Vision Expo East 2024: Shedding light on orthokeratology with Dr Brianna Rhue

With the demand for orthokeratology (ortho-k) rising, 1 optometrist is hoping to shed some light on the procedure at the upcoming Vision Expo East 2024 event, held at New York City's Javits Center from March 14-17. Brianna Rhue, OD, FAAO, FSLS, detailed her talk, "Cutting Out Surgery for the Management of Refractive Error" in an exclusive interview with Optometry Times.

Video transcript

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

Emily Kaiser Maharjan:

Hi, everyone, I'm here with Brianna Rhue, who's presenting "Cutting Out Surgery for the Management of Refractive Error" at Vision Expo East at the Javits Center in New York City later this week. So welcome Dr Rhue, it's a pleasure to have you here.

Brianna Rhue, OD, FAAO, FSLS:

Thank you for having me, excited to talk about my talk.

Kaiser Maharjan:

Of course, very excited to hear more. So first, can you give us a little bit of background on your presentation?

Rhue:

Yeah, so how this was built was just really with the emerging trend of myopia, and really the underutilization of orthokeratology. So we're going to dive really into orthokeratology, on what lenses you can utilize to benefit your patients, that it's not just for pediatric patients but also for adult patients that are looking for different ways that they can correct their vision without going through surgery. And then really how that can affect the surgeon later on down the road on if the patient wants to have LASIK or cataract surgery. So how ortho-k plays a role in that, as well as some dry eye and meibomian dysfunction and things like that that play into how we can better manage our patients that come in with refractive error.

Kaiser Maharjan:

That sounds fantastic. A whole lot of hot topics wrapped up into 1, sounds very exciting. So there's a lot of emerging research on myopia, as you've alluded to, it's been a really hot topic. And that's wonderful, because there's obviously no 1 size fits all option for patients with myopia. Can you tell me a little bit about what kind of patient is right for orthokeratology as a treatment for myopia?

Rhue:

Yeah, so I think what we'll talk about, and we'll dive into this, is just looking at refractive error as really a big equation. You have the front of the eye, which has the power, which is your cornea. In front of that you have your tear film, so you want to be looking at that, because obviously devices and things like that are changing it. But then you also have the lens power, and then you have the length of the eye. So all of that adds up into the power that we're putting in front of the patient, whether that's a contact lens, or an ortho-k lens. And so when you're looking at a patient, moving them into orthokeratology, it's looking at the full visual system. So we'll break into that to really show you how you look at each case individually, so you're setting not only yourself up for success with orthokeratology, but also the patient and their family, because it's really a family thing.

Kaiser Maharjan:

Yeah, of course. So ortho-k is something that is accessible to people now, do you feel that it's a treatment option that is underutilized?

Rhue:

Yeah completely, and that comes back to training, and then also FDA approval. So we had FDA approval, back since 2001, but there's still only about 5 to 10% of practitioners that are actually practicing orthokeratology. So before, you had to have a lens set, you had to put a lens on the patient's eye, and then you were really fitting it based on what you were seeing behind your slit lamp with new topography-based software and guided software, it's really, really enabled practitioners to dive into this. So it takes a lot of the guesswork out.

We're going to go through on how you take really good topographies with patients, to again, set the patients and yourself up for success, but we weren't really trained that way. So now that we have an FDA approved treatment with the Abiliti lens to actually treat kids with myopia with an orthokeratology lens, now's really the time to really understand orthokeratology because patients are going to start coming in asking for it. And you need to be the doctor that's well versed on it or be able to refer them to somebody in the area that's doing it.

Kaiser Maharjan:

Yeah, of course. And that kind of leads into my next question, which you've touched on a little bit, so if you want to alter it a little bit or add to it feel free to, but why is this an important topic to educate optometrists about?

Rhue:

Yeah, myopia is really something that we're treating and we're seeing every single day and as more FDA approved treatments come down the pipeline, and you're seeing big industry get behind it, patients are coming in asking for it. So if you're not well versed on it, they will search out another doctor that is. It is important that you understand what treatment options are there, that you understand why you're selecting the proper treatment for that child based on what you're seeing in their visit.

And then also just to really change this trajectory of myopia. I hear all the time, "It's just myopia, why?" It's not that. Really, it's your vision, right? And if the kid is underutilizing their vision where they can't see the board clearly, right, that affects everything down the road. I heard too, where it was like, a lady, she went in and she had everybody in the room take off their glasses, and they're like, "Could you imagine now, looking back at your success, having vision like this?" So I think it's cool to see where you can really involve yourself, not only in this generation, but how it affects generations behind us on the myopia front. So that's what excites me about myopia.

Kaiser Maharjan:

Absolutely, and what are some of the key takeaways that you're hoping clinicians take back to their practices?

Rhue:

Key takeaways is really how to do orthokeratology, how, again, that's going to change the trajectory of myopia. Really, I'll dive into some cases on how happy the patients have been that come in for orthokeratology and also some cases, what happens if it doesn't go quite as well, what you can do. So really some fundamentals and foundations around orthokeratology, and then also we'll touch on some dry eye things, but we only have an hour together. This used to be a 2 hour talk so we got it pushed into an hour. So just really, I want them to come away understanding orthokeratology, typography, what you can gain from typography, and really how easy it is to implement this into your practice. So we'll touch on some practice pearls as well so they can set themselves and the clinic up for success.

Kaiser Maharjan:

Fantastic. That sounds like such a great session. Is there anything else that you'd like to add that we haven't touched on?

Rhue:

No, [just] come and join me Friday morning. It's going to be fun.

Kaiser Maharjan:

Certainly sounds like it. So thank you so much for telling me about your Vision Expo East presentation Dr Rhue, it's been enlightening.

Rhue:

Thank you.