ALTHOUGH PATIENTS are more educated than ever about their contact lens options (i.e., daily disposables, multifocals, and some specialty designs), orthokeratology (ortho-k) has yet to earn its place as the front-runner option for eligible patients. This is, unfortunately, due to lack of awareness about ortho-k and its many benefits. Having a solid protocol in place when eligible patients present in clinical practice will create effective communication and ultimately increase the number of interested and successful ortho-k patients.
1) Leverage Staff Highly trained staff members are arguably just as valuable to a practice as the practitioner. Thus, it is imperative to invest time in educating them.
Consider centering staff meetings focused on the basic science behind ortho-k, how to spot eligible patients, and how to initiate the conversation. For example, “Based on your previous prescription and contact lens history, it appears you may be a great candidate for ortho-k. This is a custom-designed GP lens that is worn overnight, so you do not have to wear any correction during the day! Would you like the doctor to share more information?” In this scenario, the stage is set for the practitioner and more detailed information can be given during the exam.
Furthermore, fit a couple of eligible staff members or their children in ortho-k lenses. The organic conversation that flows between an experienced ortho-k wearer or parent and an interested patient is an invaluable segue for the eyecare provider.
2) Create a Protocol During a busy clinic day, it does not take much to derail a schedule. Having a solid protocol in place for interested patients is vital as opposed to backtracking and creating unnecessary inefficiencies.
The most important piece of clinical information when deciding eligibility is topography. Thus, any necessary scans should be performed during pretesting.
Another common clinical hurdle is the additional time it takes to discuss all of the nuances of ortho-k. Most of the time, patients and parents have never heard of ortho-k, so the questions can seem never-ending. Having one articulate and knowledgeable staff member who can seamlessly step in will allow the physician to move on and then circle back when time allows.
3) Showcase Technology The concept of ortho-k is quite tricky for a layperson to understand, but demonstrating the before and aftereffects with a topography image can provide clarity that even the best verbal description cannot achieve. To save time, have a generic baseline topography image and a fully treated topography image handy or preloaded onto your computer (Figure 1).
Be sure to explain the basics of the corneal shape and how it relates to vision, and then compare the baseline to the altered corneal shape which results in clear, uncorrected daytime vision. Patients are typically amazed and appreciative of this visual.
In addition, most patients have never seen a rigid lens and cannot imagine how a contact lens can alter the shape of the cornea. Allow both the parents and the child to handle a trial lens—this will certainly drive home the mechanical aspect of ortho-k.
Ortho-k can be an exciting aspect of patient care. However, without the proper systems in place, practitioners may miss out on the opportunity to offer it to patients. Simply take time to create a protocol and support staff that empowers you and streamlines the mundane aspects of ortho-k. With this in place, you can spend your valuable time on the more exciting aspects—designing and fitting lenses.
