Spring 2017

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"Y our Pediatric Patient: Myopia Control" is one topic we could not have imagined a generation ago. The rise in myopia is a global concern. An alarming number of Asian children between the ages of seven and twelve-years-old have myopia. Statistics rank Asian children at 95% for myopia, with American children at 44% and European children at 30%. The exact reason for this increase is not known, but we do have some good ideas on why more children's eyes are too long. Research shows genetics, accommodation, screen time on handheld devices and computer screens, lack of daylight exposure, and reading without frequent breaks are contributing to the rise in myopia. Asian school days start earlier and end later than our American schools, and they often study for an additional two or three hours in the evening. Add in time on cellphones and handheld devices, and it is not surprising myopia is on the rise. So why be concerned about myopia in kids? Why not just put on a pair of glasses or fit them with traditional contacts to correct their vision? Because of the concerns of being highly myopic, including a greater risk of glaucoma, retinal detachment and macular issues in the elongated, myopic eye. When we contemplate the seriousness of these issues, controlling myopia takes on new meaning. Now let's consider methods of controlling myopia, especially in pediatric cases: • We have Atropine. It can work, but it is a medication and the long-term effects are still unknown. Sometimes, bifocal or progressive glasses are still needed during treatment. One of the side effects, light sensitivity, can be problematic if we want to encourage children to play outside when possible. This method isn't always the most appealing. • Conventional or modified soft contact lenses are another method of myopia control. There are studies with positive results, and this could be more preferable than using medication long-term. Children wearing contact lenses all day could be a drawback. • Orthokeratology is a growing method of controlling myopia. This treatment, using specialty designed gas permeable contact lenses overnight for corneal reshaping, The Bottom Line The Myopia Epidemic By Nick Siviglia, Ph.D., Sc.D., FCLSA(H) Nick Siviglia, Ph.D., Sc.D., FCLSA(H), is founder and CEO of Lancaster Contact Lens, Inc. in Lancaster, Pennsylvania. He specializes in fitting and manufacturing contact lenses for the diseased, the disasters, and the difficult. Memberships include CLSA, CLMA, and CLAO. He has been a clinical instructor at Wills Eye Hospital, Osteopathic Hospital of Philadelphia, and Milton S. Hershey Medical Center of PA. Nick holds 18 patents – including the original patent for reverse geometry design and his Ni-Cone for keratoconus and post-PK. His specialty contact lens practice also includes fitting and manufacturing artificial eyes and scleral shells. is appealing to many. It is consistent. It allows the kids to be free of glasses or contact lenses during the day and can be safe when properly managed. And it can increase your revenue on a consistent basis. The fees a practitioner can charge for orthokeratology treatment are higher, and should be, due to the increased chair time and follow-up time these children require. Also, infection prevention is key to long-term successful wear of Ortho-K lenses in children. It is imperative that Ortho-K contact lenses be cleaned thoroughly and replaced more frequently than traditional gas permeable lenses. Consider bundling in your fees your recommended cleaning system, along with a clean case, artificial tears, and anything else you would feel pertinent to the daily care and management of these lenses. Parents will appreciate the convenience and will be less apt to skimp and shop around on solutions. Myopia control is a growing facet of eye care. It is more costly than most traditional contact lenses. The higher fees generated by more chair time and quality, specialty designed contacts are acceptable to those patients seeking treatment rather than just correction. It becomes a different aspect of eye care that can be as rewarding as it is profitable. That's the Bottom Line! EW CLSA EyeWitness Spring 2017 6

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