl., FSLS:

Well, thank you, Emily. I'm happy to be here.

Kaiser Maharjan:

First, can you tell us a little bit more about the workshop?

Fuller:

I believe it's the third year—might be fourth year—that we're giving it, and it's backed by popular demand. It's been well received each time we gave it. And I'm sharing the stage with my colleague, Dr. Susan Gromacki, and it's always an honor to do that.

Kaiser Maharjan:

Fantastic. And can you share a few key takeaway points that you hope to drive home?

Fuller:

Well, we're very interested in making sure that the participants do a couple of things. We want to make sure that they take away the technical knowledge to go ahead and integrate orthokeratology into their practice with an eye towards myopia control. And we're going to provide them with resources to do that, both with hands on training with trial sets, and also giving them the technical background and a PowerPoint presentation. But we're also going to bring some of our own office resources forms that we use to help with the practice management side of integrating that into your practice.

Kaiser Maharjan:

So you already kind of touched on some of the points. But how can optometrists leverage this information to better run their clinics?

Fuller:

Well, we're going to give them a number of ways in which they can do that. They can use fitting sets to do that; there are ways of designing things empirically online. When I started doing ortho-k, probably about 40 years ago or so, it was a lot more complicated than it is today from the standpoint of going through the fitting process.

And we now have more accelerated designs and things that you don't even have to have a trial set to fit. And, really, your chair time at the initial visit is no more than the amount of time you would spend with a typical primary care examination. And so that fits very nicely, I think, into the flow of most private practitioner's offices, and doesn't really take up as much time as you might think to do do those sorts of things.

Kaiser Maharjan:

Lovely, kind of changing gears a little bit, what do you think the future of myopia control will look like?

Fuller:

Oh, it's it's going to be a toolbox, you're gonna have all kinds of things that we already do.

We've got controversies in low dose atropine and conflicting information from your Pacific Rim countries versus the studies we've done in the US as to what doses are appropriate, and how effective they may or may not be.

We've got a number of companies that are already offering spectacle lenses—or DIMS stripe lenses—that provide control. That's probably going to be one of the more popular options for doctors to implement in the US once it becomes available because of the ease with which it'll fit into the normal flow—or I should say, the exam process.

Orthokeratology has been out there for a very long time, has a very excellent track record for both protecting the ocular health of the patient while wearing the lens overnight, and also delivering high levels of efficacy with the lenses in terms of controlling myopia, as well as giving you the flexibility to manage myopia for folks that are past the sweet spot and the age range where myopia control is of benefit to those patients that just playing want to get rid of their glasses. So we're going to see those kinds of things come in.

We've got the low levels of red light therapy that are being explored out there as a possible option. And, certainly, we've got—with the MiSight lens from CooperVision—FDA-approved designs; we've got other designs approved overseas, one with Johnson & Johnson through their Abiliti program.

So there's a number of things coming, a number of things that are already here. And, you know, every practitioner needs to be integrating this into their practices. It's not a specialty carve out a niche with myopia epidemic, you're seeing these patients in large numbers every day. And you don't want to miss the opportunity to change the course and trajectory of their quality of life.

Kaiser Maharjan:

Fantastic. Well, thank you so much for taking the time to chat today, Dr. Fuller, it's been so great hearing about this myopia control workshop and I can't wait to hear more.

Fuller:

It's my pleasure, thanks.